Hawaii Revised Statutes
432. Benefit Societies
432:1-621 Medication synchronization; proration; dispensing fees.

§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

Hawaii Revised Statutes

Title 24. Insurance

432. Benefit Societies

432:1-101 Scope; exemptions.

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 Definitions.

432:1-104.5 Bona fide trade associations.

432:1-105 Penalty.

432:1-106 REPEALED.

432:1-107 Federal law compliance.

432:1-107.5 Prohibition on rescissions of coverage. (a) Notwithstanding sections 431:10-226.5 and 431:10A-106 to the contrary, a society shall not rescind coverage under a health benefit plan with respect to an individual, including a group to which...

432:1-108 Fees.

432:1-201 Incorporation by charter.

432:1-202 Constitution and bylaws; officers; government of society.

432:1-203 Actions or proceedings.

432:1-204 Foreign societies.

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.

432:1-304 Authority to offer death, sick, disability, or other benefits; special deposit and control of certain funds.

432:1-305 Authority to offer death, sick, disability, or other benefits; restrictions on use of funds.

432:1-306 Authority to offer death, sick, disability, or other benefits; deposit or bond.

432:1-307 REPEALED.

432:1-308 Suspension, revocation, or denial of certificate of authority.

432:1-401 REPEALED.

432:1-402 Investments of certain mutual benefit societies.

432:1-403 Nonprofit medical, hospital indemnity associations; tax exemption.

432:1-404 Annual exhibits.

432:1-405 Annual audit.

432:1-406 Definitions.

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.

432:1-602.5 Coverage for child health supervision services. (a) All individual and group hospital and medical service corporation contracts which provide coverage for the children of the subscriber shall provide coverage for child health supervision...

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.

432:1-607.3 Nondiscrimination on the basis of actual gender identity or perceived gender identity; coverage for services.

432:1-608 Hospice care coverage.

432:1-609 Medical foods and low-protein modified food products; treatment of inborn error of metabolism; notice.

432:1-610 Federally funded programs; exemption.

432:1-611 REPEALED.

432:1-612 Diabetes coverage.

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.

432:1-616 Cancer treatment.

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.

432:2-101 Scope of article.

432:2-102 Applicability of other laws.

432:2-103 Definitions.

432:2-103.5 Policies relating to domestic abuse cases.

432:2-104 Fraternal benefit societies.

432:2-105 Lodge system.

432:2-106 Representative form of government.

432:2-107 Purposes and powers.

432:2-108 Fees.

432:2-201 Qualifications for membership.

432:2-202 Location of office, meetings, communications to members, grievance procedures.

432:2-203 No personal liability.

432:2-204 Waiver.

432:2-301 Organization.

432:2-302 Amendments to laws.

432:2-303 Institutions.

432:2-304 Reinsurance.

432:2-305 Consolidations and mergers.

432:2-306 Conversion of fraternal benefit society into mutual life insurance company.

432:2-401 Benefits.

432:2-402 Beneficiaries.

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.

432:2-501 Investments.

432:2-502 Funds.

432:2-503 Taxation.

432:2-601 Valuations.

432:2-602 Reports.

432:2-603 Annual license.

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.

432:2-608 Injunction.

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.

432:2-701 Service of process.

432:2-702 Review.

432:2-703 Penalties.

432:2-704 Exemption of certain societies.

432:2-705 Severability.