HOUSE DOCKET, NO. 560        FILED ON: 1/25/2021

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1068

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Shawn Dooley

_________________

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 adoption of the accompanying bill:

An Act requiring continual coverage of prescription medication.

_______________

PETITION OF:

HOUSE DOCKET, NO. 560        FILED ON: 1/25/2021

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1068

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 959 OF 2019-2020.]

The Commonwealth of Massachusetts

_______________

In the One Hundred and Ninety-Second General Court
(2021-2022)

_______________

An Act requiring continual coverage of prescription medication.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 32A of the General Laws is hereby amended by inserting after section 17O,  inserted by section 1 of chapter 233 of the acts of 2016, the following section:-

Section 17P. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall provide coverage for any prescription medication previously prescribed to the insured for a preexisting condition, and previously covered under the insured’s prior health insurance plan licensed in the commonwealth, or a comparable equivalent or generic medication approved to treat such condition; provided, however, that if the coverage provided is for a comparable equivalent or generic medication, prior approval of the prescriber is required.  The prescriber shall submit to the insurance provider proof of such preexisting condition and preexisting prescription for medication.

SECTION 2. Chapter 175 of the General Laws is hereby amended by inserting after section 47II, inserted by section 3 of chapter 233 of the acts of 2016, the following section:-

47JJ. Any policy of accident and sickness insurance issued pursuant to section 108, and any group blanket policy of accident and sickness insurance pursuant to section 110 that is delivered, issued or renewed by agreement within or without the commonwealth shall provide coverage for any prescription medication previously prescribed to the insured for a preexisting condition, and previously covered under the insured’s prior health insurance plan licensed in the commonwealth, or a comparable equivalent or generic medication approved to treat such condition; provided, however, that if the coverage provided is for a comparable equivalent or generic medication, prior approval of the prescriber is required.  The prescriber shall submit to the insurance provider proof of such preexisting condition and preexisting prescription for medication.

SECTION 3. Chapter 176A of the General Laws is hereby amended by inserting after section 8KK, as inserted by section 4 of chapter 233 of the acts of 2016, the following section:-

8LL. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall provide coverage for any prescription medication previously prescribed to the insured for a preexisting condition, and previously covered under the insured’s prior health insurance plan licensed in the commonwealth, or a comparable equivalent or generic medication approved to treat such condition; provided, however, that if the coverage provided is for a comparable equivalent or generic medication, prior approval of the prescriber is required.  The prescriber shall submit to the insurance provider proof of such preexisting condition and preexisting prescription for medication.

SECTION 4. Chapter 176B of the General Laws is hereby amended by inserting after section 4KK, inserted by section 5 of chapter 233 of the acts of 2016, the following section:-

4LL. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for any prescription medication previously prescribed to the insured for a preexisting condition, and previously covered under the insured’s prior health insurance plan licensed in the commonwealth, or a comparable equivalent or generic medication approved to treat such condition; provided, however, that if the coverage provided is for a comparable equivalent or generic medication, prior approval of the prescriber is required.  The prescriber shall submit to the insurance provider proof of such preexisting condition and preexisting prescription for medication.

SECTION 5. Chapter 176G of the General Laws is hereby amended by inserting after section 4CC, inserted by section 6 of chapter 233 of the acts of 2016, the following section:-

4DD.  Any individual or group health maintenance contract shall provide coverage for any prescription medication previously prescribed to the insured for a preexisting condition, and previously covered under the insured’s prior health insurance plan licensed in the commonwealth, or a comparable equivalent or generic medication approved to treat such condition; provided, however, that if the coverage provided is for a comparable equivalent or generic medication, prior approval of the prescriber is required.  The prescriber shall submit to the insurance provider proof of such preexisting condition and preexisting prescription for medication.