HB 178 – Access to Prescription Drug Cost Information
Primary House Sponsors: Rep. Wayne Sasser (R-Cabarrus, Rowan, Stanly); Rep. Gale Adcock (D-Wake); Rep. Larry Potts (R-Davidson); Rep. Kristin Baker, MD (R-Cabarrus)
Summary
This bill enacts of series of requirements related to prescription Drug Benefit Cost information. Specifically, this bill:
- Requires health benefit plans, pharmacy benefits managers, or any entities’ action on behalf of a health benefit plan to electronically provide certain patient-specific prescription drug benefit information to inform patient prescription price transparency.
- Notes that patient prescription price transparency technology must not be prohibited from displaying patient financial and resource assistance when that information is available for the prescribed medication.
- Requires requests for patient-specific drug benefit and cost information to be sent and received in real time.
- Requires electronic health records to display the most up-to-date patient eligibility information in real time.
- Notes that the requirements should not interfere with patient choice or a clinician’s ability to convey the full range of prescription drug cost options to a patient.
- Prohibits any restriction on a health care professional’s ability to communicate prescription cost options to a patient.
- Prohibits payors from blocking the display of patient-specific prescription drug benefit and cost information at the point of prescribing that reflects options available for covering the costs of the prescription other than what might be available under the patient’s health benefit plan.
- Requires health care professionals to communicate to a patient the most therapeutically appropriate treatment for the patient’s diagnosis and prescription drug cost information.
Movement
Filed – 2/25/2021