07 LC
33 1627
House
Bill 45
By:
Representative Stephens of the
164th
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia
Annotated, relating to insurance generally, so as to prohibit prior
authorization for a prescription drug which a drug manufacturer provides to a
community pharmacy at the lowest price of a pricing structure; to provide for
definitions; to provide for related powers and duties; to repeal conflicting
laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Article
1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating
to insurance generally, is amended by adding a new Code section to the end of
such article to read as follows:
"33-24-59.13.
(a)
As used in this Code section, the term:
(1)
'Health benefit plan or policy' means any individual or group plan, policy, or
contract for health care services issued, delivered, issued for delivery, or
renewed in this state, including, but not limited to, by a health care
corporation, health maintenance organization, preferred provider organization,
accident and sickness insurer, fraternal benefit society, hospital service
corporation, medical service corporation, workers´ compensation insurance
carrier in accordance with Chapter 9 of Title 34, other insurer or similar
entity, the state health benefit plan under Article 1 of Chapter 18 of Title 45,
the medical assistance program under Article 7 of Chapter 4 of Title 49, the
PeachCare for Kids program under Article 13 of Chapter 5 of Title 49, or any
other health benefit plan or policy administered by or on behalf of the state.
(2)
'Insurer' means a health care corporation, health maintenance organization,
accident and sickness insurer, fraternal benefit society, hospital service
corporation, medical service corporation, workers´ compensation insurance
carrier, managed care plan other than a dental plan, or any similar entity
authorized to issue contracts under Title 33, and shall also include the state
for purposes of the state health benefit plan under Article 1 of Chapter 18 of
Title 45, the medical assistance program under Article 7 of Chapter 4 of Title
49, the PeachCare for Kids program under Article 13 of Chapter 5 of Title 49, or
any other health benefit plan or policy administered by or on behalf of the
state.
(3)
'Prescription drug' has the meaning provided by Code Section
26-4-5.
(b)
No health benefit plan or policy issued, delivered, or renewed in this state by
an insurer shall require prior approval for a prescription drug if a drug
manufacturer utilizing a pricing structure for sales to various classes of trade
provides that a community pharmacy is charged the lowest price in the pricing
structure for such prescription drug."
SECTION
2.
All
laws and parts of laws in conflict with this Act are repealed.