SENATE DOCKET, NO. 2070 FILED ON: 3/24/2009
SENATE . . . . . . . . . . . . . . No. 2099
The Commonwealth of Massachusetts
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PRESENTED BY:
Jennifer L. Flanagan
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To the Honorable Senate and House of
Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the passage of the accompanying bill:
An Act Ensuring continuity of care for patients taking prescripti
on medicines.
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PETITION OF:
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Name:
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District/Address:
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Jennifer L. Flanagan
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Worcester and Middlesex
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The Commonwealth of Massachusetts
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In the Year Two Thousand and Nine
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An Act Ensuring continuity of care
for patients taking prescription medicines.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
Notwithstanding
the provisions of any general or special law, regulation or
requirement
to the contrary, a
health insurance policy or health care service plan contract, that covers prescription drugs shall not limit, reduce, or deny coverage for any drug, if prior to the limitation, reduction, or denial of coverage:
(1)
the
insured was using the drug;
(2)
the
insured was covered under the policy or contract; and
(3)
the
drug was covered under the policy or contract.
A limitation, reduction, or denial of coverage includes removing a drug from the formulary or other drug li
st, imposing new prior authorization or other utilization management tools, or placing the drug on a formulary tier that increases the patient's cost sharing obligations or otherwise increases the patient's cost sharing obligations.
Nothing in this pro
vision shall prohibit an insurer from making uniform changes in its benefit design that applies to all covered drugs or from increasing cost-sharing obligations merely due to a percentage coinsurance payment that necessarily increases with an increase in t
he underlying drug prices.
