MPA Request for Comments: House Bill 4293 – Clarifies dispensing of a 90-day supply of maintenance prescription drugs
Issue Summary HB 4293 Rep. Garza (D – Taylor) has introduced legislation that would require an insurance company that provides prescription drug coverage to fill a 90-day supply of a maintenance drug through the end of the calendar year as long as the remaining duration of coverage for the insured is at least 90 days.
Proposed Regulatory Citations:
SEC. 3406U. AN INSURER THAT DELIVERS, ISSUES FOR DELIVERY, OR RENEWS IN THIS STATE A POLICY OF HEALTH INSURANCETHAT PROVIDES PRESCRIPTION DRUG COVERAGE SHALL NOT DENY A CLAIM FOR A REFILL OF A 90-DAY SUPPLY OF A MAINTENANCE PRESCRIPTION DRUG THAT MEETS ALL PRIOR AUTHORIZATION REQUIREMENTS SPECIFIC TO THAT MAINTENANCE PRESCRIPTION DRUG AT THE TIME OF THE REFILL REQUEST MERELY BECAUSE IT IS AT THE END OF THE CALENDAR YEAR IF THE REMAINING DURATION OF COVERAGE FOR THE INSURED OR ENROLLEE IS AT LEAST 90 DAYS.