Bill Text: HI SB2319 | 2016 | Regular Session | Amended

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Bill Title: Insurance; Prescription Contraceptive Supplies; Reimbursement

Spectrum: Partisan Bill (Democrat 9-0)

Status: (Passed) 2016-07-06 - Act 205, 07/05/2016 (Gov. Msg. No. 1307). [SB2319 Detail]

Download: Hawaii-2016-SB2319-Amended.html

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THE SENATE	S.B. NO.	2319
TWENTY-EIGHTH LEGISLATURE, 2016		S.D. 1
STATE OF HAWAII		H.D. 3
		C.D. 1

A BILL FOR AN ACT

 

 

RELATING TO INSURANCE.

 

 

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

 

     SECTION 1.  The legislature finds that insurance companies typically cover a thirty- or ninety-day supply of prescription contraceptives.  However, these coverage requirements may act as a barrier for women, especially those who live in rural areas, frequently travel, are unable to schedule regular visits to health care providers, or are unable to readily pick up their prescriptions.  The legislature further finds that statewide efforts to expand women's access to prescription contraceptives, including long-acting reproductive contraceptives, have been shown to help decrease unplanned pregnancies.

     The legislature additionally finds that Oregon recently enacted legislation to expand women's access to prescription contraception.  The law requires women to first obtain a three-month supply of prescription contraceptives then allows women to fill subsequent prescriptions for a year at a time.  The legislature concludes that Hawaii should adopt similar legislation, which will increase access to prescription contraceptive supplies and decrease barriers regarding reproductive health care.  The legislature notes that the American Congress of Obstetricians and Gynecologists and the federal Centers for Disease Control and Prevention recommend prescribing or supplying up to one year of oral contraceptive supplies, based on a woman's preferences and anticipated use.

     Accordingly, the purpose of this Act is to expand access to prescription contraceptives by requiring insurers to cover up to a twelve-month period of prescription contraceptive supplies for an insured.

     The legislature notes that the reimbursement for prescription contraceptive supplies required under this Act is intended to apply to all insurers in the State, including health benefits plans under chapter 87A, Hawaii Revised Statutes, and medicaid managed care programs.

     SECTION 2.  Section 431:10A-116.6, Hawaii Revised Statutes, is amended to read as follows:

     "§431:10A-116.6  Contraceptive services.  (a)  Notwithstanding any provision of law to the contrary, each employer group accident and health or sickness policy, contract, plan, or agreement issued or renewed in this State on or after January 1, 2000, shall cease to exclude contraceptive services or supplies for the subscriber or any dependent of the subscriber who is covered by the policy, subject to the exclusion under section 431:10A-116.7[.] and the exclusion under section 431:10A-102.5.

     (b)  Except as provided in subsection (c), all policies, contracts, plans, or agreements under subsection (a), that provide contraceptive services or supplies, or prescription drug coverage, shall not exclude any prescription contraceptive supplies or impose any unusual copayment, charge, or waiting requirement for such supplies.

     (c)  Coverage for oral contraceptives shall include at least one brand from the monophasic, multiphasic, and the progestin-only categories.  A member shall receive coverage for any other oral contraceptive only if:

     (1)  Use of brands covered has resulted in an adverse drug reaction; or

     (2)  The member has not used the brands covered and, based on the member's past medical history, the prescribing health care provider believes that use of the brands covered would result in an adverse reaction.

     (d)  Coverage required by this section shall include reimbursement to a prescribing health care provider or dispensing entity for prescription contraceptive supplies intended to last for up to a twelve-month period for an insured.

     [(d)] (e)  For purposes of this section:

     "Contraceptive services" means physician-delivered, physician-supervised, physician assistant–delivered, [nurse practitioner-delivered, certified nurse midwife-delivered,] advanced practice registered nurse-delivered, nurse-delivered, or pharmacist-delivered medical services intended to promote the effective use of contraceptive supplies or devices to prevent unwanted pregnancy.

     "Contraceptive supplies" means all United States Food and Drug Administration-approved contraceptive drugs or devices used to prevent unwanted pregnancy.

     [(e)] (f)  Nothing in this section shall be construed to extend the practice or privileges of any health care provider beyond that provided in the laws governing the provider's practice and privileges."

     SECTION 3.  Section 432:1-604.5, Hawaii Revised Statutes, is amended to read as follows:

     "§432:1-604.5  Contraceptive services.  (a)  Notwithstanding any provision of law to the contrary, each employer group health policy, contract, plan, or agreement issued or renewed in this State on or after January 1, 2000, shall cease to exclude contraceptive services or supplies, and contraceptive prescription drug coverage for the subscriber or any dependent of the subscriber who is covered by the policy, subject to the exclusion under section 431:10A-116.7.

     (b)  Except as provided in subsection (c), all policies, contracts, plans, or agreements under subsection (a), that provide contraceptive services or supplies, or prescription drug coverage, shall not exclude any prescription contraceptive supplies or impose any unusual copayment, charge, or waiting requirement for such drug or device.

     (c)  Coverage for contraceptives shall include at least one brand from the monophasic, multiphasic, and the progestin-only categories.  A member shall receive coverage for any other oral contraceptive only if:

     (1)  Use of brands covered has resulted in an adverse drug reaction; or

     (2)  The member has not used the brands covered and, based on the member's past medical history, the prescribing health care provider believes that use of the brands covered would result in an adverse reaction.

     (d)  Coverage required by this section shall include reimbursement to a prescribing health care provider or dispensing entity for prescription contraceptive supplies intended to last for up to a twelve-month period for a member.

     [(d)] (e)  For purposes of this section:

     "Contraceptive services" means physician-delivered, physician-supervised, physician assistant-delivered, [nurse practitioner-delivered, certified nurse midwife-delivered,] advanced practice registered nurse-delivered, or nurse-delivered medical services intended to promote the effective use of contraceptive supplies or devices to prevent unwanted pregnancy.

     "Contraceptive supplies" means all Food and Drug Administration-approved contraceptive drugs or devices used to prevent unwanted pregnancy.

     [(e)] (f)  Nothing in this section shall be construed to extend the practice or privileges of any health care provider beyond that provided in the laws governing the provider's practice and privileges."

     SECTION 4.  Notwithstanding any other law to the contrary, the reimbursement for prescription contraceptive supplies required under sections 2 and 3 of this Act shall apply to all health benefits plans under chapter 87A, Hawaii Revised Statutes, issued, renewed, modified, altered, or amended on or after January 1, 2017.

     SECTION 5.  The reimbursement for prescription contraceptive supplies required under sections 2 and 3 of this Act shall apply to all plans under medicaid managed care programs in the State.

     SECTION 6.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 7.  This Act shall take effect on July 1, 2016; provided that sections 2 and 3 shall apply to all policies, contracts, plans, or agreements issued or renewed in the State on or after January 1, 2017; provided further that section 5 shall take effect upon approval of the Hawaii medicaid state plan by the Centers for Medicare and Medicaid Services.

Report Title:

Insurance; Prescription Contraceptive Supplies; Reimbursement

 

Description:

Requires health insurers in the State, including health benefits plans under the Hawaii Employer-Union Health Benefits Trust Fund and Medicaid managed care programs, to cover reimbursement for contraceptive supplies intended to last for up to a twelve-month period for an insured.  (CD1)

 

 

 

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