Bill > S696

This bill aims to help patients and reduce healthcare costs by ensuring patient adherence to medications. Key provisions include: 1) Requiring individual or group health insurance policies to permit and apply a pro-rated daily cost-sharing rate for prescriptions dispensed by a network pharmacy for a partial supply if the prescriber or pharmacist determines it is in the patient's best interest and the patient requests or agrees to a partial supply for medication synchronization purposes. 2) Prohibiting health insurance policies from denying coverage for the dispensing of a medication by a network pharmacy on the basis that the dispensing is for a partial supply if the prescriber or pharmacist deems it appropriate for medication synchronization. 3) Requiring health plans to allow pharmacies to override any denial codes indicating a prescription is being refilled too soon for medication synchronization purposes. 4) Prohibiting health insurance policies from using payment structures that incorporate pro-rated dispensing fees, and requiring dispensing fees for partially filled or refilled prescriptions to be paid in full regardless of any pro-rated copay or fee for alignment services.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/192/S696