THE SENATE

S.B. NO.

2494

TWENTY-FIFTH LEGISLATURE, 2010

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to insurance.

 

 

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

 


SECTION 1. Chapter 431, article 10A, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

"431:10A- Prescription drug coverage; medically necessary; continuation of coverage. Any insurer who issues a policy that offers coverage for prescription drug benefits shall offer to continue to any insured who enters into a policy with the insurer on or after July 1, 2010 a coverage for prescription drug benefits that is identical to the coverage offered to the insured under the insured's previous health plan.

For the purposes of this section:

"Coverage" means the benefits, costs, and requirements for patient access to medical products and services as enumerated in the written explanation of benefits document issued by the health carrier.

"Identical" means the exact benefit as provided in the written explanation of benefits document issued by the health carrier.

"Prescription drug benefits" means the prescription drug benefits as defined in the explanation of benefits document issued by the health insurance carrier that describes the cost, cost-sharing, and available medications, as well as any utilization management requirements that patients must meet in order to access the prescribed drug."

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

"431:10A- Prescription drug coverage; medically necessary; continuation of coverage. Any insurer who issues a policy that offers coverage for prescription drug benefits shall offer to continue to any insured who enters into a policy with the insurer on or after July 1, 2010 a coverage for prescription drug benefits that is identical to the coverage offered to the insured under the insured's previous health plan.

For the purposes of this section:

"Coverage" means the benefits, costs, and requirements for patient access to medical products and services as enumerated in the written explanation of benefits document issued by the health carrier.

"Identical" means the exact benefit as provided in the written explanation of benefits document issued by the health carrier.

"Prescription drug benefits" means the prescription drug benefits as defined in the explanation of benefits document issued by the health insurance carrier that describes the cost, cost-sharing, and available medications, as well as any utilization management requirements that patients must meet in order to access the prescribed drug."

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

"432:1- Prescription drug coverage; medically necessary; continuation of coverage. Any mutual benefit society that issues a plan or contract that offers coverage for prescription drug benefits shall offer to continue to any member who is covered under a plan or contract that is entered into with the mutual benefit society on or after July 1, 2010 a coverage for prescription drug benefits that is identical to the coverage offered to the member under the member's previous health plan.

For the purposes of this section:

"Coverage" means the benefits, costs, and requirements for patient access to medical products and services as enumerated in the written explanation of benefits document issued by the health carrier.

"Identical" means the exact benefit as provided in the written explanation of benefits document issued by the health carrier.

"Prescription drug benefits" means the prescription drug benefits as defined in the explanation of benefits document issued by the health insurance carrier that describes the cost, cost-sharing, and available medications, as well as any utilization management requirements that patients must meet in order to access the prescribed drug."

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

"432D- Prescription drug coverage; medically necessary; continuation of coverage. Any health maintenance organization that that issues a contract offers coverage for prescription drug benefits shall offer to continue to any member who is covered under a contract entered into on or after July 1, 2010 a coverage for prescription drug benefits that is identical to the coverage offered to the member under the member's previous health plan.

For the purposes of this section:

"Coverage" means the benefits, costs, and requirements for patient access to medical products and services as enumerated in the written explanation of benefits document issued by the health carrier.

"Identical" means the exact benefit as provided in the written explanation of benefits document issued by the health carrier.

"Prescription drug benefits" means the prescription drug benefits as defined in the explanation of benefits document issued by the health insurance carrier that describes the cost, cost-sharing, and available medications, as well as any utilization management requirements that patients must meet in order to access the prescribed drug."

SECTION 5. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

SECTION 6. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.

 

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

Health Insurance; Drug Coverage

 

Description:

Requires health insurers and like entities to offer at least the same drug coverage to the insured that the insured had under the insured's previous policy with a different insurer or like entity.

 

 

 

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