OPA Announces Passage of the Uniform Prescription Drug Card Bill !OPA is pleased to announce that after three years of hard work, SB 43, the Uniform Prescription Drug Card Bill, sponsored by Senator Robert Spada, was voted out of the Ohio Senate on Wednesday, April 21, 2004 by a unanimous vote of 33-0.
As passed out of the Senate, SB 43 would require health care plans providing prescription drug benefits to use a standardized identification card or other standardized technology in the processing of claims. The card or technology must be in a format approved by NCPDP or include the following information:
(a) the health insurer’s name;
(b) the insured person’s name, group number, and identification number;
(c) a telephone number to inquire about pharmacy-related issues;
(d) the issuer’s international identification number labeled as “ANSI BIN” or “RxBIN;”
(e) the processor’s control number, labeled as “RxPCN;”
(f) the insured person’s pharmacy benefits group number if different from the person’s medical group number, labeled as “RxGrp.”
If there is a change in the information contained in the standardized identification card or the electronic technology issued to an insured person, the health insurer must issue a new card or electronic technology to the person. The bill doesn’t require a health insurer to issue a new card or electronic technology to an insured person more than once during a 12-month period. If changes occur, this legislation would allow the insurer to issue a sticker to be placed on the benefits’ card to announce the new or changed information.
The bill’s requirements apply to sickness and accident insurers and health insuring corporations. The bill’s requirements also apply to persons contracted by sickness and accident insurers and health insuring corporations to provide managerial or administrative services, as well as to pharmacy benefit managers and to health benefit plans administered by the state.
The bill’s requirements do not apply to the following:
(2) Medicare Advantage; individual or group policies of sickness and accident insurance that cover only accident, credit, dental, disability income, long-term care, hospital indemnity, Medicare, Medicare supplement, Tricare, specified disease, or vision care;
(3) one-time limited duration policies of six months or less;
(4) coverage issued as a supplement to liability insurance;
(5) insurance arising out of workers’ compensation or similar law;
(6) automobile medical payment insurance;
(7) insurance under which benefits are payable regardless of fault that is required by statute to be contained in any liability insurance policy or equivalent self-insurance.
We are only halfway there.
We still need your help! Now is the time to contact your state representative and tell them how important this bill is and what it means to your business. Tell them you want the bill as passed unanimously by the State Senate. If you need help finding out who your representative is, go to www.ohiopharmacists.org/leginfo.html and click on Contact Your State Representative. Write a letter and feel free to give examples of why this legislation is important to you, or call their district office and speak to them personally. It is vitally important that the legislators understand the importance of this legislation. There is only a short time left in this General Assembly. We must make it count!
If you have questions or concerns about this article, please contact Kelly Vyzral, Director of Government Affairs, at 614.798.0037, or firstname.lastname@example.org.
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