Bill Text: HI HB62 | 2013 | Regular Session | Amended
Bill Title: Pharmacy Benefits Managers; Health Information; Right to Privacy; Prohibited Practices
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Passed) 2013-07-02 - Act 225, on 6/27/2013 (Gov. Msg. No. 1328). [HB62 Detail]
Download: Hawaii-2013-HB62-Amended.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
62 |
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TWENTY-SEVENTH LEGISLATURE, 2013 |
H.D. 2 |
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STATE OF HAWAII |
S.D. 1 |
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A BILL FOR AN ACT
RELATING TO PHARMACY BENEFITS MANAGERS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that numerous states have enacted or are considering legislation to regulate pharmacy benefits managers. Pharmacy benefits managers are intermediaries that negotiate services and costs between pharmaceutical companies and third party payors, such as insurance companies, businesses, and cash-paying customers. Pharmacy benefits managers manage all aspects of a prescription drug benefit plan, from establishing formularies of preferred drugs and negotiations with drug manufacturers and pharmacies, to ownership of their own mail order pharmacy to directly fill prescriptions. The three largest pharmacy benefits managers administer prescription drug benefits for approximately eighty per cent of insured prescriptions and ninety per cent of insured mail order prescriptions.
Pharmacy benefits managers often use a patient's prescription drug claims information to directly market to that patient the services of a preferred pharmacy provider that is owned by the pharmacy benefits manager. This practice allows pharmacy benefits managers to influence patient behavior in a manner that drives business to the pharmacy benefits managers' own subsidiary pharmacies. Such a practice would appear to be unfair and deceptive since the patient often does not know that the patient's claim information is being used in this manner and that the pharmacy network being advertised is affiliated with or owned by the pharmacy benefits manager.
The purpose of this Act is to prohibit pharmacy benefits managers from using a patient's claim information to market or advertise to that patient the services of a preferred pharmacy network that is owned by the pharmacy benefits manager.
SECTION 2. Chapter 481B, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§481B- Pharmacy benefits managers; prohibited marketing practices. (a) A pharmacy benefits manager shall take no action that would restrict a patient's choice of pharmacy from which to receive prescription drug benefits, including:
(1) Use of an individual's prior prescription drug benefits claim information, unless use of the individual's prescription drug benefits claim information is medically necessary to the health and safety of the individual or the individual has consented to use of the information; or
(2) Requiring patients to receive prescription drug benefits from any pharmacy affiliated with or owned wholly or in part by the pharmacy benefits managers, including mail order pharmacies.
(b) As used in this section, "pharmacy benefits manager" means any person, business, or entity that performs pharmacy benefits management, including but not limited to a person or entity under contract with a pharmacy benefits manager to perform pharmacy benefits management on behalf of a managed care company, nonprofit hospital or medical service organization, insurance company, third-party payor, or health program administered by the State."
SECTION 3. New statutory material is underscored.
SECTION 4. This Act shall take effect on July 1, 2112.
Report Title:
Pharmacy Benefits Managers; Prohibited Practices
Description:
Prohibits a pharmacy benefits manager from using a patient's prescription drug benefits claim information to market to that patient the services of a preferred pharmacy network that is owned by the pharmacy benefits manager, except in certain situations. Effective July 1, 2112. (SD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
