Bill Text: HI SB330 | 2018 | Regular Session | Introduced
Bill Title: Relating To Workers' Compensation.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2018-01-17 - Re-Referred to LBR/CPH, WAM. [SB330 Detail]
Download: Hawaii-2018-SB330-Introduced.html
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THE SENATE |
S.B. NO. |
330 |
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TWENTY-NINTH LEGISLATURE, 2017 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to workers' compensation.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The purpose of this Act is to amend section 386-21.7, Hawaii Revised Statutes, which was enacted to curtail the alarming cost increases of prescription drugs and compounds under workers' compensation law. The legislature finds that since that section was enacted, analysis of other states shows a wide range of reimbursement rates among the thirty-seven states that reimburse prescription drugs on the basis of a percentage of average wholesale price. Hawaii has the highest rate of reimbursement for brand name and generic drugs at one hundred forty per cent of the average wholesale price. The next highest rate is in Louisiana at one hundred ten per cent of the average wholesale price and a $10.51 dispensing fee for brand name drugs. The national average for brand name drugs is average wholesale price minus three per cent with a $4.32 dispensing fee and for generic drugs, average wholesale price minus four per cent with a $4.94 dispensing fee. For both brand name and generics drugs, California reimburses at average wholesale price minus seventeen per cent with a $7.25 dispensing fee, and Oregon reimburses at average wholesale price minus 16.5 per cent with a $2.00 dispensing fee. California and Oregon are considered progressive workers' compensation states and have worked extensively on their systems. This Act is intended to bring Hawaii closer to the rest of the nation in terms of its reimbursement rate for prescription drugs and compounds under the workers' compensation law.
SECTION 2. Section 386-21.7, Hawaii Revised Statutes, is amended to read as follows:
"[[]§386-21.7[]]
Prescription drugs; pharmaceuticals. (a) Notwithstanding any other
provision to the contrary, immediately after a work injury is sustained by an
employee and so long as reasonably needed, the employer shall furnish to the employee
all prescription drugs as the nature of the injury requires. The liability for
the prescription drugs shall be subject to the deductible under section 386-100.
(b) Payment for all forms of prescription
drugs including repackaged and relabeled drugs shall be [one hundred forty]
ninety per cent of the average wholesale price set by the original
manufacturer of the dispensed prescription drug as identified by its National
Drug Code and as published in the Red Book: Pharmacy's Fundamental Reference as
of the date of dispensing, except where the employer or carrier, or any entity
acting on behalf of the employer or carrier, directly contracts with the
provider or the provider's assignee for a lower amount.
(c) Payment for compounded prescription drugs
shall be the sum of [one hundred forty] ninety per cent of the
average wholesale price by gram weight of each underlying prescription drug
contained in the compounded prescription drug. For compounded prescription
drugs, the average wholesale price shall be that set by the original
manufacturer of the underlying prescription drug as identified by its National
Drug Code and as published in the Red Book: Pharmacy's Fundamental Reference
as of the date of compounding, except where the employer or carrier, or any
entity acting on behalf of the employer or carrier, directly contracts with the
provider or provider's assignee for a lower amount.
(d) All pharmaceutical claims submitted for
repackaged, relabeled, or compounded prescription drugs shall include the
National Drug Code of the original manufacturer. If the original manufacturer
of the underlying drug product used in repackaged, relabeled, or compounded
prescription drugs is not provided or is unknown, then reimbursement shall be [one
hundred forty] ninety per cent of the average wholesale price for
the original manufacturer's National Drug Code number as listed in the Red
Book: Pharmacy's Fundamental Reference of the prescription drug that is most
closely related to the underlying drug product.
(e) Notwithstanding any other provision in this section to the contrary, equivalent generic drug products shall be substituted for brand name pharmaceuticals unless the prescribing physician certifies that no substitution shall be prescribed because the injured employee's condition does not tolerate an equivalent generic drug product.
(f) Physician dispensed prescription drugs may only be prescribed during the first ninety days from the date of injury.
[(f)] (g) For purposes of this
section, "equivalent generic drug product" has the same meaning as
provided in section 328-91."
SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 4. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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Report Title:
Workers' Compensation; Prescription Drugs; Average Wholesale Price
Description:
Reduces repackaged, relabeled, and compounded prescription drug payments under workers' compensation from 140% to 90% of the average wholesale price. Requires physician dispensed prescription drugs to only be prescribed within 90 days of the injury.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
