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Amendments › HF 2551

Amendment H-8131 to HF 2551

Relating to price transparency for prescription drugs and cost-sharing calculations by carriers, and including applicability provisions

Never voted on

Filed March 10, 2020 in the House by

What it changes

AI summary This amendment adds rules for how the insurance commissioner can enforce the law against drug manufacturers and health insurance companies. It allows the commissioner to issue orders to stop illegal practices and establishes specific fines and penalties for those who violate these orders.1

Read the amendment’s wording
  1. Page 3, by striking lines 32 through 35 and inserting: “Sec. ___. NEW SECTION . 510D.5 Summary enforcement.
  2. Upon a determination by the commissioner that a manufacturer or a manufacturer’s agent has violated a provision of this chapter, a rule adopted by the commissioner, or an order issued by the commissioner under this chapter, the commissioner may do any of the following: a. Issue a summary order, including a brief statement of findings of fact and conclusions of law, and direct the manufacturer or the manufacturer’s agent to cease and desist engaging in the act or practice that is in violation of the provisions of this chapter. b. Take other affirmative action that in the judgment of the commissioner is necessary to ensure that the manufacturer or the manufacturer’s agent complies with the requirements of this chapter.
  3. a. A manufacturer or a manufacturer’s agent that has been issued a summary order under this section may contest the summary order by filing a request for a contested case proceeding and hearing pursuant to chapter 17A, and in accordance with rules adopted by the commissioner. The manufacturer or the manufacturer’s agent shall have at least thirty calendar days from the date that the summary order is issued to file a request for a contested case proceeding and hearing. If a contested case proceeding and hearing is not timely requested the summary order shall become final by operation of law. b. Section 17A.18A shall not apply to a summary order issued under this section. c. A summary order issued pursuant to this section shall remain effective from the date of issuance unless overturned by a presiding officer of a contested case hearing, or by a court following the manufacturer’s or the manufacturer’s agent’s request for judicial review of a final action by the commissioner.
  4. A manufacturer or a manufacturer’s agent violating a summary order issued under this section shall be deemed in contempt of the summary order. Upon request of the commissioner, the attorney general shall petition the district court to enforce the summary order as certified by the commissioner. The district court shall adjudge the manufacturer or the manufacturer’s agent in contempt of the summary order if the court finds after hearing that the manufacturer or the manufacturer’s agent is not in compliance with the summary order. The court may assess a civil penalty of not more than one thousand dollars for each day that the manufacturer or the manufacturer’s agent is in violation of the summary order and may issue further orders as the court deems appropriate. Sec. ___. NEW SECTION . 510D.6 Enforcement after hearing.
  5. If, after a hearing pursuant to section 510D.5, the commissioner determines that a manufacturer or a manufacturer’s agent has violated a provision of this chapter, a rule adopted by the commissioner, or an order issued by the commissioner under this chapter, the commissioner shall reduce the findings to writing and shall issue and cause to be served upon the manufacturer or the manufacturer’s agent all of the following: a. A copy of the commissioner’s findings. b. An order requiring the manufacturer or the manufacturer’s agent to cease and desist from violating the provisions of this chapter.
  6. The commissioner may take other affirmative action that in the judgment of the commissioner is necessary to ensure that the manufacturer or the manufacturer’s agent complies with the requirements of this chapter. The commissioner may also, at the commissioner’s discretion, order payment of a civil penalty of not more than five thousand dollars for each of the manufacturer’s or the manufacturer’s agent’s violations of this chapter.
  7. A manufacturer or a manufacturer’s agent that violates an order of the commissioner, and while such order is in effect, may, after notice and hearing and upon order of the commissioner, be subject to a civil penalty of not more than ten thousand dollars for each violation of the commissioner’s order. A manufacturer or a manufacturer’s agent violating an order issued by the commissioner under this subsection shall be deemed in contempt of the order. A civil penalty collected pursuant to this section shall be deposited as provided in section 505.7.
  8. Judicial review of an action of the commissioner may be sought by a manufacturer or a manufacturer’s agent pursuant to chapter 17A. To the extent that a decision or order of the commissioner is affirmed in a judicial review proceeding, the court shall issue an order directing that the manufacturer or the manufacturer’s agent comply with the terms of the commissioner’s decision or order.
  9. After the period for judicial review of an order of the commissioner has expired and no petition for judicial review has been filed, upon request of the commissioner, the attorney general shall proceed in the district court to enforce the order of the commissioner. The court shall issue an order directing that the manufacturer or the manufacturer’s agent comply with the terms of the commissioner’s order.
  10. Upon request of the commissioner, the attorney general shall petition the district court to enforce an order as certified by the commissioner. The district court shall adjudge the manufacturer or the manufacturer’s agent in contempt of the commissioner’s order if the court finds after hearing that the manufacturer or the manufacturer’s agent is not in compliance with the commissioner’s order. The court may order a civil penalty of not more than one thousand dollars per day for each day of noncompliance against the manufacturer or the manufacturer’s agent and may issue further orders as the court deems appropriate.”
  11. Page 6, by striking lines 15 through 18 and inserting: “Sec. ___. NEW SECTION . 510E.4 Summary enforcement.
  12. Upon a determination by the commissioner that a health carrier or a health carrier’s agent has violated a provision of this chapter, a rule adopted by the commissioner, or an order issued by the commissioner under this chapter, the commissioner may do any of the following: a. Issue a summary order, including a brief statement of findings of fact and conclusions of law, and direct the health carrier or the health carrier’s agent to cease and desist engaging in the act or practice that is in violation of the provisions of this chapter. b. Take other affirmative action that in the judgment of the commissioner is necessary to ensure that the health carrier or the health carrier’s agent complies with the requirements of this chapter.
  13. a. A health carrier or a health carrier’s agent that has been issued a summary order under this section may contest the summary order by filing a request for a contested case proceeding and hearing pursuant to chapter 17A, and in accordance with rules adopted by the commissioner. The health carrier or the health carrier’s agent shall have at least thirty calendar days from the date that the summary order is issued to file a request for a contested case proceeding and hearing. If a contested case proceeding and hearing is not timely requested the summary order shall become final by operation of law. b. Section 17A.18A shall not apply to a summary order issued under this section. c. A summary order issued pursuant to this section shall remain effective from the date of issuance unless overturned by a presiding officer of a contested case hearing, or by a court following the health carrier’s or the health carrier’s agent’s request for a judicial review of a final action by the commissioner.
  14. A health carrier or a health carrier’s agent violating a summary order issued under this section shall be deemed in contempt of the summary order. Upon request of the commissioner, the attorney general shall petition the district court to enforce the summary order as certified by the commissioner. The district court shall adjudge the health carrier or the health carrier’s agent in contempt of the summary order if the court finds after hearing that the health carrier or the health carrier’s agent is not in compliance with the summary order. The court may assess a civil penalty of not more than one thousand dollars per day against the health carrier or the health carrier’s agent for each day that the health carrier or the health carrier’s agent is in violation of the summary order, and may issue further orders as the court deems appropriate. Sec. ___. NEW SECTION . 510E.5 Enforcement after hearing.
  15. If, after a hearing pursuant to section 510E.4, the commissioner determines that a health carrier or a health carrier’s agent has violated a provision of this chapter, a rule adopted by the commissioner, or an order issued by the commissioner under this chapter, the commissioner shall reduce the findings to writing and shall issue and cause to be served upon the health carrier or the health carrier’s agent all of the following: a. A copy of the commissioner’s findings. b. An order requiring the health carrier or the health carrier’s agent to cease and desist from violating the provisions of this chapter.
  16. The commissioner may take other affirmative action that in the judgment of the commissioner is necessary to ensure that the health carrier or the health carrier’s agent complies with the requirements of this chapter. The commissioner may also, at the commissioner’s discretion, order payment of a civil penalty of not more than five thousand dollars for each of the health carrier’s or the health carrier’s agent’s violations of this chapter.
  17. A health carrier or a health carrier’s agent that violates an order of the commissioner, and while such order is in effect, may, after notice and hearing and upon order of the commissioner, be subject to a civil penalty of not more than ten thousand dollars for each violation of the commissioner’s order. A health carrier or a health carrier’s agent violating an order issued by the commissioner under this section shall be deemed in contempt of the order. A civil penalty collected pursuant to this subsection shall be deposited as provided in section 505.7.
  18. Judicial review of an action of the commissioner may be sought by a health carrier or a health carrier’s agent pursuant to chapter 17A. To the extent that a decision or order of the commissioner is affirmed in a judicial review proceeding, the court shall issue an order directing that the health carrier or the health carrier’s agent comply with the terms of the commissioner’s decision or order.
  19. After the period for judicial review of an order of the commissioner has expired and no petition for judicial review has been filed, upon request of the commissioner, the attorney general shall proceed in the district court to enforce the order of the commissioner. The court shall issue an order directing that the health carrier or the health carrier’s agent comply with the terms of the commissioner’s order.
  20. Upon request of the commissioner, the attorney general shall petition the district court to enforce an order as certified by the commissioner. The district court shall adjudge the health carrier or the health carrier’s agent in contempt of the commissioner’s order if the court finds after hearing that the health carrier or the health carrier’s agent is not in compliance with the commissioner’s order. The court may order a civil penalty of not more than one thousand dollars per day for each day of noncompliance against the health carrier or the health carrier’s agent and may issue further orders as the court deems appropriate.”
  21. By renumbering as necessary.

Official amendment (PDF) · In the Bill Book