SB 226-FN - AS INTRODUCED
2015 SESSION
\t15-0939
\t01/09
SENATE BILL\t\t226-FN
AN ACT\trequiring certain notice from pharmacy benefit managers.
SPONSORS:\tSen. Soucy, Dist 18; Sen. Stiles, Dist 24; Rep. Rosenwald, Hills 30
COMMITTEE:\tHealth and Human Services
\tThis bill requires pharmacy benefit managers to notify pharmacists when a prior authorization request has been initiated by the prescribing physician and approval is still pending before the prescription can be filled.
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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\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.
\t15-0939
\t01/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Fifteen
AN ACT\trequiring certain notice from pharmacy benefit managers.
Be it Enacted by the Senate and House of Representatives in General Court convened:
\t1 Emergency Prescription; Notification of Prior Authorization Required. Amend RSA 318:47-i to read as follows:
\t318:47-i Emergency Prescription. Pharmacy managers shall notify the pharmacist if a prior authorization request has been initiated by the prescribing physician and approval is still pending. In the event a pharmacist receives a request for a prescription that requires a prior authorization that has neither been approved nor denied, and such medication is determined by the pharmacist to be essential to the maintenance of life or to the continuation of therapy in a chronic condition, or the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort, the pharmacist may dispense a one-time emergency prescription of a maximum 72-hour supply of the prescribed medication to be reimbursed according to RSA 420-J:7-b, IX. A product that is packaged in a dosage form that is fixed and unbreakable may be dispensed as a 72-hour supply.
\t2 Effective Date. This act shall take effect January 1, 2016.
\t\t\t\t\t\t\t\t\t\t\t\t\tLBAO
\t\t\t\t\t\t\t\t\t\t\t15-0939
\t\t\t\t\t\t\t\t\t\t\t01/30/15
SB 226-FN - FISCAL NOTE
AN ACT\trequiring certain notice from pharmacy benefit managers.
FISCAL IMPACT:
The Department of Health and Human Services states this bill, as introduced, may increase state expenditures by an indeterminable amount in FY 2016 and each fiscal year thereafter. There will be no impact on county and local expenditures or state, county, and local revenue.
METHODOLOGY:
The Department of Health and Human Services states this bill would require pharmacy benefits managers (PBMs) to preemptively notify pharmacists if a prior authorization for an emergency prescription has been initiated by the prescribing physician and whether the approval is still pending. Whereas the State’s Medicaid program utilizes PBMs for both the fee for service and Medicaid Care Management plans, the Department states to the extent PBM operating costs increase to ensure compliance, the potential exists for those costs to be passed on to the State. The Department is unable to estimate to what extent if any, additional compliance costs incurred by the PBMs would increase state expenditures.
The Insurance Department notes the proposed legislation would have no effect on the insurance premium tax base. The Department states if the proposed legislation were to result in increased administrative costs to insurers, that those increased administrative costs would likely be absorbed by general market dynamics. Accordingly, the Department states this bill would have no impact on state revenues.