This bill aims to enhance patient adherence to medications and reduce healthcare costs by mandating that health insurance policies providing prescription drug coverage allow for partial supplies of medications. Specifically, it requires that if a prescriber or pharmacist determines that a partial fill is in the patient's best interest and the patient agrees, the insurance must apply a pro-rated daily cost-sharing rate for these prescriptions. Additionally, the bill prohibits health insurance policies from denying coverage for partial supplies and requires that pharmacies be allowed to override denial codes related to early refills when they are for the purpose of medication synchronization.
Furthermore, the bill stipulates that health insurance policies cannot implement payment structures that include pro-rated dispensing fees. Instead, pharmacies must receive full dispensing fees for each prescription, regardless of whether the copay is pro-rated for the patient or if a fee is charged for alignment services. This legislation is designed to facilitate better medication management for patients while ensuring that pharmacies are fairly compensated for their services.