SB 690 - AS INTRODUCED
SENATE BILL 690
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
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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty
Be it Enacted by the Senate and House of Representatives in General Court convened:
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.
|Jan. 21, 2020||Senate||Hearing|
|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|