House Bill #5486 (2017)

AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

Provides full year insurance coverage for all forms of FDA-approved contraceptives and would provide coverage thereto.

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  • 2017 – H 5486
  • 2017 – H 5486 SUBSTITUTE A
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  • LC001206
  • LC001206/SUB A/2
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  • S TATE OF RHODE IS L AND
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2017
  • ____________
  • A N A C T
  • RELATING TO INSURANCE – ACCIDENT AND SICKNESS INSURANCE POLICIES
  • Introduced By: Representatives Kazarian, Regunberg, Blazejewski, Fogarty, and Tanzi
  • Date Introduced: February 15, 2017
  • Referred To: House Corporations
  • It is enacted by the GeneralAssembly as follows:
  • SECTION 1. Chapter 23-1 of the General Laws entitled "Department of Health" is hereby amended by adding thereto the following section:
  • 23-1-59. Emergency contraception.
  • (a) As used in this section "emergency contraception" shall, unless the context clearly requires otherwise, mean any drug approved by the Federal Food and Drug Administration as a contraceptive method for use after sexualintercourse.
  • (b) Notwithstanding any other general, public or special law to the contrary, a licensed doctor, professional nurse or pharmacist may dispense emergency contraception in accordance with written, standardized procedures or protocols developed by an actively practicing physician registered with the department to distribute or dispense a controlled substance in the course of professional practice pursuant to title 23 if such procedures or protocols are filed at the pharmacist's place of practice and with the department.
  • (c) Before dispensing emergency contraception authorized under this section, a pharmacist shall complete a training program approved by the commissioner on emergency contraception, which training shall include, but not be limited to, proper documentation, quality assurance, and referral to additional services, including appropriate recommendation that the patient follow up with a medicalpractitioner.
  • (d) A pharmacist dispensing emergency contraception under this section shall annually provide to the department of health the number of times such emergency contraception is dispensed. Reports made pursuant to this section shall not identify any individual patient, shall be confidential and shall not be public records.
  • (e) The department of health, board of medical licensure and discipline, and board of registration in pharmacy shall adopt rules and regulations necessary to implement this section.
  • SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section:
  • 27-18-83. Health insurance contracts - Full year coverage for contraception.
  • (a) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • (b) Subsection (a) of this section shall not apply to self-insured employee welfare benefit plans established pursuant to the Federal Employee Retirement Income Security Act of 1974, 29 U.S.C. §§1001 et seq.
  • (c) Nothing in this section shall be construed as requiring a health insurance carrier to cover any prescription contraceptive that it does not currently cover or require any pharmacy to dispense any medication that it does not currently dispense.
  • (d) This section shall be applicable to all contracts, plans, or policies of:
  • (1) All health insurers subject to this title;
  • (2) All group and blanket health insurers subject to this title;
  • (3) All nonprofit hospital, medical, surgical, dental, and health service corporations;
  • (4) All health maintenance organizations;
  • (5) Any provision of medical, hospital, surgical, and funeral benefits, and of coverage against accidental death or injury, when the benefits or coverage are incidentalto or part of other insurance authorized by the laws of this state;
  • (6) All health care facilities, as defined in §23-17-2;
  • (7) All pharmacies subject to the provisions of chapter 19.1 of title 5; and
  • (8) Family planning centers and essentialcommunity providers.
  • SECTION 3. Section 27-18-57 of the General Laws in Chapter 27-18 entitled "Accident and Sickness Insurance Policies" is hereby amended to read as follows:
  • 27-18-57. F.D.A. approved prescription contraceptive drugs and devices.
  • (a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for F.D.A. approved contraceptive drugs and devices requiring a prescription. Provided,
  • LC001206 - Page 2of 12 that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.
  • (b) Every individual or group health insurance contract plan or policy licensed pursuant to this title that is issued, amended, renewed, effective or delivered on or after January 1, 2018, shall provide coverage for allof the following services and contraceptive methods:
  • (1) All FDA-approved contraceptive drugs, devices, and other products. This includes all FDA-approved over-the-counter contraceptive drugs, devices, and products as prescribed or as otherwise authorized under state or federallaw. The following applies to this coverage:
  • (i) Where the FDA has approved one or more therapeutic and pharmaceuticalequivalent, as defined by the FDA, versions of a contraceptive drug, device, or product, a group or blanket policy is not required to include all such therapeutic and pharmaceutical equivalent versions in its formulary, so long as at least one is included and covered without cost-sharing and in accordance with this subsection;
  • (ii) If the covered therapeutic and pharmaceutical equivalent versions of a drug, device, or product are not available or are deemed medically inadvisable a group or blanket policy shall provide coverage for an alternate therapeutic and pharmaceutical equivalent version of the contraceptive drug, device, or product without cost-sharing;
  • (iii) This coverage shall include emergency contraception without cost-sharing when provided pursuant to an ordinary prescription, or a non-patient specific regimen order, and when lawfully provided other than through a prescription or order; and
  • (iv) This coverage must allow for the dispensing of a twelve (12) month supply of a contraceptive at one time;
  • (2) Voluntary sterilization procedures;
  • (3) Patient education and counseling on contraception; and
  • (4) Follow-up services related to the drugs, devices, products, and procedures covered under this subsection, including, but not limited to, management of side effects, counseling for continued adherence, and device insertion and removal.
  • (c) A group or blanket policy subject to this subsection shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this subsection.
  • (d) Except as otherwise authorized under this subsection, a group or blanket policy shall not impose any restrictions or delays on the coverage required under this subsection.
  • (e) Benefits for an enrollee under this subsection shall be the same for an enrollee's covered spouse or domestic partner and covered non-spouse dependents.
  • LC001206 - Page 3of 12
  • (b)(f) Notwithstanding any other provision of this section, any insurance company may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c)(g) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • (d)(h) This section does not apply to insurance coverage providing benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare supplement; (6) limited benefit health; (7) specified diseased indemnity; (8) sickness of bodily injury or death by accident or both; and (9) other limited benefit policies.
  • (e)(i) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • SECTION 4. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section:
  • SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section:
  • 27-18-83. Health insurance contracts - Full year coverage for contraception.
  • Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 2. Section 27-18-57 of the General Laws in Chapter 27-18 entitled "Accident and Sickness Insurance Policies" is hereby amended to read as follows:
  • 27-18-57. F.D.A. approved prescription contraceptive drugs and devices.
  • (a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for F.D.A. approved contraceptive drugs and devices requiring a prescription. Provided, that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.
  • (b) Notwithstanding any other provision of this section, any insurance company may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • (d) This section does not apply to insurance coverage providing benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare supplement; (6) limited benefit health; (7) specified diseased indemnity; (8) sickness of bodily injury or death by accident or both; and (9) other limited benefit policies.
  • (e) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • (f) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section:
  • 27-19-74. Health insurance contracts - Full year coverage for contraception.
  • (a) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • (b) Subsection (a) of this section shall not apply to self-insured employee welfare benefit plans established pursuant to the Federal Employee Retirement Income Security Act of 1974, 29 U.S.C. §§1001 et seq.
  • (c) Nothing in this section shall be construed as requiring a health insurance carrier to cover any prescription contraceptive that it does not currently cover or require any pharmacy to dispense any medication that it does not currently dispense.
  • (d) This section shall be applicable to all contracts, plans, or policies of:
  • (1) All health insurers subject to this title;
  • (2) All group and blanket health insurers subject to this title;
  • (3) All nonprofit hospital, medical, surgical, dental, and health service corporations;
  • (4) All health maintenance organizations;
  • (5) Any provision of medical, hospital, surgical, and funeral benefits, and of coverage against accidental death or injury, when the benefits or coverage are incidentalto or part of other insurance authorized by the laws of this state;
  • LC001206 - Page 4of 12
  • (6) All health care facilities, as defined in §23-17-2;
  • (7) All pharmacies subject to the provisions of chapter 19.1 of title 5; and
  • (8) Family planning centers and essentialcommunity providers.
  • SECTION 5. Section 27-19-48 of the General Laws in Chapter 27-19 entitled "Nonprofit Hospital Service Corporations" is hereby amended to read as follows:
  • Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 4. Section 27-19-48 of the General Laws in Chapter 27-19 entitled "Nonprofit Hospital Service Corporations" is hereby amended to read as follows:
  • 27-19-48. F.D.A. approved prescription contraceptive drugs and devices.
  • (a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for F.D.A. approved contraceptive drugs and devices requiring a prescription. Provided, that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.
  • (b) Every individual or group health insurance contract, plan or policy licensed pursuant to this title that is issued, amended, renewed, effective or delivered on or after January 1, 2018, shall provide coverage for allof the following services and contraceptive methods:
  • (1) All FDA-approved contraceptive drugs, devices, and other products. This includes all FDA-approved over-the-counter contraceptive drugs, devices, and products as prescribed or as otherwise authorized under state or federallaw. The following applies to this coverage:
  • (i) Where the FDA has approved one or more therapeutic and pharmaceutical equivalent, as defined by the FDA, versions of a contraceptive drug, device, or product, a contract is not required to include all such therapeutic and pharmaceutical equivalent versions in its formulary, so long as at least one is included and covered without cost-sharing and in accordance with this subsection;
  • (ii) If the covered therapeutic and pharmaceutical equivalent versions of a drug, device, or product are not available or are deemed medically inadvisable a contract shall provide coverage for an alternate therapeutic and pharmaceutical equivalent version of the contraceptive drug, device, or product without cost-sharing;
  • (iii) This coverage shall include emergency contraception without cost-sharing when provided pursuant to an ordinary prescription, or a non-patient specific regimen order, and when lawfully provided other than through a prescription or order; and
  • (iv) This coverage must allow for the dispensing of a twelve (12) month supply of a contraceptive at one time;
  • (2) Voluntary sterilization procedures;
  • (3) Patient education and counseling on contraception; and
  • (4) Follow-up services related to the drugs, devices, products, and procedures covered
  • LC001206 - Page 5of 12 under this subsection, including, but not limited to, management of side effects, counseling for continued adherence, and device insertion and removal.
  • (c) A contract subject to this subsection shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this subsection.
  • (d) Except as otherwise authorized under this subsection, a contract shallnot impose any restrictions or delays on the coverage required under this subsection.
  • (e) Benefits for an enrollee under this subsection shall be the same for an enrollee's covered spouse or domestic partner and covered non-spouse dependents.
  • (b)(f) Notwithstanding any other provision of this section, any hospital service corporation may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c)(g) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • (d)(h) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • SECTION 6. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section:
  • 27-20-70. Health insurance contracts - Full year coverage for contraception.
  • (a) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • (b) Subsection (a) of this section shall not apply to self-insured employee welfare benefit plans established pursuant to the Federal Employee Retirement Income Security Act of 1974, 29 U.S.C. §§1001 et seq.
  • (c) Nothing in this section shall be construed as requiring a health insurance carrier to cover any prescription contraceptive that it does not currently cover or require any pharmacy to dispense any medication that it does not currently dispense.
  • (d) This section shall be applicable to all contracts, plans, or policies of:
  • (1) All health insurers subject to this title;
  • (2) All group and blanket health insurers subject to this title;
  • LC001206 - Page 6of 12
  • (3) All nonprofit hospital, medical, surgical, dental, and health service corporations;
  • (4) All health maintenance organizations;
  • (5) Any provision of medical, hospital, surgical, and funeral benefits, and of coverage against accidental death or injury, when the benefits or coverage are incidentalto or part of other insurance authorized by the laws of this state;
  • (6) All health care facilities, as defined in § 23-17-2;
  • (7) All pharmacies subject to the provisions of chapter 19.1 of title 5; and
  • (8) Family planning centers and essentialcommunity providers.
  • SECTION 7. Section 27-20-43 of the General Laws in Chapter 27-20 entitled "Nonprofit Medical Service Corporations" is hereby amended to read as follows:
  • 27-20-43. F.D.A. approved prescription contraceptive drugs and devices.
  • (a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for F.D.A. approved contraceptive drugs and devices requiring a prescription. Provided, that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.
  • (b) Every individual or group health insurance contract, plan or policy licensed pursuant to this title that is issued, amended, renewed, effective or delivered on or after January 1, 2018, shall provide coverage for allof the following services and contraceptive methods:
  • (1) All FDA-approved contraceptive drugs, devices, and other products. This includes all FDA-approved over-the-counter contraceptive drugs, devices, and products as prescribed or as otherwise authorized under state or federallaw. The following applies to this coverage:
  • (i) Where the FDA has approved one or more therapeutic and pharmaceutical equivalent, as defined by the FDA, versions of a contraceptive drug, device, or product, a contract is not required to include all such therapeutic and pharmaceutical equivalent versions in its formulary, so long as at least one is included and covered without cost-sharing and in accordance with this subsection;
  • (ii) If the covered therapeutic and pharmaceutical equivalent versions of a drug, device, or product are not available or are deemed medically inadvisable a contract shall provide coverage for an alternate therapeutic and pharmaceutical equivalent version of the contraceptive drug, device, or product without cost-sharing;
  • (iii) This coverage shall include emergency contraception without cost-sharing when provided pursuant to an ordinary prescription, or a non-patient specific regimen order, and when lawfully provided other than through a prescription or order; and
  • LC001206 - Page 7of 12
  • (iv) This coverage must allow for the dispensing of a twelve (12) month supply of a contraceptive at one time;
  • (2) Voluntary sterilization procedures;
  • (3) Patient education and counseling on contraception; and
  • (4) Follow-up services related to the drugs, devices, products, and procedures covered under this subsection, including, but not limited to, management of side effects, counseling for continued adherence, and device insertion and removal.
  • (c) A contract subject to this subsection shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this subsection.
  • (d) Except as otherwise authorized under this subsection, a contract shallnot impose any restrictions or delays on the coverage required under this subsection.
  • (e) Benefits for an enrollee under this subsection shall be the same for an enrollee's covered spouse or domestic partner and covered non-spouse dependents.
  • (b)(f) Notwithstanding any other provision of this section, any medical service corporation may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c)(g) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • (d)(h) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • SECTION 8. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:
  • (b) Notwithstanding any other provision of this section, any hospital service corporation may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • LC001206/SUB A/2 - Page 2of 6
  • (d) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • (e) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 5. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section:
  • 27-20-70. Health insurance contracts - Full year coverage for contraception.
  • Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 6. Section 27-20-43 of the General Laws in Chapter 27-20 entitled "Nonprofit Medical Service Corporations" is hereby amended to read as follows:
  • 27-20-43. F.D.A. approved prescription contraceptive drugs and devices.
  • (a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for F.D.A. approved contraceptive drugs and devices requiring a prescription. Provided, that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.
  • (b) Notwithstanding any other provision of this section, any medical service corporation may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • (d) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • (e) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive
  • LC001206/SUB A/2 - Page 3of 6 to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 7. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:
  • 27-41-87. Health insurance contracts - Full year coverage for contraception.
  • (a) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • (b) Subsection (a) of this section shall not apply to self-insured employee welfare benefit plans established pursuant to the Federal Employee Retirement Income Security Act of 1974, 29 U.S.C. §§1001 et seq.
  • (c) Nothing in this section shall be construed as requiring a health insurance carrier to
  • LC001206 - Page 8of 12 cover any prescription contraceptive that it does not currently cover or require any pharmacy to dispense any medication that it does not currently dispense.
  • (d) This section shall be applicable to all contracts, plans, or policies of:
  • (1) All health insurers subject to this title;
  • (2) All group and blanket health insurers subject to this title;
  • (3) All nonprofit hospital, medical, surgical, dental, and health service corporations;
  • (4) All health maintenance organizations;
  • (5) Any provision of medical, hospital, surgical, and funeral benefits, and of coverage against accidental death or injury, when the benefits or coverage are incidentalto or part of other insurance authorized by the laws of this state;
  • (6) All health care facilities, as defined in § 23-17-2;
  • (7) All pharmacies subject to the provisions of chapter 19.1 of title 5; and
  • (8) Family planning centers and essentialcommunity providers.
  • SECTION 9. Section 27-41-59 of the General Laws in Chapter 27-41 entitled "Health Maintenance Organizations" is hereby amended to read as follows:
  • 27-41-59. F.D.A. approved prescription contraceptive drugs and devices.
  • (a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for F.D.A. approved contraceptive drugs and devices requiring a prescription; provided, that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.
  • (b) Every individual or group health insurance contract, plan or policy licensed pursuant to this title that is issued, amended, renewed, effective or delivered on or after January 1, 2018, shall provide coverage for allof the following services and contraceptive methods:
  • (1) All FDA-approved contraceptive drugs, devices, and other products. This includes all FDA-approved over-the-counter contraceptive drugs, devices, and products as prescribed or as otherwise authorized under state or federallaw. The following applies to this coverage:
  • (i) Where the FDA has approved one or more therapeutic and pharmaceutical equivalent, as defined by the FDA, versions of a contraceptive drug, device, or product, a contract is not required to include all such therapeutic and pharmaceutical equivalent versions in its formulary, so long as at least one is included and covered without cost-sharing and in accordance with this subsection;
  • (ii) If the covered therapeutic and pharmaceutical equivalent versions of a drug, device, or product are not available or are deemed medically inadvisable a contract shall provide
  • LC001206 - Page 9of 12 coverage for an alternate therapeutic and pharmaceutical equivalent version of the contraceptive drug, device, or product without cost-sharing;
  • (iii) This coverage shall include emergency contraception without cost-sharing when provided pursuant to an ordinary prescription, or a non-patient specific regimen order, and when lawfully provided other than through a prescription or order; and
  • (iv) This coverage must allow for the dispensing of a twelve (12) month supply of a contraceptive at one time;
  • (2) Voluntary sterilization procedures;
  • (3) Patient education and counseling on contraception; and
  • (4) Follow-up services related to the drugs, devices, products, and procedures covered under this subsection, including, but not limited to, management of side effects, counseling for continued adherence, and device insertion and removal.
  • (c) A contract subject to this subsection shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this subsection.
  • (d) Except as otherwise authorized under this subsection, a contract shallnot impose any restrictions or delays on the coverage required under this subsection.
  • (e) Benefits for an enrollee under this subsection shall be the same for an enrollee's covered spouse or domestic partner and covered non-spouse dependents.
  • (b)(f) Notwithstanding any other provision of this section, any health maintenance corporation may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c)(g) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • (d)(h) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • SECTION 10. Chapter 42-12.3 of the General Laws entitled "Health Care for Children and Pregnant Women"is hereby amended by adding thereto the following section:
  • 42-12.3-3.1. Medical assistance expansion for women - Full year coverage for contraception.
  • (a) Within one hundred eighty (180) days from January 1, 2018, the department of human services shall develop and implement a system by which the Medicaid program reimburses for, and Medicaid pharmacies dispense:
  • (1) Twelve (12) months of prescription contraception at a time to enrollees with a valid prescription for twelve (12) months of contraception; or
  • (2) As many months of prescription contraception as there is a valid prescription for, up to twelve (12) months.
  • (b) This section shall apply to all Medicaid programs, including managed care.
  • (c) The department of human services may issue rules and regulations to implement the provisions of this section.
  • (d) This section shall serve as legislative approval for any Medicaid State Plan Amendment that is required by the Centers for Medicare and Medicaid Services to implement this section.
  • SECTION 11. This act shalltake effect upon passage.
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  • LC001206
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  • Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 8. Section 27-41-59 of the General Laws in Chapter 27-41 entitled "Health Maintenance Organizations" is hereby amended to read as follows:
  • 27-41-59. F.D.A. approved prescription contraceptive drugs and devices.
  • (a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for F.D.A. approved contraceptive drugs and devices requiring a prescription; provided, that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.
  • (b) Notwithstanding any other provision of this section, any health maintenance corporation may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods which are contrary to the religious employer's bona fide religious tenets.
  • (c) As used in this section, "religious employer" means an employer that is a "church or a qualified church-controlled organization" as defined in 26 U.S.C. § 3121.
  • (d) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons.
  • (e) Beginning on the first day of each plan year after January 1, 2018, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive to fewer than three hundred sixty-five (365) days at a time.
  • SECTION 9. Chapter 40-8.4 of the General Laws entitled "Health Care For Families"is hereby amended by adding thereto the following section:
  • 40-8.4-20. Full year coverage for contraception.
  • No later than July 1, 2018, the executive office of health and human services (EOHHS) shall apply for the appropriate federal approval to provide Medicaid beneficiaries at least three
  • LC001206/SUB A/2 - Page 4of 6 hundred sixty-five (365) days of prescription contraception dispensed as a single prescription.
  • SECTION 10. Section 9 of this act, pertaining to Medicaid, shalltake effect July 1, 2018. The remaining sections shall take effect January 1, 2018. ======== LC001206/SUB A/2 ========
  • LC001206/SUB A/2 - Page 5of 6
  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • OF
  • A N A C T
  • RELATING TO INSURANCE – ACCIDENT AND SICKNESS INSURANCE POLICIES
  • ***
  • This act would provide full year insurance coverage for all forms of FDA-approved contraceptives and would provide coverage thereto.
  • This act would take effect upon passage. ======== LC001206 ========
  • ***
  • This act would provide fullyear insurance coverage for contraceptives and would provide coverage thereto.
  • Section 9 of this act, pertaining to Medicaid, would take effect July 1, 2018. The remaining sections would take effect January 1, 2018. ======== LC001206/SUB A/2 ========
  • LC001206/SUB A/2 - Page 6of 6

Votes

NOTE: Electronic voting records are unofficial and may not be accurate. For an official vote tally, check the House or Senate Journal from the day of the vote.

Floor vote for PASSAGE

September 19, 2017 at 3:12pm
Yeas: 64 / Nays: 4 / Not voting: 7 / Recused: 0
Legislator Vote
Rep. Abney Y
Rep. Ackerman Y
Rep. Ajello Y
Rep. Almeida Y
Rep. Amore Y
Rep. Azzinaro Y
Rep. Barros Y
Rep. Bennett Y
Rep. Blazejewski Y
Rep. Canario Y
Rep. Carson NV
Rep. Casey Y
Rep. Casimiro Y
Rep. Chippendale N
Rep. Corvese Y
Rep. Costantino Y
Rep. Coughlin Y
Rep. Craven Y
Rep. Cunha Y
Rep. Diaz NV
Rep. Donovan Y
Rep. Edwards Y
Rep. Fellela Y
Rep. Filippi Y
Rep. Fogarty Y
Rep. Giarrusso N
Rep. Handy Y
Rep. Hearn Y
Rep. Hull Y
Rep. Jacquard Y
Rep. Johnston Y
Rep. Kazarian Y
Rep. Keable Y
Rep. Kennedy NV
Rep. Knight Y
Rep. Lancia Y
Rep. Lima Y
Rep. Lombardi Y
Rep. Maldonado Y
Rep. Marshall Y
Rep. Marszalkowski Y
Rep. Mattiello Y
Rep. McEntee Y
Rep. McKiernan Y
Rep. McLaughlin N
Rep. McNamara Y
Rep. Mendonca NV
Rep. Messier Y
Rep. Morgan Y
Rep. Morin Y
Rep. Nardolillo Y
Rep. Newberry Y
Rep. Nunes Y
Rep. O'Brien Y
Rep. O'Grady Y
Rep. Perez Y
Rep. Phillips Y
Rep. Price NV
Rep. Quattrocchi NV
Rep. Ranglin-Vassell Y
Rep. Regunberg Y
Rep. Roberts N
Rep. Ruggiero Y
Rep. Serpa Y
Rep. Shanley NV
Rep. Shekarchi Y
Rep. Slater Y
Rep. Solomon Y
Rep. Tanzi Y
Rep. Tobon Y
Rep. Ucci Y
Rep. Vella-Wilkinson Y
Rep. Walsh Y
Rep. Williams Y
Rep. Winfield Y