MISSISSIPPI LEGISLATURE
2018 Regular Session
To: Insurance
By: Senator(s) Kirby
AN ACT TO PROVIDE THAT ALL INDIVIDUAL AND GROUP HEALTH INSURANCE CONTRACTS PROVIDING PRESCRIPTION DRUG COVERAGE IN THE STATE SHALL APPLY A PRORATED DAILY COST-SHARING RATE FOR A PARTIAL SUPPLY TO ALLOW BENEFICIARIES TO SYNCHRONIZE THEIR MEDICATIONS ON THE SAME DAY EACH MONTH; TO PROVIDE THAT THIS MEDICATION SYNCHRONIZATION AUTHORITY SHALL BE FULLY APPLICABLE TO THE STATE AND SCHOOL EMPLOYEES HEALTH INSURANCE PLAN AND THE MISSISSIPPI MEDICAID PROGRAM; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) An individual or group health insurance policy providing prescription drug coverage in the state shall permit and apply a prorated daily cost-sharing rate to prescriptions that are dispensed by a network pharmacy for a partial supply if the prescriber or pharmacist determines the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of synchronizing the patient's medications.
(2) No individual or group health insurance policy providing prescription drug coverage shall deny coverage for the dispensing of a medication that is dispensed by a network pharmacy on the basis that the dispensing is for a partial supply if the prescriber or pharmacist determines the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of synchronizing the patient's medications. The individual or group health plan must allow a pharmacy to override any denial codes indicating that a prescription is being refilled too soon for the purposes of medication synchronization.
(3) No individual or group health insurance policy providing prescription drug coverage shall use payment structures incorporating prorated dispensing fees. Dispensing fees for partially filled or refilled prescriptions shall be paid in full for each prescription dispensed, regardless of any prorated daily cost-sharing rate for the beneficiary or fee paid for alignment services.
(4) The provisions of this section shall be fully applicable to any managed health care delivery entities including the State and School Employees Health Insurance Plan and the Mississippi Medicaid Program.
SECTION 2. This act shall take effect and be in force from and after July 1, 2018.