§432:1-621 Medication synchronization; proration; dispensing fees. (a) Each hospital or medical service plan contract that provides prescription drug coverage in the State shall apply a prorated daily cost-sharing rate to prescriptions that are dispensed by a network pharmacy for less than a thirty-day supply for the purpose of medication synchronization; provided that the member patient requests or agrees to less than a thirty-day supply.
(b) For the purposes of medication synchronization under this section, the mutual benefit society that provides prescription drug coverage shall:
(1) Not deny coverage for the dispensing of a maintenance medication that is dispensed by a network pharmacy on the basis that the dispensed amount is a partial supply and the member patient requests or agrees to a partial supply; and
(2) Authorize a network pharmacy to override any denial codes indicating that a prescription is being refilled too soon.
(c) No plan contract 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 copayment for the beneficiary or fee paid for medication synchronization services.
(d) A network pharmacy shall identify an anchor prescription to which all other prescriptions may be subject to medication synchronization; provided that any medication dispensed in an unbreakable package shall not be considered the anchor prescription for purposes of this section.
(e) No schedule II narcotic controlled substance listed in section 329-16 shall be eligible for medication synchronization.
(f) For purposes of this section:
"Medication synchronization" means the coordination of medication refills that are being dispensed by a single contracted pharmacy to a member patient taking two or more medications for one or more chronic conditions so that the patient's medications are refilled on the same schedule for a given time period.
"Unbreakable package" means a medication form or package that is to be dispensed in its original container. The term "unbreakable package" includes but is not limited to eye drops, inhalers, creams, and ointments. [L 2018, c 197, §3]
Structure Hawaii Revised Statutes
432:1-101.5 Disclosure of health care coverage and benefits.
432:1-101.6 Policies relating to domestic abuse cases.
432:1-102 Applicability of other laws.
432:1-103 Applicability of this article to existing societies and union mutual benefit societies.
432:1-104.5 Bona fide trade associations.
432:1-107 Federal law compliance.
432:1-201 Incorporation by charter.
432:1-202 Constitution and bylaws; officers; government of society.
432:1-203 Actions or proceedings.
432:1-301 Registration with commissioner: certificate of registration and certificate of authority.
432:1-302 Commissioner refusal to authorize certificate or solicitation; appeal to circuit court.
432:1-303 Authority to offer death, sick, disability, or other benefits; conditions.
432:1-306 Authority to offer death, sick, disability, or other benefits; deposit or bond.
432:1-308 Suspension, revocation, or denial of certificate of authority.
432:1-402 Investments of certain mutual benefit societies.
432:1-403 Nonprofit medical, hospital indemnity associations; tax exemption.
432:1-407 Protection against insolvency.
432:1-408 Uncovered expenditures insolvency deposit.
432:1-409 Rehabilitation, liquidation, or conservation of mutual benefit societies.
432:1-410 Reserve credit for reinsurance.
432:1-501 Examination by commissioner, assistance of other officers.
432:1-502 Summary orders and supervision.
432:1-503 Closing of doors without notice.
432:1-601 Contract limitations for handicapped children and children with intellectual disabilities.
432:1-601.5 Coverage for telehealth.
432:1-602 Newborn children coverage.
432:1-602.6 Newborn adoptee; coverage.
432:1-603 Reimbursement for psychological services.
432:1-604 In vitro fertilization procedure coverage.
432:1-604.5 Contraceptive services.
432:1-605 Mammogram screening.
432:1-605.5 Mammograms; referral not required.
432:1-606 Qualified medical child support order.
432:1-607 Genetic information nondiscrimination in health insurance coverage.
432:1-608 Hospice care coverage.
432:1-610 Federally funded programs; exemption.
432:1-613 Orthodontic services for orofacial anomalies; benefits and coverage; notice.
432:1-614 Autism benefits and coverage; notice; definitions.
432:1-615 Primary care provider; advanced practice registered nurse.
432:1-617 Colon cancer screening coverage.
432:1-618 Human immunodeficiency virus and acquired immunodeficiency syndrome screening coverage.
432:1-620 Formulary; accessibility requirements.
432:1-621 Medication synchronization; proration; dispensing fees.
432:1-622 Extension of dependent coverage.
432:1-623 Prohibition of preexisting condition exclusions.
432:1-624 Prohibited discrimination in premiums or contributions.
432:1-625 Reimbursement to providers.
432:2-102 Applicability of other laws.
432:2-103.5 Policies relating to domestic abuse cases.
432:2-104 Fraternal benefit societies.
432:2-106 Representative form of government.
432:2-107 Purposes and powers.
432:2-201 Qualifications for membership.
432:2-202 Location of office, meetings, communications to members, grievance procedures.
432:2-203 No personal liability.
432:2-305 Consolidations and mergers.
432:2-306 Conversion of fraternal benefit society into mutual life insurance company.
432:2-403 Benefits not attachable.
432:2-404 The benefit contract.
432:2-404.5 Genetic information nondiscrimination in health insurance coverage.
432:2-405 Nonforfeiture benefits, cash surrender values, certificate loans and other options.
432:2-406 Mammogram coverage required; referral not required.
432:2-410 Primary care provider; advanced practice registered nurse.
432:2-604 Examination of societies; no adverse publications.
432:2-605 Foreign or alien society, admission.
432:2-606 Injunction, liquidation, receivership of domestic society.
432:2-607 Suspension, revocation or refusal of license of foreign or alien society.
432:2-609 Licensing of producers.
432:2-610 Unfair methods of competition and unfair and deceptive acts and practices.
432:2-611 Federal law compliance.