July 14, 2015
On June 19, 2015, the Arizona Department of Insurance published Regulatory Bulletin 2015-05, which summarizes significant newly enacted legislation relating to insurance in Arizona. Only one piece of legislation impacts health insurance coverage: SB 1288.
SB 1288 was signed April 1, 2015, creating Chapter 159. This law relates to prescription drug coverage and medication synchronization. Under the law, policies that provide prescription drug coverage may not deny coverage and must prorate the cost-sharing rate for a prescription drug if it is dispensed by a pharmacy for less than the standard refill amount. For that to apply, the covered individual must request enrollment into a medication synchronization program and must request less than the standard refill amount for the purpose of synchronizing their medications. For this purpose, ‘medical synchronization’ is defined as the coordination of medication refills for a patient taking two or more medications for a chronic condition that are being dispensed by a single pharmacy to facilitate the synchronization of the patient’s medication for the purpose of improving medication adherence. Chapter 159 is effective for plans and policies issued or renewed on or after Jan. 1, 2017.
The new law does not create additional employer compliance obligations, but employers will want to be aware of the new law in case questions arise relating to prescription drug coverage for employees enrolled in fully insured plans.
Bulletin 2015-05 » Chapter 159 »