Prescription RCW Issuer must have a prescription synchronization/coordination policy for 48.43.096(1) the dispensing of prescription drugs to the plan's enrollees. 48.43.096 If an enrollee requests medication synchronization for a new prescription, (1)(a) the health plan must permit filling the drug: 48.43.096 o for less than a one-month supply of the drug if synchronization will (1)(a)(i) require more than a fifteen-day supply of the drug; or (1)(a)(ii) o for more than a one-month supply of the drug if synchronization will Prescription require a fifteen-day supply of the drug or less. Drug Services 48.43.096 The health benefit plan adjust the enrollee cost-sharing for a (EHB) (1)(b) prescription drug subject to coinsurance that is dispensed for less than (Cont’d) the standard refill amount for the purpose of synchronizing the medications. 48.43.096 The health benefit plan adjust the enrollee cost-sharing for a (1)(c) prescription drug with a copayment that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications by: Discounting the copayment rate by fifty percent; Discounting the copayment rate based on fifteen-day increments; or Any other method that meets the intent of this section and is approved by the OIC. Note: In order to have an alternative method approved by OIC, the issuer should submit a request for approval to the Manager of the Health & Disability Forms Unit. The request may be sent by any means, including being submitted on the Supporting Documentation tab as part of the filing seeking to utilize the method. The request must include complete information regarding the proposed alternative method. If the plan utilizes an alternative method that has already been approved by the OIC, the filing should include this information in
Prescription Drug Services (EHB) (Cont’d) Prescription RCW 48.43.096(1) Issuer must have a prescription synchronization/coordination policy for the dispensing of prescription drugs to the plan's enrollees. 48.43.096 (1)(a) 48.43.096 (1)(a)(i) (1)(a)(ii) If an enrollee requests medication synchronization for a new prescription, the health plan must permit filling the drug: o for less than a one-month supply of the drug if synchronization will require more than a fifteen-day supply of the drug; or o for more than a one-month supply of the drug if synchronization will require a fifteen-day supply of the drug or less. 48.43.096 (1)(b) The health benefit plan adjust the enrollee cost-sharing for a prescription drug subject to coinsurance that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications. 48.43.096 (1)(c) The health benefit plan adjust the enrollee cost-sharing for a prescription drug with a copayment that is dispensed for less than the standard refill amount for the purpose of synchronizing the medications by: Discounting the copayment rate by fifty percent; Discounting the copayment rate based on fifteen-day increments; or Any other method that meets the intent of this section and is approved by the OIC. Note: In order to have an alternative method approved by OIC, the issuer should submit a request for approval to the Manager of the Health & Disability Forms Unit. The request may be sent by any means, including being submitted on the Supporting Documentation tab as part of the filing seeking to utilize the method. The request must include complete information regarding the proposed alternative method. If the plan utilizes an alternative method that has already been approved by the OIC, the filing should include this information in
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