Bill
Number: S.B. 1288
Yee
Floor Amendment
Reference
to: printed bill
Amendment
drafted by: Fareed Bailey
FLOOR
AMENDMENT EXPLANATION
The Yee floor amendment does the following:
1. Prohibits health
plans with prescription drug benefits from denying coverage for approved
prescription drugs if the patient requests:
a) enrollment into a
medication synchronization program; and
b) less than the
standard refill amount for the purpose of synchronizing their medications.
2. Requires health plans
to accept early refill and short fill requests for approved prescription drugs
using:
a) submission
clarification and message codes adopted by the National Council for
Prescription Drug Plans; or
b) alternative codes
provided by the plans on the effective date of the bill.
3. Clarifies that medication
synchronization applies to the coordination of refills for two or more
medications for a chronic condition that are dispensed by a single
contracted pharmacy to synchronize patient medications so as to improve
medication adherence.
4. Changes the
applicability of the bill’s provisions from health plans that are in effect
January 1, 2016 to those that are in effect January 1, 2017.
Page 1, line 7, strike “2016” insert “2017”
Line 10, strike the colon
Strike lines 11 through 23, insert “THE SUBSCRIBER REQUESTS ENROLLMENT INTO A MEDICATION
SYNCHRONIZATION PROGRAM AND LESS THAN THE STANDARD REFILL AMOUNT FOR THE
PURPOSE OF SYNCHRONIZING THE SUBSCRIBER’S MEDICATIONS.
2. SHALL ACCEPT EARLY
REFILL AND SHORT FILL REQUESTS FOR PRESCRIPTION DRUGS USING THE SUBMISSION
CLARIFICATION AND MESSAGE CODES AS ADOPTED BY THE NATIONAL COUNCIL FOR
PRESCRIPTION DRUG PLANS OR ALTERNATIVE CODES PROVIDED BY THE PLAN UPON THE
EFFECTIVE DATE OF THIS ACT.”
Strike lines 26 and 27, insert “MEDICATIONS FOR A CHRONIC CONDITION THAT ARE BEING
DISPENSED BY A SINGLE CONTRACTED PHARMACY TO FACILITATE THE SYNCHRONIZATION OF
THE PATIENT’S MEDICATIONS FOR THE PURPOSE OF IMPROVING MEDICATION ADHERENCE.”
Line 33, strike “2016” insert “2017”
Line 36, strike the colon
Strike lines 37 through 43
Page 2, strike lines 1 through 6, insert “THE ENROLLEE REQUESTS ENROLLMENT INTO A MEDICATION SYNCHRONIZATION
PROGRAM AND LESS THAN THE STANDARD REFILL AMOUNT FOR THE PURPOSE OF
SYNCHRONIZING THE ENROLLEE’S MEDICATIONS.
2. SHALL ACCEPT EARLY
REFILL AND SHORT FILL REQUESTS FOR PRESCRIPTION DRUGS USING THE SUBMISSION
CLARIFICATION AND MESSAGE CODES AS ADOPTED BY THE NATIONAL COUNCIL FOR
PRESCRIPTION DRUG PLANS OR ALTERNATIVE CODES PROVIDED BY THE PLAN UPON THE
EFFECTIVE DATE OF THIS ACT.”
Strike lines 9 and 10, insert “MEDICATIONS FOR A CHRONIC CONDITION THAT ARE BEING
DISPENSED BY A SINGLE CONTRACTED PHARMACY TO FACILITATE THE SYNCHRONIZATION OF
THE PATIENT’S MEDICATIONS fOR THE PURPOSE OF IMPROVING MEDICATION ADHERENCE.”
Page 2, line 16, strike “2016” insert “2017”
Line 19, strike the colon
Strike lines 20 through 32, insert “THE INSURED REQUESTS ENROLLMENT INTO A MEDICATION
SYNCHRONIZATION PROGRAM AND LESS THAN THE STANDARD REFILL AMOUNT FOR THE
PURPOSE OF SYNCHRONIZING THE INSURED’S MEDICATIONS.
2. SHALL ACCEPT EARLY
REFILL AND SHORT FILL REQUESTS FOR PRESCRIPTION DRUGS USING THE SUBMISSION
CLARIFICATION AND MESSAGE CODES AS ADOPTED BY THE NATIONAL COUNCIL FOR
PRESCRIPTION DRUG PLANS OR ALTERNATIVE CODES PROVIDED BY THE PLAN UPON THE
EFFECTIVE DATE OF THIS ACT.”
Strike lines 35 and 36, insert “MEDICATIONS FOR A CHRONIC CONDITION THAT ARE BEING DISPENSED
BY A SINGLE CONTRACTED PHARMACY TO FACILITATE THE SYNCHRONIZATION OF THE
PATIENT’S MEDICATIONS FOR THE PURPOSE OF IMPROVING MEDICATION ADHERENCE.”
Line 42, strike “2016” insert “2017”
Page 3, line 3, strike the colon
Strike lines 4 through 16, insert “THE INSURED REQUESTS ENROLLMENT INTO A MEDICATION
SYNCHRONIZATION PROGRAM AND LESS THAN THE STANDARD REFILL AMOUNT FOR THE
PURPOSE OF SYNCHRONIZING THE INSURED’S MEDICATIONS.
2. SHALL ACCEPT EARLY
REFILL AND SHORT FILL REQUESTS FOR PRESCRIPTION DRUGS USING THE SUBMISSION
CLARIFICATION AND MESSAGE CODES AS ADOPTED BY THE NATIONAL COUNCIL FOR
PRESCRIPTION DRUG PLANS OR ALTERNATIVE CODES PROVIDED BY THE PLAN UPON THE
EFFECTIVE DATE OF THIS ACT.”
Strike lines 19 and 20, insert “MEDICATIONS FOR A CHRONIC CONDITION THAT ARE BEING
DISPENSED BY A SINGLE CONTRACTED PHARMACY TO FACILITATE THE SYNCHRONIZATION OF
THE PATIENT’S MEDICATIONS FOR THE PURPOSE OF IMPROVING MEDICATION ADHERENCE.”
Amend title to conform