<?xml version="1.0" encoding="UTF-8"?><slim:Document xmlns:slim="urn:legix:slim" xmlns:xhtml="http://www.w3.org/1999/xhtml" xmlns:atipl="http://www.arbortext.com/namespace/PageLayout" class="codeChapter" id="chp514L" name="514L"><slim:About class="header"><slim:Property type="string" name="version"/></slim:About><slim:TOC><slim:Item idref="sec514L.1" title="514L.1   Definitions."/><slim:Item idref="sec514L.2" title="514L.2   Uniform prescription drug information cards."/><slim:Item idref="sec514L.3" title="514L.3   Application — enforcement."/></slim:TOC><slim:Body><slim:Level class="codeChapter" id="chp514L"><slim:Heading class="heading"><xhtml:span class="identifier">514L</xhtml:span><xhtml:span class="headnote">UNIFORM PRESCRIPTION DRUG INFORMATION CARD</xhtml:span></slim:Heading><slim:Section class="codeSection" id="sec514L.1"><xhtml:div class="heading"><xhtml:span class="identifier">514L.1</xhtml:span><xhtml:span class="headnote">Definitions.</xhtml:span></xhtml:div><xhtml:p class="para">As used in <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>, unless the context otherwise requires:</xhtml:p><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Guide”</xhtml:span> means the most recent national council for prescription drug programs pharmacy identification card implementation guide, or its successor.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Prescription drug”</xhtml:span> means prescription drug as defined in <xhtml:span class="iowaCodeRef">section 155A.3</xhtml:span> and includes a device as defined in <xhtml:span class="iowaCodeRef">section 155A.3</xhtml:span>.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="i">“Provider of third-party payment or prepayment of prescription drug expenses”</xhtml:span> or <xhtml:span class="term">“provider”</xhtml:span> means a provider of an individual or group policy of accident or health insurance or an individual or group hospital or health care service contract issued pursuant to <xhtml:span class="iowaCodeRef">chapter 509</xhtml:span>, <xhtml:span class="iowaCodeRef">514</xhtml:span>, or <xhtml:span class="iowaCodeRef">514A</xhtml:span>, a provider of a plan established pursuant to <xhtml:span class="iowaCodeRef">chapter 509A</xhtml:span> for public employees, a provider of an individual or group health maintenance organization contract issued and regulated under <xhtml:span class="iowaCodeRef">chapter 514B</xhtml:span>, a provider of a preferred provider contract issued pursuant to <xhtml:span class="iowaCodeRef">chapter 514F</xhtml:span>, a provider of a self-insured multiple employer welfare arrangement, and any other entity providing health insurance or health benefits which provide for payment or prepayment of prescription drug expenses coverage subject to state insurance regulation.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2001 Acts, ch 77, §1</xhtml:span>; <xhtml:span class="iowaActsRef">2017 Acts, ch 148, §97</xhtml:span></xhtml:div></xhtml:div></slim:Section><slim:Section class="codeSection" id="sec514L.2"><xhtml:div class="heading"><xhtml:span class="identifier">514L.2</xhtml:span><xhtml:span class="headnote">Uniform prescription drug information cards.</xhtml:span></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">A provider of third-party payment or prepayment of prescription drug expenses, including the provider’s agents or contractors and pharmacy benefits managers, that issues a card or other technology for claims processing and an administrator of the payor, excluding administrators of self-funded employer sponsored health benefit plans qualified under the federal <xhtml:span class="USActsRef">Employee Retirement Income Security Act of 1974</xhtml:span>, shall issue to its insureds a card or other technology containing uniform prescription drug information. The commissioner of insurance shall adopt rules for the uniform prescription drug information card or technology applicable to those entities subject to regulation by the commissioner of insurance. The rules shall require at least both of the following regarding the card or technology:</xhtml:p><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">With respect to the information required, be consistent with the guide, except that the address of the pharmacy benefits manager shall not be required.</xhtml:p></xhtml:div><xhtml:div class="subpara"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">With respect to the location of the information required, be substantially consistent with the guide.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">Any information on the card shall be formatted and arranged in a manner that corresponds to the current content and format required by the provider for processing of claims.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">A new uniform prescription drug information card or technology, as required pursuant to <xhtml:span class="iowaCodeRef">subsection 1</xhtml:span>, shall be issued by a provider of third-party payment or prepayment or the provider’s agents or contractors or pharmacy benefits managers upon enrollment and reissued upon any change in the insured’s coverage that impacts data contained on the card or technology. The commissioner of insurance shall review the national council for prescription drug programs implementation guide or successor document on an ongoing basis to determine changes, and shall modify or adopt rules as determined appropriate.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para">The card or other technology may be used for any health insurance or health benefits coverage and nothing in <xhtml:span class="iowaCodeRef">this chapter</xhtml:span> shall require a provider to issue a separate card for prescription drug coverage if the card or other technology can accommodate the information necessary to process claims.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">4</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="iowaCodeRef">This chapter</xhtml:span> shall not apply to prescription drug coverage provided through or in conjunction with any of the following:</xhtml:p><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">Accident-only or disability income insurance coverage.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">Hospital confinement indemnity coverage.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">c</xhtml:span></xhtml:div><xhtml:p class="para">Coverage issued as a supplement to liability insurance.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">d</xhtml:span></xhtml:div><xhtml:p class="para">Basic hospital and medical-surgical expense coverage.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">e</xhtml:span></xhtml:div><xhtml:p class="para">Liability insurance, including general liability insurance and automobile liability insurance.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">f</xhtml:span></xhtml:div><xhtml:p class="para">Workers’ compensation or similar insurance.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">g</xhtml:span></xhtml:div><xhtml:p class="para">Automobile medical payment insurance.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">h</xhtml:span></xhtml:div><xhtml:p class="para">Credit only insurance.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">i</xhtml:span></xhtml:div><xhtml:p class="para">Coverage for on-site medical clinic care.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">j</xhtml:span></xhtml:div><xhtml:p class="para">Dental or vision coverage.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">k</xhtml:span></xhtml:div><xhtml:p class="para">Benefits for long-term care, nursing home care, or community-based care.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">l</xhtml:span></xhtml:div><xhtml:p class="para">Short-term hospital, medical, or major medical coverage.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">m</xhtml:span></xhtml:div><xhtml:p class="para">Medicare supplemental as defined pursuant to 42 U.S.C. §1395ss(g)(1), coverage supplemental to the coverage provided under 10 U.S.C. §1071 – 1109, and similar coverage that is supplemental to coverage under group health insurance coverage as defined by the commissioner of insurance.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">n</xhtml:span></xhtml:div><xhtml:p class="para">Any other similar limited benefits as defined by the commissioner of insurance.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2001 Acts, ch 77, §2</xhtml:span>; <xhtml:span class="iowaActsRef">2017 Acts, ch 148, §98</xhtml:span></xhtml:div></xhtml:div></slim:Section><slim:Section class="codeSection" id="sec514L.3"><xhtml:div class="heading"><xhtml:span class="identifier">514L.3</xhtml:span><xhtml:span class="headnote">Application — enforcement.</xhtml:span></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">A health insurance or health benefits policy or contract issued and delivered, amended, or renewed on or after July 1, 2003, shall comply with <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para">The commissioner of insurance shall enforce <xhtml:span class="iowaCodeRef">this chapter</xhtml:span> and shall adopt rules necessary to implement <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:p class="p"><xhtml:span class="iowaActsRef">2001 Acts, ch 77, §3</xhtml:span></xhtml:p></xhtml:div></xhtml:div></slim:Section></slim:Level></slim:Body></slim:Document>