SF0077 - Insurance-standard prescription drug identification cards.
|
2001 |
State of Wyoming |
01LSO-0335 |
SENATE FILE NO. SF0077
Insurance-standard prescription drug identification cards.
Sponsored by: Senator(s) Anderson, J.
A BILL
for
1 AN ACT relating to
insurance; creating the Standard
2 Prescription
Drug Beneficiary Identification Card Act;
3
providing a definition; providing it is unlawful to
4
distribute a prescription drug cash discount card under
5
certain circumstances; providing for a standard
6
prescription drug beneficiary identification card as
7
specified; providing for remedies and penalties; and
8
providing for an effective date.
9
10 Be It Enacted by the Legislature of the State of Wyoming:
11
12 Section 1. W.S. 26-50-101
through 26-50-105 are
13 created to read:
14
15 CHAPTER 50
16 PRESCRIPTION DRUG BENEFICIARY IDENTIFICATION CARD
17
Page 1
1 26-50-101. Short title.
2
3 This act shall be known
and may be cited as the "Standard
4
Prescription Drug Beneficiary Identification Card Act."
5
6 26-50-102. Definition.
7
8 (a) As used in
this act and unless the context
9
clearly indicates otherwise, "health benefit plan" means:
10
11 (i) An accident
and health insurance policy or
12 certificate;
13
14 (ii) Prescription
services provided as medical
15 assistance under the Wyoming Medical
Assistance and
16 Services Act, W.S. title 42, chapter 4;
17
18 (iii) A nonprofit
hospital or medical service
19 corporation contract;
20
21 (iv) A health
maintenance organization
22 subscriber contract;
23
Page 2
1 (v) A plan
provided by a multiple employer
2
welfare arrangement; and
3
4 (vi) A plan
provided by another benefit
5
arrangement, to the extent permitted by the Employee
6
Retirement Income Security Act of 1974, P.L. 93-406, 88
7
Stat. 829, or by any waiver of or other exception to that
8 act
provided under federal law or regulation.
9
10 26-50-103. Prescription drug cash discount cards.
11
12 (a) It shall be
unlawful and a violation of this act
13 for any person to sell, market, promote,
advertise or
14 otherwise distribute any card or other
purchasing mechanism
15 or device which is not insurance, that
purports to offer
16 discounts or access to discounts from
pharmacies for the
17 purchase or receipt of prescription drugs or
devices where:
18
19 (i) The card or
other purchasing mechanism or
20 device does not expressly provide in bold
and prominent
21 type that the discounts are not an insurance
benefit;
22
23 (ii) The
discounts are not specifically
24 authorized by an individual and separate
contract with each
Page 3
1
pharmacy listed in conjunction with the card or other
2
purchasing mechanism or device; or
3
4 (iii) The
discounts or access to discounts
5
offered, or the range of discounts or access to the range
6 of
discounts offered, are misleading, deceptive or
7
fraudulent, regardless of the literal wording used.
8
9 (b) Nothing in
this section shall be construed to
10 apply to a customer discount or membership
card issued by a
11 pharmacy.
12
13 26-50-104. Standard prescription drug
beneficiary
14 identification card.
15
16 (a) A health
benefit plan that provides coverage for
17 prescription drugs or devices or the
administrator of the
18 plan, including, but not limited to,
third-party
19 administrators for self-insured plans and
state-
20 administered plans, shall issue to the
beneficiaries of the
21 coverage an identification card, purchasing
device or
22 mechanism which, at a minimum, shall include
the following
23 information:
24
Page 4
1 (i) The name or
logo of the plan or benefit
2
administrator issuing the identification card. This
3
information is to be located at the top, front side of the
4
identification card;
5
6 (ii) The
beneficiary name or names and
7
identification number or numbers. This information is to be
8
left justified and located on the front side of the
9
identification card;
10
11 (iii) The name
and address of the administrator
12 to be used for sending nonelectronic
prescription claims or
13 other patient or provider correspondence.
This information
14 is to be located on the reverse side of the
identification
15 card;
16
17 (iv) The
telephone number that providers may
18 call for assistance. This information is to
be located on
19 the reverse side of the identification card;
20
21 (v) The
complete electronic transaction routing
22 information including, at a minimum, the
international
23 identification number. Processor control
numbers and group
24 numbers are required if needed by the
benefit administrator
Page 5
1 to
electronically process the prescription claim. This
2
information is to be left justified and located on the
3
front side of the identification card; and
4
5 (vi) Any
additional information required by the
6
plan or benefit administrator to process a prescription
7
claim.
8
9 (b) The format
of the identification card, purchasing
10 device or mechanism shall further conform to
standards
11 approved by the National Council for
Prescription Drug
12 Programs (NCPDP) or to a nationally
recognized format
13 approved by the insurance commissioner.
14
15 (c) A new
standard prescription drug beneficiary
16 identification card, purchasing device or
mechanism as
17 required under subsection (a) of this
section shall be
18 issued by a health benefit plan or its
administrator to
19 beneficiaries upon enrollment and reissued
on the occasion
20 of any change in benefits or other elements
contained
21 within the identification card, purchasing
device or
22 mechanism.
23
24 26-50-105. Remedies and penalties.
Page 6
1
2 (a) The
insurance commissioner, attorney general or
3 any
person may maintain an action to enjoin a continuance
4 of
any acts in violation of this act and for the recovery
5 of
damages.
6
7 (b) A violation
of this act shall constitute a
8
violation of W.S. 26-13-103 of the Unfair Trade Practices
9 Act
within the Insurance Code, and shall be subject to the
10 remedies under W.S. 26-13-115 of that act.
11
12 Section 2. This act is effective July 1, 2001.
13
14 (END)
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