H.F. 2508 Section 1. Section 155A.29, subsection 3, Code 2022, is 1 amended to read as follows: 2 3. a. Prescriptions may be refilled once pursuant to 3 subsection 2 for a period of time reasonably necessary for the 4 pharmacist to secure prescriber authorization. 5 b. Notwithstanding paragraph “a” , a prescription may be 6 refilled pursuant to subsection 2 once in a twelve-month 7 period, and the pharmacist may dispense an amount not to exceed 8 a thirty-day supply, or if the standard unit of dispensing 9 exceeds a thirty-day supply or is unit dosed, an amount not to 10 exceed the standard supply or unit of dispensing. 11 Sec. 2. NEW SECTION . 514C.18A Prescription emergency 12 refills —— coverage. 13 1. As used in this section, unless the context otherwise 14 requires: 15 a. “Cost-sharing” means any coverage limit, copayment, 16 coinsurance, deductible, or other out-of-pocket expense 17 obligation imposed on a covered person by a policy, contract, 18 or plan providing for third-party payment or prepayment of 19 health or medical expenses. 20 b. “Covered person” means a policyholder, subscriber, or 21 other person participating in a policy, contract, or plan that 22 provides for third-party payment or prepayment of health or 23 medical expenses. 24 2. a. Notwithstanding the uniformity of treatment 25 requirements of section 514C.6, a policy, contract, or plan 26 providing for third-party payment or prepayment of health 27 or medical expenses that provides coverage for prescription 28 drugs shall provide coverage for a prescription refilled and 29 dispensed pursuant to section 155A.29, subsection 3, paragraph 30 “b” . 31 b. Notwithstanding any cost-sharing obligation imposed under 32 a policy, contract, or plan providing for third-party payment 33 or prepayment of health or medical expenses to the contrary, 34 any cost-sharing imposed on a covered person for a prescription 35 -1- LSB 5662YH (1) 89 pf/rh 1/ 3

H.F. 2508 refilled and dispensed pursuant to section 155A.29, subsection 1 3, paragraph “b” , shall not exceed the cost-sharing imposed 2 on the refilling and dispensing of the same prescription with 3 prescriber authorization. 4 3. a. This section applies to the following classes of 5 third-party payment provider contracts, policies, or plans 6 delivered, issued for delivery, continued, or renewed in this 7 state on or after January 1, 2023: 8 (1) Individual or group accident and sickness insurance 9 providing coverage on an expense-incurred basis. 10 (2) An individual or group hospital or medical service 11 contract issued pursuant to chapter 509, 514, or 514A. 12 (3) An individual or group health maintenance organization 13 contract regulated under chapter 514B. 14 (4) Any other entity engaged in the business of insurance, 15 risk transfer, or risk retention, which is subject to the 16 jurisdiction of the commissioner. 17 (5) A plan established pursuant to chapter 509A for public 18 employees. 19 b. This section shall not apply to accident-only, 20 specified disease, short-term hospital or medical, hospital 21 confinement indemnity, credit, dental, vision, Medicare 22 supplement, long-term care, basic hospital and medical-surgical 23 expense coverage as defined by the commissioner, disability 24 income insurance coverage, coverage issued as a supplement 25 to liability insurance, workers’ compensation or similar 26 insurance, or automobile medical payment insurance. 27 4. The commissioner of insurance may adopt rules pursuant to 28 chapter 17A to administer this section. 29 EXPLANATION 30 The inclusion of this explanation does not constitute agreement with 31 the explanation’s substance by the members of the general assembly. 32 This bill relates to the emergency refilling and dispensing 33 of a prescription, including associated insurance coverage. 34 The bill provides that in addition to existing provisions 35 -2- LSB 5662YH (1) 89 pf/rh 2/ 3

H.F. 2508 relating to the refilling of a prescription without prescriber 1 authorization, a pharmacist may exercise professional judgment 2 and refill a prescription once in a 12-month period and may 3 dispense an amount not to exceed a 30-day supply, or if the 4 standard amount of dispensing exceeds a 30-day supply or is 5 unit dosed, an amount not to exceed the standard supply or 6 limit of dispensing. 7 The bill also provides that notwithstanding the uniformity 8 of treatment requirements, a policy, contract, or plan 9 providing for third-party payment or prepayment of health 10 or medical expenses that provides coverage for prescription 11 drugs shall provide coverage for a prescription refilled 12 and dispensed as provided in the bill. Additionally, 13 notwithstanding any cost-sharing obligation imposed under a 14 policy, contract, or plan to the contrary, any cost-sharing 15 imposed on a covered person for the prescription refilled 16 and dispensed as provided in the bill shall not exceed the 17 cost-sharing imposed on the refilling of the same prescription 18 with prescriber authorization. 19 The bill provides definitions of “cost-sharing” and “covered 20 person” for the purposes of this portion of the bill. 21 This portion of the bill applies to third-party payment 22 provider contracts, policies, or plans delivered, issued for 23 delivery, continued, or renewed in the state on or after 24 January 1, 2023, including those provider contracts, policies, 25 or plans specified in the bill. The bill also specifies 26 the types of insurance to which the requirements of the bill 27 are not applicable. The commissioner of insurance may adopt 28 administrative rules to administer this portion of the bill. 29 -3- LSB 5662YH (1) 89 pf/rh 3/ 3