Emergency Advance Refill Notification Act of 2022

To amend the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide notices relating to prescription drug refills to individuals covered under such plans or coverage who reside in emergency areas during emergency periods. 1. Short title This Act may be cited as the Emergency Advance Refill Notification Act of 2022 2. Requiring prescription drug refill notifications during emergencies (a) ERISA (1) In general Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185 et seq. 726. Provision of prescription drug refill notifications during emergencies (a) In general A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, that provides benefits for prescription drugs under such plan or such coverage shall provide to each participant or beneficiary under such plan or such coverage who resides in an emergency area during an emergency period— (1) not later than 5 business days after the date of the beginning of such period with respect to such area (or, the case of the emergency period described in section 1135(g)(1)(B) of the Social Security Act, not later than 5 business days after the date of the enactment of this section), a notification (written in a manner that is clear and understandable to the average participant or beneficiary)— (A) of whether such plan or coverage will waive, during such period with respect to such a participant or beneficiary, any time restrictions under such plan or coverage on any authorized refills for such drugs to enable such refills in advance of when such refills would otherwise have been permitted under such plan or coverage; and (B) in the case that such plan or coverage will waive such restrictions during such period with respect to such a participant or beneficiary, that contains information on how such a participant or beneficiary may obtain such a refill; and (2) in the case such plan or coverage elects to so waive such restrictions during such period with respect to such a participant or beneficiary after the notification described in paragraph (1) has been provided with respect to such period, not later than 5 business days after such election, a notification of such election that contains the information described in subparagraph (B) of such paragraph. (b) Emergency area; emergency period For purposes of this section, an emergency area emergency period (1) an emergency or disaster declared by the President pursuant to the National Emergencies Act or the Robert T. Stafford Disaster Relief and Emergency Assistance Act; and (2) a public health emergency declared by the Secretary pursuant to section 319 of the Public Health Service Act. . (2) Clerical amendment The table of contents of the Employee Retirement Income Security Act of 1974 is amended by inserting after the item relating to section 725 the following: Sec. 726. Provision of prescription drug refill notifications during emergencies. . (b) PHSA Part D of title XXVII of the Public Health Service Act ( 42 U.S.C. 300gg–111 et seq. 2799A–11. Provision of prescription drug refill notifications during emergencies (a) In general A group health plan, and a health insurance issuer offering group or individual health insurance coverage, that provides benefits for prescription drugs under such plan or such coverage shall provide to each participant, beneficiary, or enrollee enrolled under such plan or such coverage who resides in an emergency area during an emergency period— (1) not later than 5 business days after the date of the beginning of such period with respect to such area (or, the case of the emergency period described in section 1135(g)(1)(B) of the Social Security Act, not later than 5 business days after the date of the enactment of this section), a notification (written in a manner that is clear and understandable to the average participant, beneficiary, or enrollee)— (A) of whether such plan or coverage will waive, during such period with respect to such a participant, beneficiary, or enrollee, any time restrictions under such plan or coverage on any authorized refills for such drugs to enable such refills in advance of when such refills would otherwise have been permitted under such plan or coverage; and (B) in the case that such plan or coverage will waive such restrictions during such period with respect to such a participant, beneficiary, or enrollee, that contains information on how such a participant, beneficiary, or enrollee may obtain such a refill; and (2) in the case such plan or coverage elects to so waive such restrictions during such period with respect to such a participant, beneficiary, or enrollee after the notification described in paragraph (1) has been provided with respect to such period, not later than 5 business days after such election, a notification of such election that contains the information described in subparagraph (B) of such paragraph. (b) Emergency area; emergency period For purposes of this section, an emergency area emergency period (1) an emergency or disaster declared by the President pursuant to the National Emergencies Act or the Robert T. Stafford Disaster Relief and Emergency Assistance Act; and (2) a public health emergency declared by the Secretary pursuant to section 319. . (c) IRC (1) In general Subchapter B of chapter 100 9826. Provision of prescription drug refill notifications during emergencies (a) In general A group health plan that provides benefits for prescription drugs under such plan shall provide to each participant or beneficiary enrolled under such plan who resides in an emergency area during an emergency period, not later than 5 business days after the date of the beginning of such period with respect to such area (or, the case of the emergency period described in described in section 1135(g)(1)(B) of the Social Security Act, not later than 5 business days after the date of the enactment of this section)— (1) a notification (written in a manner that is clear and understandable to the average participant or beneficiary)— (A) of whether such plan will waive, during such period with respect to such a participant or beneficiary, any time restrictions under such plan on any authorized refills for such drugs to enable such refills in advance of when such refills would otherwise have been permitted under such plan; and (B) in the case that such plan will waive such restrictions during such period with respect to such a participant or beneficiary, that contains information on how such a participant or beneficiary may obtain such a refill; and (2) in the case such plan elects to so waive such restrictions during such period with respect to such a participant or beneficiary after the notification described in paragraph (1) has been provided with respect to such period, not later than 5 business days after such election, a notification of such election that contains the information described in subparagraph (B) of such paragraph. (b) Emergency area; emergency period For purposes of this section, an emergency area emergency period (1) an emergency or disaster declared by the President pursuant to the National Emergencies Act or the Robert T. Stafford Disaster Relief and Emergency Assistance Act; and (2) a public health emergency declared by the Secretary pursuant to section 319 of the Public Health Service Act. . (2) Clerical amendment The table of sections for subchapter B of chapter 100 Sec. 9826. Provision of prescription drug refill notifications during emergencies. . (d) Effective date The amendments made by this section shall apply with respect to— (1) emergency periods beginning on or after the date of the enactment of this Act; and (2) the emergency period described in section 1135(g)(1)(B) of the Social Security Act ( 42 U.S.C. 1320b–5(g)(1)(B)

Summary: Emergency Advance Refill Notification Act of 2022 This bill requires private health insurance plans that cover prescription drugs to notify plan holders about the plan's policy concerning advance drug refills in response to a national or public health emergency. Specifically, the plan must notify plan holders in emergency areas whether the plan is waiving time limits on authorized prescription refills and, if so, the process for obtaining an early refill. Plans must issue such notification within five days of an emergency being declared. Concerning the public health emergency declared in response to COVID-19, a plan must provide initial notification of its waiver policy not later than five days after this bill is enacted.