Relating to dispensing fees and copayments for partially dispensed quantities of prescription drugs

This bill relates to the dispensing of prescription drugs in partial quantities. The bill provides that if a person authorized to dispense prescription drugs under Code chapter 155A initially dispenses a partial quantity of a 30-day supply of a prescription drug and subsequently dispenses the remaining quantity as authorized by the prescription within days of the initial dispensing, the cumulative dispensing fee applicable to all partially dispensed quantities of the prescription drug shall not exceed the established dispensing fee applicable as if the total quantity prescribed had been dispensed at one time, and the cumulative copayment required for all partially dispensed quantities of the prescription drug shall not exceed the established copayment applicable as if the total quantity prescribed had been dispensed at one time. These requirements apply whether the partial dispensing of a quantity authorized by a prescription is due to a policy of the authorized dispenser, a requirement of the third-party payment provider contract or policy, a supply deficit, or for any other reason. The bill directs the department of human services to adopt administrative rules to require Medicaid providers to comply with these provisions, whether the partial dispensing of the quantity authorized by the prescription is due to a policy of the authorized dispenser, a requirement of a managed care organization or third-party payment provider contract or policy, a supply deficit, or for any other reason. The requirement applies under both fee-for-service and managed care program administration of Medicaid. Similarly, the bill provides that any third-party payment provider contracts or policies delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2021, that provide for third-party payment or prepayment of health or medical expenses shall provide that if a person authorized pursuant to Code chapter 155A to dispense initially dispenses a partial quantity of a 30-day supply of a prescription drug and subsequently dispenses the remaining quantity as authorized by the prescription within days of the initial dispensing, the cumulative dispensing fee applicable to all partially dispensed quantities of the prescription drug shall not exceed the established dispensing fee applicable as if the total quantity prescribed had been dispensed at one time, and the cumulative copayment required for all partially dispensed quantities of the prescription drug shall not exceed the established copayment applicable as if the total quantity prescribed had been dispensed at one time. The provision applies whether the partial dispensing of a quantity authorized by a prescription is due to a policy of the authorized dispenser, a requirement of the third-party payment provider contract or policy, a supply deficit, or for any other reason.