Bill > S670

This bill requires individual and group health insurance plans providing prescription drug coverage in the state to permit and apply a pro-rated daily cost-sharing rate to prescriptions dispensed by a network pharmacy for a partial supply, if the prescriber or pharmacist determines it to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of synchronizing their medications. The bill also prohibits health plans from denying coverage for the dispensing of a medication by a network pharmacy on the basis that the dispensing is for a partial supply under these circumstances, and requires health plans to allow pharmacies to override any denial codes indicating a prescription is being refilled too soon for medication synchronization. Additionally, the bill prohibits health plans from using payment structures incorporating pro-rated dispensing fees, and requires dispensing fees for partially filled or refilled prescriptions to be paid in full, regardless of any pro-rated copay for the beneficiary or fee paid for alignment services.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/193/S670