MISSISSIPPI LEGISLATURE

1999 Regular Session

To: Insurance

By: Representative Hudson

AN ACT TO REQUIRE THE ISSUER OF ANY PHARMACY BENEFIT CARD TO ANY MEMBER OF A PRESCRIPTION DRUG PROGRAM IN MISSISSIPPI TO INCLUDE ON THE FACE OF THE CARD ALL OF THE INFORMATION NEEDED FOR A PARTICIPATING PHARMACY TO TRANSMIT A CLAIM TO THE CLAIMS PROCESSOR IN A TIMELY MANNER; TO SPECIFY THE MINIMUM INFORMATION THAT MUST BE PROVIDED ON A PHARMACY BENEFIT CARD; TO PROVIDE A PENALTY FOR ANY ISSUER OF A PHARMACY BENEFIT CARD THAT DOES NOT CONTAIN THE REQUIRED INFORMATION; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. (1) As used in this section:

(a) "Pharmacy benefit card" means the program identification card of a member or participant of a prescription drug program that allows the holder to obtain a prescription drug, generally at a discount, from a pharmacy that participates in the prescription drug program.

(b) "Prescription drug program" means a program or plan that provides coverages and benefits for prescription drugs for members or participants in the program, whether the program is a separate program or part of a health benefit plan.

(2) The sponsor, vendor or claims processor of a prescription drug program that issues the pharmacy benefit cards to members or participants in the prescription drug program

shall not issue any pharmacy benefit card to any resident of the State of Mississippi, unless the card contains all of the information that is necessary for a participating pharmacy to transmit a claim to the claims processor in a timely manner without causing undue delay for the cardholder. The information shall be displayed on the face of the card in a readily retrievable manner and shall be properly identified. At a minimum, the card shall contain the following information:

(a) The name, birth date and sex of the cardholder, and the relationship of the cardholder to the member or participant in the prescription drug program;

(b) The name of the claims processor for the prescription drug program;

(c) The group number, if required by the program sponsor or claims processor to process a claim;

(d) The dependent code, if required by the program sponsor or claims processor to process a claim;

(e) A toll-free telephone number to the claims processor where a pharmacy can receive timely assistance in transmitting a claim to the processor; and

(f) Any other information that is necessary for a pharmacy to transmit a claim to the claims processor in a timely manner.

(3) Any provision in any prescription drug program or health benefit plan that is executed, delivered, renewed or otherwise contracted for in the State of Mississippi that is not in compliance with the requirements of subsection (2) of this section shall be void to the extent of the noncompliance.

(4) Any person who issues a pharmacy benefit card to any resident of the State of Mississippi that does not contain the information required by subsection (2) of this section is guilty of a misdemeanor and, upon conviction, shall be fined not more than One Thousand Dollars ($1,000.00), or imprisoned for not more than six (6) months in the county jail, or both.

SECTION 2. This act shall take effect and be in force from and after July 1, 1999.