HF 1304

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:48am

A bill for an act
relating to health; requiring coverage for certain anti-epileptic drugs; prohibiting
pharmacists from substituting anti-epileptic drugs without consent; proposing
coding for new law in Minnesota Statutes, chapters 62Q; 151.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62Q.528] NONFORMULARY ANTI-EPILEPTIC DRUGS;
REQUIRED COVERAGE.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms
have the meanings given them.
new text end

new text begin (b) "Anti-epileptic drug" means any drug prescribed for the treatment of epilepsy or
a drug used to treat or prevent seizures.
new text end

new text begin (c) "Epilepsy" means a neurological condition characterized by recurrent seizures.
new text end

new text begin (d) "Health plan" has the meaning given in section 62Q.01, subdivision 3, but
includes the coverages described in section 62A.011, subdivision 3, clauses (7) and (10).
new text end

new text begin (e) "Seizure" means an acute clinical change secondary to a brief disturbance in
the electrical activity of the brain.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage for anti-epileptic drugs. new text end

new text begin (a) A health plan that
provides prescription drug coverage must provide coverage for an anti-epileptic drug
prescribed to treat epilepsy or treat or prevent seizures regardless of whether the drug is in
the health plan's drug formulary, if the health care provider prescribing the drug certifies
in writing to the health plan company that the health care provider has considered all
equivalent drugs in the health plan's drug formulary and has determined that the drug
prescribed will best treat the patient's condition.
new text end

new text begin (b) The health plan is not required to provide coverage for a drug if the drug was
removed from the health plan's drug formulary for safety reasons.
new text end

new text begin (c) For drugs covered under this section, no health plan company that has received a
certification from the health care provider, as described in paragraph (a), may:
new text end

new text begin (1) impose a special deductible, co-payment, coinsurance, or other special payment
requirement that the health plan does not apply to drugs that are in the health plan's drug
formulary; or
new text end

new text begin (2) require written certification from the prescribing provider each time a prescription
is refilled or renewed that the drug prescribed will best treat the patient's condition.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

new text begin [151.2101] ANTI-EPILEPTIC DRUGS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section, the following
definitions apply:
new text end

new text begin (1) "anti-epileptic drug" means any drug prescribed for the treatment of epilepsy or
a drug used to treat or prevent seizures;
new text end

new text begin (2) "epilepsy" means a neurological condition characterized by recurrent seizures;
and
new text end

new text begin (3) "seizure" means an acute clinical change secondary to a brief disturbance in
the electrical activity of the brain.
new text end

new text begin Subd. 2. new text end

new text begin Substitution prohibited. new text end

new text begin A pharmacist may not dispense an anti-epileptic
drug or formulation of an anti-epileptic drug that is different from the one ordered or
prescribed without first obtaining signed, written informed consent from the prescribing
physician and the patient or the patient's parent, legal guardian, or spouse.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end