SB690 (2020) Detail

Relative to prescription drug formulary changes.


SB 690  - AS INTRODUCED

 

 

2020 SESSION

20-2763

01/10

 

SENATE BILL 690

 

AN ACT relative to prescription drug formulary changes.

 

SPONSORS: Sen. Fuller Clark, Dist 21; Sen. Rosenwald, Dist 13; Sen. Bradley, Dist 3; Sen. Sherman, Dist 24; Rep. MacKay, Merr. 14; Rep. Marsh, Carr. 8; Rep. Bartlett, Merr. 19; Rep. McMahon, Rock. 7

 

COMMITTEE: Commerce

 

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ANALYSIS

 

This bill prohibits prescription drug formulary changes during a contract year 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

20-2763

01/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty

 

AN ACT relative to prescription drug formulary changes.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

1  New Paragraph; Managed Care Law; Prescription Drugs.  Amend RSA 420-J:7-b by inserting after paragraph XI the following new paragraph:

XII.(a)  Except as provided in subparagraph (c), a health care plan shall not:

(1)  Remove a prescription drug from a formulary;

(2)  Move a prescription drug to a tier with a larger deductible, copayment, or coinsurance if the formulary includes 2 or more tiers of benefits providing for different deductibles, copayments, or coinsurance applicable to the prescription drugs in each tier; or

(3)  Add utilization management restrictions to a prescription drug on a formulary, unless such changes occur at the time of enrollment or issuance of coverage.

(b)  The prohibitions under subparagraph (a) shall apply beginning on the date on which open enrollment begins for a plan year and through the end of the plan year to which such open enrollment period applies.

(c)(1)  A health care plan with a formulary that includes 2 or more tiers of benefits providing for different deductibles, copayments, or coinsurance applicable to prescription drugs in each tier may move a prescription drug to a tier with a larger deductible, copayment, or coinsurance if an AB-rated generic equivalent or interchangeable biological product for such prescription drug is added to the formulary at the same time.

(2)  A health care plan may remove a prescription drug from a formulary if the federal Food and Drug Administration (FDA) determines that such prescription drug should be removed from the market, including new utilization management restrictions issued pursuant to FDA safety concerns.

(d)  A health care plan shall provide notice to policyholders of the intent to remove a prescription drug from a formulary or alter deductible, copayment, or coinsurance requirements in the upcoming plan year, 30 days prior to the open enrollment period for the consecutive plan year.  Such notice of impending formulary and deductible, copayment, or coinsurance changes shall also be posted on the plan's online formulary and in any prescription drug finder system that the plan provides to the public.

(e)  The provisions of this paragraph shall not supersede the terms of a collective bargaining agreement, or the rights of labor representation groups to collectively bargain changes to the formularies.

2  Effective Date.  This act shall take effect 60 days after its passage.

Links

SB690 at GenCourtMobile
SB690 Discussion

Action Dates

Date Body Type
Jan. 21, 2020 Senate Hearing

Bill Text Revisions

SB690 Revision: 8008 Date: Jan. 14, 2020, 4:16 p.m.

Docket

Date Status
Jan. 8, 2020 Introduced 01/08/2020 and Referred to Commerce; SJ 2
Jan. 21, 2020 Hearing: 01/21/2020, Room 100, SH, 01:30 pm; SC 3
June 16, 2020 Vacated from Committee and Laid on Table, MA, VV; 06/16/2020 SJ 8
June 16, 2020 No Pending Motion; 06/16/2020 SJ 8