HOUSE OF REPRESENTATIVES

H.B. NO.

156

TWENTY-NINTH LEGISLATURE, 2017

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to reimbursement of pharmacists.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


     SECTION 1.  The legislature finds that there is a need for more access to healthcare professionals, particularly registered pharmacists, who can safely provide certain health care services to achieve positive outcomes for patients.  Registered pharmacists can administer routine drug therapy-related patient assessment procedures, order drug therapy-related laboratory tests; initiate emergency contraception oral drug therapy; administer immunizations and vaccines or other drugs orally, topically, by intranasal delivery, or by injection, including vaccines to persons between fourteen and seventeen years of age; initiate or adjust the drug regimen of a patient; and provide consultation, information, or education to patients and health care professionals.  Improving quality of life and health outcomes in a cost-effective manner are important goals of the evolving health care system.  Proper use of medications is essential to meeting these goals, especially for those with chronic conditions requiring complex medication therapies.

     The legislature further finds that pharmacists and pharmacists' patient care services are not included in key sections of the Social Security Act, which determines eligibility for health care programs such as Medicare Part B. In the case of Medicare Part B, the omission of pharmacists as listed providers limits Medicare beneficiaries' access to pharmacists' services in the outpatient setting.  Many state and private health plans often cite the omission from Medicare Part B as a reason for lack of coverage for beneficiaries or lack of compensation of pharmacists for providing comprehensive, patient-centered care.

     The legislature further finds that the disciplines of medicine and nursing and the roles of registered pharmacists are complementary.  Ultimately, the interests of patients are well served when registered pharmacists are included as an essential component of the primary health care team.

     The purpose of this Act is to recognize the practice and services provided by registered pharmacists for insurance coverage purposes.

     SECTION 2.  Chapter 431, article 10A, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§431:10A-     Registered pharmacists' services.  (a)  Each policy of accident and health or sickness insurance delivered or issued for delivery in this State shall recognize registered pharmacists, as defined under section 461-1, as participating providers and shall include coverage for care provided by participating registered pharmacists practicing within the scope of their licenses for purposes of health maintenance to the extent that the policy provides benefits for identical services rendered by another health care provider.

     (b)  For the purposes of this section, "participating registered pharmacists" means registered pharmacists who have contracted with the insurer to provide healthcare services to its insureds."

     SECTION 3.  Chapter 432, article 1, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§432:1-     Registered pharmacists' services.  (a)  Each individual and group hospital or medical service plan contract delivered or issued for delivery in this State by a mutual benefit society shall recognize registered pharmacists, as defined under section 461-1, as participating providers and shall include coverage for care provided by participating registered pharmacists practicing within the scope of their licenses for purposes of health maintenance to the extent that the plan contract provides benefits for identical services rendered by another health care provider.

     (b)  For the purposes of this section, "participating registered pharmacists" means registered pharmacists who have contracted with the mutual benefit society to provide healthcare services to its members."

     SECTION 4.  Chapter 432, article 2, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§432:2-     Registered pharmacists' services.  (a)  Each benefit contract delivered or issued for delivery in this State by a fraternal benefit society shall recognize registered pharmacists, as defined under section 461-1, as participating providers and shall include coverage for care provided by participating registered pharmacists practicing within the scope of their licenses for purposes of health maintenance to the extent that the benefit contract provides benefits for identical services rendered by another health care provider.

     (b)  For the purposes of this section, "participating registered pharmacists" means registered pharmacists who have contracted with the fraternal benefit society to provide healthcare services to its contract owners."

     SECTION 5.  Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

     "§432D-23  Required provisions and benefits.  Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-140, 431:10A-   , and 431:10A-134, and chapter 431M."

     SECTION 6.  The insurance commissioner shall submit a report of findings and recommendations of the effects of this Act to the legislature not later than twenty days prior to the convening of the regular session of 2019.

     SECTION 7.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 8.  New statutory material is underscored.

     SECTION 9.  This Act shall take effect upon its approval.

 

INTRODUCED BY:

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Report Title:

Health Care Insurance; Pharmacy Services

 

Description:

Requires insurers, mutual and fraternal benefit societies, and health maintenance organizations to recognize services provided by pharmacists.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.