2001 REGULAR SESSION (71st) A AB415 595
ASSEMBLY ACTION Initial and Date |SENATE ACTION Initial and Date
Adopted Lost | Adopted Lost
Concurred In Not |Concurred In Not
Receded Not | Receded Not
Amend the bill as a whole by adding new sections designated sections 7 through 9, following sec. 6, to read as follows:
“Sec. 7. Chapter 679B of NRS is hereby amended by adding thereto a new section to read as follows:
1. If a health care plan that provides coverage for prescription drugs or devices issues a single identification card or other device to an insured that contains information solely needed to process a claim for a prescription drug or device, the card or other device must conform to the requirements of the National Council for Prescription Drug Programs set forth in the NCPDP Pharmacy ID Card Implementation Guide that are consistent with applicable regulations adopted pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104‑191, as they may be amended from time to time, or must contain at least the following elements:
(a) The name or logo of the administrator issuing the card or device.
(b) The insured’s identification number, which must be displayed on the front side of the card or device.
(c) The name and address of the administrator to which prescription claims that are not processed electronically or correspondence should be sent.
(d) The telephone number that providers may call for assistance concerning pharmacy benefits.
(e) Complete information concerning routing of electronic transactions, including, without limitation, the international identification number and, if required by the administrator to process the claim, the processing control number and group number.
(f) Any other information required for proper administration of the claim.
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The information on the
card or device must be arranged in a manner that corresponds both in content
and form to the content and form required by the plan to process the claim.
2. An identification card or other device issued to an insured pursuant to this section must be revised and reissued to the insured if the information contained on the card or device is rendered inaccurate by any change in:
(a) The coverage provided under the health care plan;
(b) The applicable requirements of the NCPDP Pharmacy ID Card Implementation Guide; or
(c) Any of the elements required to be included on the card or device pursuant to this section.
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A new card or device must
be issued upon enrollment and updated as required to comply with the provisions
of this section. A card or device may be updated for not more than 1 year by
issuing a sticker or other technology approved by the commissioner in lieu of
replacing the card or device.
3. An identification card or other device that is issued or reissued to an insured pursuant to this section must:
(a) Contain information regarding coverage; and
(b) Conform to the requirements approved by the commissioner,
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in effect at the time the
card or device is issued or reissued.
4. The commissioner shall adopt such regulations as are necessary to carry out the provisions of this section.
5. As used in this section:
(a) “Administrator” has the meaning ascribed to it in NRS 683A.025, and includes a pharmacy benefits manager.
(b) “Health care plan” means a policy, contract, certificate or agreement offered by an insurer, health maintenance organization or prepaid limited health service organization to provide for, deliver payment for, arrange for the payment of, pay for or reimburse any of the costs of health care services. The term does not include:
(1) Coverage that is only for accident or disability income insurance, or any combination thereof.
(2) Credit insurance.
(3) Coverage that is only for a specified disease or illness.
(4) Dental or vision benefits that are provided under a separate policy, certificate or contract of insurance or are otherwise not an integral part of a health care plan.
(5) Coverage issued as a supplement to liability insurance.
(6) Coverage for medical payments under a policy of automobile or homeowners’ insurance.
(7) Coverage for benefits that are payable without regard to fault and that are statutorily required to be included in a policy of liability insurance or equivalent self-insurance.
(8) Hospital income or indemnity insurance.
Sec. 8. The provisions of section 7 of this act do not apply to the division of health care financing and policy of the department of human resources or a person providing prescription drug benefits in a health care program provided by contract with the division until the division becomes capable of producing a card or other device that meets the requirements of that section. The director of the department of human resources shall issue an order requiring compliance with section 7 of this act when the division produces such a card or device.
Sec. 9. 1. This section becomes effective upon passage and approval.
2. Sections 1 to 6, inclusive, of this act, become effective on October 1, 2001.
3. Section 7 of this act becomes effective upon passage and approval for the purpose of adopting regulations and on January 1, 2003, for all other purposes.
4. Section 8 of this act becomes effective on January 1, 2003.”.
Amend the title of the bill, seventh line, after “board;” by inserting:
“providing for the issuance of uniform identification cards and devices to process claims for prescription drugs or devices;”.