California considering Rx mail-order opt-out law

July 2, 2014

State lawmakers in California are considering a bill that would allow patients to opt out of health plan requirements that certain prescriptions be filled by mail order.

 

State lawmakers in California are considering a bill that would allow patients to opt out of health plan requirements that certain prescriptions be filled by mail order.

The bill (AB 2418) has already passed the state’s assembly and is being considered by the Senate Health Committee. Specifically, the bill would “prohibit a health care service plan contract or a health insurance policy issued, amended, or renewed on or after January 1, 2015, that provides prescription drug benefits from denying coverage for the refill of an otherwise covered drug when the refill is ordered for the purpose of placing all of the enrollee's or insured's medications on the same schedule for refill.”

About 1 million California residents are enrolled in plans that require certain drugs to be dispensed through mail order.

The California Pharmacists Association, the California Association of Physician Groups, and some drug and grocery retailers support the bill. Anthem Blue Cross, Blue Shield of California, the California Association of Health Plans, CVS Caremark, and Express Scripts oppose it.

 

The bill’s sponsor, Susan Bonilla (D-Concord), said it would “improve patients' access to medications and encourages interaction between patients, pharmacists, and doctors to ensure patients receive their medications in a timely, convenient manner."

However, the Pharmaceutical Care Management Association (PCMA) is campaigning against bill.  "[The bill] profits the drugstore lobby by eliminating a safer, more affordable pharmacy option that many employers have embraced,” said Mark Merritt, PCMA’s CEO.