HB 657 - FINAL VERSION
HOUSE BILL 657
SPONSORS: Rep. Butler, Carr. 7; Rep. Marsh, Carr. 8; Rep. Knirk, Carr. 3; Rep. Hennessey, Graf. 1; Sen. Sherman, Dist 24
COMMITTEE: Commerce and Consumer Affairs
This bill clarifies the law regarding prescription drugs under the managed care law.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
6Jun2019... 2350-EBA 19-0801
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Nineteen
Be it Enacted by the Senate and House of Representatives in General Court convened:
II. Every health benefit plan that provides prescription drug benefits shall maintain an expeditious exception process, not to exceed 48 hours, by which covered persons may obtain coverage for a medically necessary nonformulary prescription drug or for a nonformulary prescription drug that was available during the previous 12 months. The exception process shall begin when the prescribing provider has submitted a request with a clinical rationale for the exception to the health benefit plan. The exception process shall also begin when a covered person has submitted a non-clinical request for access to a drug approved by the federal Food and Drug Administration for treating a specific condition when such drug was available on the formulary during the previous 12 months. A prescription that requires an exception for coverage shall be considered approved if the exception process exceeds 48 hours.
II-a. No health benefit plan that provides prescription drug benefits and establishes the specific sequence in which prescription drugs for a medical condition are to be prescribed shall require failure on the same medication on more than one occasion for patients continuously enrolled in the plan. Nothing in this section shall be construed to prevent a health care provider from prescribing a medication to the same patient on more than one occasion, when he or she determines it is medically appropriate.
III. Every health plan that provides prescription drug benefits shall [notify] provide written notice in a conspicuous font and size to covered persons affected by deletions to the plan list or plan formulary, provide an explanation of the exception process by which a covered person can access nonformulary medically necessary prescription drugs, and provide a toll-free telephone number through which a covered person can request additional information. For purposes of this paragraph, covered persons affected by deletions to the plan list or plan formulary shall include those covered persons for whom the health plan has provided coverage for the deleted prescription drugs during the 12-month period immediately prior to the deletion. Upon notification to covered persons, the health benefit plan shall allow at least 45 days before implementation of any formulary deletions; provided, however, that advance notice shall not be required if the federal Food and Drug Administration has determined that a prescription drug on the health benefit plan's formulary is unsafe. For purposes of this section, “conspicuous font and size” shall mean a font that is at least 12 point in size and in an easily legible font. If a covered person avails himself or herself of the exception process as outlined in 420-J:7-b, II, the medication shall be covered by the health plan until there is a resolution of the exception process.
IX.(a) Every health benefit plan that provides prescription drug benefits shall allow its covered persons to obtain an emergency prescription for up to a 72-hour supply of covered prescription drugs on the covered person's health benefit plan formulary or a prescription drug that was deleted from the formulary within the last 90 days in the event a prescription requires prior authorization or an exception by an insurance carrier and the prior authorization or exception has neither been approved nor denied and a pharmacist has determined the medication is essential as provided in RSA 318:47-i. Such reimbursement shall be according to the payment rates of the provider contract. If authorization or exception is subsequently denied, the carrier shall reimburse the pharmacist for the prescription as given based on the pro-rated amount they would have otherwise received under the terms of the provider contract.
Approved: July 10, 2019
Effective Date: September 08, 2019
|Feb. 19, 2019||House||Hearing|
|Feb. 21, 2019||House||Exec Session|
|March 8, 2019||House||Exec Session|
|March 8, 2019||House||Exec Session|
|March 19, 2019||House||Floor Vote|
|April 25, 2019||Senate||Hearing|
|April 30, 2019||Senate||Hearing|
|May 7, 2019||Senate||Hearing|
|May 23, 2019||Senate||Floor Vote|
July 10, 2019: Signed by Governor Sununu 07/10/2019; Chapter 180; Eff: 09/08/2019
June 13, 2019: Enrolled 06/13/2019 HJ 19 P. 18
June 13, 2019: Enrolled (In recess 06/13/2019); SJ 21
June 6, 2019: Enrolled Bill Amendment # 2019-2350e: AA VV 06/06/2019 HJ 18 P. 40
May 30, 2019: Enrolled Bill Amendment # 2019-2350e Adopted, VV, (In recess of 05/30/2019); SJ 19
May 23, 2019: Ought to Pass: MA, VV; OT3rdg; 05/23/2019; SJ 17
May 23, 2019: Committee Report: Ought to Pass, 05/23/2019; Vote 5-0; CC SC 23
May 7, 2019: ==RECONVENE== Hearing: 05/07/2019, Room 100, SH, 01:15 pm; SC 21
April 30, 2019: ==RECESSED== Hearing: 04/30/2019, Room 102, LOB, 03:00 pm; SC 20
April 25, 2019: ==RECESSED== Hearing: 04/25/2019, Room 100, SH, 02:15 pm; SC 19
March 28, 2019: Introduced 03/28/2019 and Referred to Commerce; SJ 12
March 19, 2019: Ought to Pass with Amendment 2019-0906h (NT): MA VV 03/19/2019 HJ 10 P. 13
March 19, 2019: Amendment # 2019-0906h (NT): AA VV 03/19/2019 HJ 10 P. 13
: Committee Report: Ought to Pass with Amendment # 2019-0906h (NT) (Vote 20-0; CC)
March 19, 2019: Committee Report: Ought to Pass with Amendment # 2019-0906h (NT) for 03/19/2019 (Vote 20-0; CC) HC 16 P. 5
March 8, 2019: ==CONTINUED== Executive Session: 03/08/2019 01:30 pm LOB 302-304
March 8, 2019: Subcommittee Work Session: 03/08/2019 09:00 am LOB 302-304
March 6, 2019: Subcommittee Work Session: 03/06/2019 02:30 pm LOB 302
Feb. 21, 2019: ==RECESSED== Executive Session: 02/21/2019 02:00 pm LOB 302
Feb. 21, 2019: Subcommittee Work Session: 02/21/2019 10:30 am LOB 302
Feb. 19, 2019: Public Hearing: 02/19/2019 10:15 am LOB 302
Jan. 3, 2019: Introduced 01/03/2019 and referred to Commerce and Consumer Affairs HJ 3 P. 23