Revision: June 11, 2016, midnight
\t \t\tCHAPTER 221
HB 1210 - FINAL VERSION
05/05/2016 1873s
19May2016... 2004EBA
2016 SESSION
\t16-2087
\t01/10
HOUSE BILL\t1210
AN ACT\trelative to prescriptions for controlled drugs by telemedicine and relative to rulemaking authority and enforcement concerning prices for filling certain prescriptions.
SPONSORS:\tRep. MacKay, Merr. 14; Rep. Fothergill, Coos 1; Rep. Snow, Hills. 42; Rep. Ford, Graf. 3; Rep. LeBrun, Hills. 32; Rep. Sherman, Rock. 24; Sen. Reagan, Dist 17; Sen. Fuller Clark, Dist 21
COMMITTEE:\tHealth, Human Services and Elderly Affairs
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AMENDED ANALYSIS
\tThis bill clarifies when it is appropriate for practitioners to adjust or prescribe controlled drugs to patients by telemedicine.
\tThis bill also adds rulemaking authority for the pharmacy board concerning the price of filling prescriptions paid by a pharmacy benefits manager or insurer. The bill also adds authority for the insurance department to adopt rules for enforcement of requirements for the price of filling prescriptions.
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Explanation:\tMatter added to current law appears in bold italics.
\t\tMatter removed from current law appears [in brackets and struckthrough.]
\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.
05/05/2016 1873s
19May2016... 2004EBA\t16-2087
\t01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Sixteen
AN ACT\trelative to prescriptions for controlled drugs by telemedicine and relative to rulemaking authority and enforcement concerning prices for filling certain prescriptions.
Be it Enacted by the Senate and House of Representatives in General Court convened:
\t221:1 Controlled Drug Act; Acts Prohibited; Exceptions. Amend RSA 318-B:2, XII-f to read as follows:
\t\tXII-f. It shall be unlawful for any person to prescribe by means of telemedicine a controlled drug classified in schedule II through IV, except as provided in RSA 318-B:2, XVI, (a) and (b).
\t221:2 Controlled Drug Act; Acts Prohibited; Exceptions. Amend RSA 318-B:2, XVI(a) to read as follows:
\t\tXVI.(a) The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care, or who are treating patients at a state designated community mental health center pursuant to RSA 135-C or at a Substance Abuse and Mental Health Services Administration (SAMHSA)-certified state opioid treatment program, and shall require an initial in-person exam by a practitioner licensed to prescribe the drug. Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually.
\t221:3 Physicians and Surgeons; Telemedicine. Amend RSA 329:1-d, IV(a) to read as follows:
\t\tIV.(a) The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care, or who are treating patients at a state designated community mental health center pursuant to RSA 135-C or at a Substance Abuse and Mental Health Services Administration (SAMHSA)-certified state opioid treatment program, and shall require an initial in-person exam by a practitioner licensed to prescribe the drug. Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition, and drug, but not less than annually.
\t221:4 Nurse Practice Act; Telemedicine. Amend RSA 326-B:2, XII (d)(1) to read as follows:
\t\t\t(d)(1) The prescribing of a non-opioid controlled drug classified in schedule II through IV by means of telemedicine shall be limited to prescribers as defined in RSA 329:1-d, I and RSA 326-B:2, XII(a), who are treating a patient with whom the prescriber has an in-person practitioner-patient relationship, for purposes of monitoring or follow-up care, or who are treating patients at a state designated community mental health center pursuant to RSA 135-C or at a Substance Abuse and Mental Health Services Administration (SAMHSA)-certified state opioid treatment program, and shall require an initial in-person exam by a practitioner licensed to prescribe the drug. Subsequent in-person exams shall be by a practitioner licensed to prescribe the drug at intervals appropriate for the patient, medical condition and drug, but not less than annually.
\t221:5 New Paragraph; Pharmacists and Pharmacies; Price of Filling Prescriptions. Amend RSA 318:47-h by inserting after paragraph II the following new paragraph:
\t\tIII. The board shall adopt rules under RSA 541-A establishing procedures to receive complaints of violations of paragraphs I and II. Such rules shall include:
\t\t\t(a) Criteria and procedure to refer complaints to the insurance department.
\t\t\t(b) Method for tracking the status of complaints referred to the insurance department and receiving department of insurance reports on the status.
\t\t\t(c) Procedures for reporting to the senate president, the speaker of the house of representatives, and the chairpersons of the house and senate committees with oversight of pharmacy benefit manager regulation, the number of complaints received, the number and nature of complaints referred to the insurance department, and the status of referred complaints.
\t221:6 New Paragraph; Managed Care Law; Prescriptions; Price of Filling Prescriptions. Amend RSA 420-J:7-b by inserting after paragraph IX the following new paragraph:
\t\tX.(a) A pharmacy benefits manager or insurer shall require a contracted pharmacy to charge an enrollee or insured person the pharmacy’s usual and customary price of filling the prescription or the contracted copayment, whichever is less.
\t\t\t(b) Once it has settled a claim for filling a prescription for an enrollee or insured person and notified the pharmacy of the amount the pharmacy benefits manager or insurer shall pay to the pharmacy for that prescription, the pharmacy benefits manager or insurer shall not lower the amount to be paid to the pharmacy by the pharmacy benefits manager or the insurer for such settled claim; provided, however, that this paragraph shall not apply if the claim was submitted fraudulently or with inaccurate or misrepresented information.
\t\t\t(c) The commissioner shall adopt rules under RSA 541-A to implement this paragraph. Such rules shall include procedures for addressing complaints, provisions for enforcement, the receipt of complaints referred to the insurance department under RSA 318:47-h, III(b), and for reporting to the board of pharmacy on the status of complaints referred.
\t221:7 New Section; Accident and Health Insurance; Price of Filling Prescriptions. Amend RSA 415 by inserting after section 25 the following new section:
\t415:26 Price of Filling Prescriptions.
\t\tI. A pharmacy benefits manager or insurer shall require a contracted pharmacy to charge an enrollee or insured person the pharmacy’s usual and customary price of filling the prescription or the contracted copayment, whichever is less.
\t\tII. Once it has settled a claim for filling a prescription for an enrollee or insured person and notified the pharmacy of the amount the pharmacy benefits manager or insurer shall pay to the pharmacy for that prescription, the pharmacy benefits manager or insurer shall not lower the amount to be paid to the pharmacy by the pharmacy benefits manager or the insurer for such settled claim; provided, however, that this paragraph shall not apply if the claim was submitted fraudulently or with inaccurate or misrepresented information.
\t\tIII. The commissioner shall adopt rules under RSA 541-A to implement this paragraph. Such rules shall include procedures for addressing complaints, provisions for enforcement, the receipt of complaints referred to the insurance department under RSA 318:47-h, III(b), and for reporting to the board of pharmacy on the status of complaints referred.
\t221:8 Insurance Department; Rulemaking. The commissioner of insurance shall adopt rules under RSA 541-A within 180 days of the effective date of this act to implement the authority established in RSA 420-J:7-b, X and RSA 415:26 of this act.
\t\tI. Sections 1-4 of this act shall take effect 60 days after its passage.
\t\tII. The remainder of this act shall take effect upon its passage.
Approved: June 9, 2016
Effective Date:\t\tI. Sections 1-4 shall take effect August 8, 2016
\t\t\t\t II. Remainder shall take effect June 9, 2016