House Bill 367

Chair’s Name: Tom Knox

Committee:Insurance

House Sponsor: Earl Carter

HB 367 requires every health plan in the state that provides coverage for prescription drugs to ensure that if a physician prescribes a drug that is not on the plan’s formulary, the pharmacist may dispense up to a ten-day supply of the prescribed drug and the health plan must cover that supply. This will allow time for the pharmacist to contact the physician for approval of an alternate drug that is on the plan’s formulary or obtain prior approval. The Commissioner is authorized to enforce this coverage and impose a $500 penalty on the health plans.

This bill comes to the Floor under the Modified Open Rule.

Chairman Knox’s Opinion of the legislation:

Patients are unable to have prescriptions filled due to a doctor not being available and prescription benefit managers not being willing to allow another drug to be used until the doctor approves. This will allow the patient to receive a limited supply until the doctor can be consulted.