Prescription drug cards, uniformity required.
Section 1. Any health benefit plan that provides coverage for prescription drugs or devices on an outpatient basis, or administers such a plan, including third-party administrators for self-insured plans and state-administered plans, shall issue to its primary insured a card or other technology containing uniform prescription drug information. The director of the Division of Insurance shall
prescribe the format and elements of information for the uniform prescription drug information card
or technology and shall consider the format and elements of information approved by the National
Council for Prescription Drug Programs (NCPDP) and the required and conditional or situational
fields and the most recent pharmacy identification card or technology implementation guide
produced by NCPDP. A health benefit plan is not required to issue a pharmacy identification card
separate from another identification card issued to an insured under the health benefit plan if the
identification card contains the elements of information required by the Division of Insurance.
A health benefit plan shall issue a card or other technology required by section 1 of
this Act upon enrollment. The card or technology shall be reissued upon any change in the insured's
coverage that impacts data contained on the card or upon any change in the format adopted by the
director of the Division of Insurance. However, the health benefit plan is not required to issue a new
card or technology more often than once each calendar year. Newly issued cards or technology shall
be updated with the latest coverage information and the director of the Division of Insurance shall
consider the NCPDP standards then in effect and the implementation guide then in use.
As used in this Act, the term, health benefit plan, means an accident and health
insurance policy or certificate; a nonprofit hospital or medical service corporation contract; a health
maintenance organization subscriber contract; a plan provided by a multiple employer welfare
arrangement; or a plan provided by another benefit arrangement, to the extent permitted by the
Employee Retirement Income Security Act of 1974, as amended to January 1, 2001, or by any
waiver of or other exception to that Act provided under federal law or regulation. The term does
not apply to any plan, policy, or contract that provides coverage only for:
Section 5. The director of insurance shall enforce the provisions of this Act. The director of insurance may promulgate rules pursuant to chapter 1-26 to establish the format and elements of
information for the uniform information card or technology to be used in the state following the
standards established in sections 1 and 2 of this Act.