Prescription drug fairness act would guarantee coverage for a year

Senate would ensure health insurance contracts are honored

By Mike Holfeld - Investigative Reporter

TALLAHASSEE, Fla. - A bill that would guarantee prescription medication coverage for the length of the health insurance contract is gaining traction in Tallahassee.

SB 360, sponsored by state Sen. Debbie Mayfield, R-Melbourne, has been referred to the
Senate Health Committee, although staffers told News 6 Tuesday, it’s not clear if the bill will make it to a full vote this session. 

A similar version of the bill made it through a full Senate vote last year but failed in the House.
Mayfield told News 6 she has been working with insurance companies to develop a plan that delivers a “win- win for everyone.”  

“We’ve been working with some pharmaceutical benefit managers, hired to trying to come up with the right solutions, making health care affordable includes keeping the patient on their medication,” Mayfield said.

Suddenly dropped prescription coverage by health insurance companies has been labeled a "bait-and-switch" tactic by critics and consumers who paid for coverage that included prescription drugs they needed only to be told the coverage for that medication was pulled.

The legislation would require health insurance companies to honor the contract and the list of prescription drugs for 12 months to allow current insurance holders to continue the benefits for which they paid.

There would be exceptions including Food and Drug Administration warnings that would question the clinical safety of a listed prescription drug. 

Michael Rupal, executive director of the AIDS Institute, said he has handled dozens of cases for patients who lost their prescription coverage.

 In June, it happened to him.

Rupal said his prescription for acid reflux was no longer covered, the insurance company told him to try three alternative drugs before the company would consider covering the original drug.

“I’m on my second drug, six months of failing on my second drug," Rupal said. “When we sign up for one year of insurance, just honor it until the end of the year, if you want to make changes, change it at the end of the year."

Mayfield said she will continue to work toward a solution to make sure patients get the coverage they need.

“Part of staying healthy is staying on the drug that keeps you healthy," she said. “When we shop our health care plan, if you're on a specific drug that you have been taking, you look for that drug availability on the plan that you buy. this bill simply says if that person has signed up with you they have to keep that health care plan for 12 months.” 

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