Official Summary Text
An Act to help patients and reduce healthcare costs by ensuring patient adherence to medications
By Ms. Lovely, a petition (accompanied by bill, Senate, No. 781) of Joan B. Lovely for legislation relative to medication synchronization. Financial Services.
Current Bill Text
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Bill S.781
An individual or group health insurance policy providing prescription drug coverage in the state must 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 the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of synchronizing the patient’s medications.
No individual or group health insurance policy providing prescription drug coverage shall deny 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 determines the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of synchronizing the patient’s medications. The individual or group health plan must allow a pharmacy to override any denial codes indicating that a prescription is being refilled too soon for the purposes of medication synchronization.
No individual or group health insurance policy providing prescription drug coverage shall use payment structures incorporating pro-rated dispensing fees. Dispensing fees for partially filled or refilled prescriptions shall be paid in full for each prescription dispensed regardless of any pro-rated copay for the beneficiary or fee paid for alignment services.
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