§ 23-80-404 — Uniform card requirement

(a) Every health benefit plan that provides coverage for prescription drugs or devices and issues a card or other technology for claims processing and every administrator of such plans, including third-party administrators for self-insured plans, pharmacy benefit managers, and administrators of state plans, shall issue to all covered persons a uniform card or other technology containing uniform prescription drug information as required under this subchapter. (b) The uniform prescription drug information card or other technology shall: (1) (A) Be in a format approved by the National Council for Prescription Drug Programs, in which case the card or other technology shall include all fields of information required by the council and conform to the most recent pharmacy information card or other technology implementation guide produced by the council. (B) In the alternative, the card or other technology shall conform to a national format established in an administrative rule by the Insurance Commissioner; (2) Include in a clear, readable, and understandable manner all information, exclusive of information provided on the prescription as required by law or regulation, that is necessary to process a claim for prescription drug benefits under the health benefit plan; (3) Format and arrange all information on the card or other technology in a manner that corresponds both in content and format to the content and format required by the health benefit plan to process the claim for prescription drug benefits; (4) Conform all information on the card or other technology not specified by the council to a content and format established in an administrative rule by the commissioner; and (5) If the health benefit plan requires a conditional or situational field as defined by the council, conform the conditional or situational field to the most recent pharmacy information card or other technology implementation guide produced by the council or to a national format established in an administrative rule by the commissioner.

Legislative History

Acts 2001, No. 1409, § 4; 2003, No. 1473, § 54.