GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 2007

H                                                                                                                                                    1

HOUSE BILL 748*

 

 

 

 

Short Title:     Insurers/Cover Rx in Emergencies.-AB

(Public)

Sponsors:

Representatives Glazier, Lucas, Carney (Primary Sponsors);  Alexander, England, Farmer‑Butterfield, Harrison, Insko, and Wray.

Referred to:

Insurance.

March 15, 2007

A BILL TO BE ENTITLED

AN ACT TO REQUIRE INSURERS TO COVER EXTRA PRESCRIPTIONS DURING A STATE OF EMERGENCY OR DISASTER.

The General Assembly of North Carolina enacts:

SECTION 1.  Article 3 of Chapter 58 of the General Statutes is amended by adding a new section to read:

"§ 58‑3‑228.  Coverage for extra prescriptions during a state of emergency or disaster.

(a)       All health benefit plans as defined in G.S. 58‑3‑167, the Teachers' and State Employees' Comprehensive Major Medical Plan, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand-alone prescription medication plans issued by entities that are licensed by the Department  shall, when an event described in subdivision (b)(1) of this section occurs and the requirements of subdivision (b)(2) of this section are satisfied, waive time restrictions on filling or refilling prescriptions for medication, which includes suspension of electronic "refill too soon" edits to pharmacies, to enable covered persons or subscribers to:

(1)       Obtain one refill on a prescription if there are authorized refills remaining; or

(2)       Fill a replacement prescription for one that was recently filled, as prescribed or approved by the prescriber of the prescription that is being replaced and not contrary to the dispensing authority of the dispensing pharmacy.

(b)       All entities subject to this section shall authorize payment to pharmacies for any prescription dispensed in accordance with subsection (a) of this section regardless of the date upon which the prescription had most recently been filled by a pharmacist, as long as the following conditions are met:

(1)       The covered person requesting coverage of the refill or replacement prescription resides in a county that:

a.         Is declared to be under a state of emergency in an executive order or proclamation issued by the Governor of the State of North Carolina, or by a resolution of the North Carolina General Assembly;

b.         Has activated its emergency operations center and its emergency management plan; or

c.         Is covered under a proclamation of state of disaster issued by the Governor under G.S. 166A‑6 or a declaration of major disaster issued by the President of the United States under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. § 5121, et seq., as amended.

(2)       The prescription medication is requested within 29 days after the origination date of the conditions stated in subsection (b)(1) of this section.

(c)       The time period for the waiver of prescription medication refills may be extended in 30‑day increments by emergency orders issued by the Commissioner, in which case additional refills still remaining on a prescription shall be covered by the entities subject to this section as long as consistent with the orders of the prescriber or authority of the dispensing pharmacy.

(d)       This section does not excuse or exempt an insured or subscriber from compliance with all other terms of the policy or certificate providing prescription medication coverage.

(e)       Nothing in this section is intended to affect the respective authority or practice of prescribers or pharmacies."

SECTION 2.  This act is effective when it becomes law.