Bill Text: IA HF696 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to the dispensing fee for partially dispensed prescriptions. (Formerly HSB 238.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2019-04-04 - Referred to Human Resources. H.J. 755. [HF696 Detail]
Download: Iowa-2019-HF696-Introduced.html
House
File
696
-
Introduced
HOUSE
FILE
696
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
HSB
238)
A
BILL
FOR
An
Act
relating
to
the
dispensing
fee
for
partially
dispensed
1
prescriptions.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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696
Section
1.
MEDICAID
PROGRAM
——
DISPENSING
FEE
FOR
1
PRESCRIPTIONS
DISPENSED
IN
PARTIAL
QUANTITIES.
The
department
2
of
human
services
shall
adopt
rules
pursuant
to
chapter
17A
to
3
require
that
if
a
Medicaid
provider,
under
both
fee-for-service
4
and
managed
care
program
administration,
who
is
authorized
5
to
dispense
prescription
drugs
pursuant
to
chapter
155A,
6
initially
dispenses
a
partial
quantity
of
a
prescription
drug
7
authorized
by
a
prescription,
and
subsequently
dispenses
the
8
remaining
quantity
as
authorized
by
the
prescription,
the
total
9
dispensing
fee
charged
by
the
provider
for
that
prescription
10
shall
not
exceed
the
standard
dispensing
fee
applicable
to
the
11
same
prescription
as
if
the
total
quantity
authorized
had
been
12
dispensed
at
one
time.
This
provision
shall
apply
whether
the
13
partial
dispensing
of
a
quantity
authorized
by
a
prescription
14
is
due
to
a
policy
of
the
authorized
dispenser,
a
supply
15
deficit,
or
for
any
other
reason.
16
Sec.
2.
NEW
SECTION
.
155A.38A
Prescriptions
dispensed
in
17
partial
quantities
——
limitation
on
dispensing
fee.
18
If
a
person
authorized
pursuant
to
this
chapter
to
dispense
19
prescription
drugs,
initially
dispenses
a
partial
quantity
20
of
a
prescription
drug
authorized
by
a
prescription,
and
21
subsequently
dispenses
the
remaining
quantity
as
authorized
22
by
the
prescription,
the
total
dispensing
fee
charged
for
23
that
prescription
shall
not
exceed
the
standard
dispensing
24
fee
applicable
to
the
same
prescription
as
if
the
total
25
quantity
authorized
had
been
dispensed
at
one
time.
This
26
provision
shall
apply
whether
the
partial
dispensing
of
a
27
quantity
authorized
by
a
prescription
is
due
to
a
policy
of
28
the
authorized
dispenser,
a
supply
deficit,
or
for
any
other
29
reason.
30
Sec.
3.
NEW
SECTION
.
514C.35
Dispensing
fee
for
31
prescription
dispensed
in
partial
quantity.
32
1.
Third-party
payment
provider
contracts
or
policies
33
delivered,
issued
for
delivery,
continued,
or
renewed
in
34
this
state
on
or
after
January
1,
2020,
that
provide
for
35
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696
third-party
payment
or
prepayment
of
health
or
medical
expenses
1
shall
provide
that
if
a
person
authorized
pursuant
to
chapter
2
155A
to
dispense,
initially
dispenses
a
partial
quantity
3
of
a
prescription
drug
authorized
by
a
prescription,
and
4
subsequently
dispenses
the
remaining
quantity
as
authorized
5
by
a
prescription,
the
total
dispensing
fee
charged
for
6
that
prescription
shall
not
exceed
the
standard
dispensing
7
fee
applicable
to
the
same
prescription
as
if
the
total
8
quantity
authorized
had
been
dispensed
at
one
time.
This
9
provision
shall
apply
whether
the
partial
dispensing
of
a
10
quantity
authorized
by
a
prescription
is
due
to
a
policy
of
11
the
authorized
dispenser,
a
supply
deficit,
or
for
any
other
12
reason.
13
2.
For
the
purposes
of
this
section,
“third-party
payment
14
provider
contracts
or
policies”
includes:
15
a.
Individual
or
group
accident
and
sickness
insurance
16
providing
coverage
on
an
expense-incurred
basis.
17
b.
An
individual
or
group
hospital
or
medical
service
18
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
19
c.
An
individual
or
group
health
maintenance
organization
20
contract
regulated
under
chapter
514B.
21
d.
Any
other
entity
engaged
in
the
business
of
insurance,
22
risk
transfer,
or
risk
retention,
which
is
subject
to
the
23
jurisdiction
of
the
commissioner.
24
e.
A
plan
established
pursuant
to
chapter
509A
for
public
25
employees.
26
3.
This
section
shall
not
apply
to
accident-only,
27
specified
disease,
short-term
hospital
or
medical,
hospital
28
confinement
indemnity,
credit,
dental,
vision,
Medicare
29
supplement,
long-term
care,
basic
hospital
and
medical-surgical
30
expense
coverage
as
defined
by
the
commissioner,
disability
31
income
insurance
coverage,
coverage
issued
as
a
supplement
32
to
liability
insurance,
workers’
compensation
or
similar
33
insurance,
or
automobile
medical
payment
insurance.
34
EXPLANATION
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696
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
1
the
explanation’s
substance
by
the
members
of
the
general
assembly.
2
This
bill
relates
to
the
dispensing
fee
for
partially
3
dispensed
prescriptions.
4
The
bill
requires
the
department
of
human
services
to
adopt
5
administrative
rules
to
require
that
if
a
Medicaid
provider
6
who
is
authorized
to
dispense
prescription
drugs
pursuant
to
7
Code
chapter
155A
(pharmacy)
initially
dispenses
a
partial
8
quantity
of
a
prescription
drug
authorized
by
a
prescription,
9
and
subsequently
dispenses
the
remaining
quantity
as
authorized
10
by
the
prescription,
the
total
dispensing
fee
charged
by
the
11
provider
for
that
prescription
shall
not
exceed
the
standard
12
dispensing
fee
applicable
to
the
same
prescription
as
if
the
13
total
quantity
authorized
had
been
dispensed
at
one
time.
14
The
provision
applies
whether
the
partial
dispensing
of
a
15
quantity
authorized
by
a
prescription
is
due
to
a
policy
16
of
the
authorized
dispenser,
a
supply
deficit,
or
for
any
17
other
reason.
The
bill
also
requires
this
provision
for
an
18
authorized
dispenser
under
Code
chapter
155A
(pharmacy)
and
19
under
third-party
payment
provider
contracts
or
policies
20
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
21
state
on
or
after
January
1,
2020.
22
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