Bill Summary for H 178 (2021-2022)

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Summary date: 

May 11 2021

Bill Information:

View NCGA Bill Details2021
House Bill 178 (Public) Filed Thursday, February 25, 2021
Intro. by Sasser, Adcock, Potts, K. Baker.

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Bill summary

House committee substitute makes the following changes to the 1st edition. 

Revises the definitions set forth for new Article 56B, Access to Prescription Drug Benefit Cost Information, in GS Chapter 58. Modifies health care services to include procedures or services rendered by a prescriber or health care provider that meet the specified criteria (was, limited to rendering by a health care provider). Includes a health maintenance organization that prescribes drugs to individuals or groups under contracts issued or delivered in the State in the defined term payor. Replaces the definition for real time to now define the term as exchange of patient eligibility, product coverage, and benefit financials for a choice product and pharmacy and identification of coverage restrictions and alternatives when they exist, delivered immediately after product selection using electronic prescribing platforms or systems (was, defined as delivered immediately after collection). Revises the criteria for the term therapeutically equivalent alternative to include that the prescription drug uses real-time prescription benefit standards developed by an organization accredited by the American National Standards Institute.

Revises the new Article as follows. Makes technical and clarifying changes to the required electronic provision of certain information relating to prescription price transparency and patient access to prescribed medications; corrects a statutory cross-reference. Adds prescribers to the electronic health record entities involved in the process of prescribing, dispensing, paying for, and exchanging information relating to prescription drugs which must partner with intermediaries to ensure the delivery of accurate patient-specific prescription price transparency information. Now requires prescribers, alternatively to providers, to communicate to a patient the most therapeutically appropriate treatment for the patient's diagnosis and the drug cost information, therapeutically equivalent alternatives, and delivery options. Adds that a pharmacist filling a prescription for a specific biological product can substitute an interchangeable biological product only if (1) the prescriber has not indicated that the pharmacist cannot substitute an interchangeable biosimilar biological product for the prescribed biological product and (2) the FDA has determined the biological product to be substituted is interchangeable with the prescribed biological product. Changes the act's effective date to January 1, 2023 (was, July 1, 2021).