Emergency Advance Refill Notification Act of 2022
Bill: H.R.8270 | Sponsor: Rep. McBath, Lucy (D-GA)
Policy area: Health

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.

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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Emergency Advance Refill 
Notification Act of 2022''.

SEC. 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.) is amended by adding at the end the 
        following new section:

``SEC. 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' is a geographical area in which, and an 
`emergency period' is the period during which, there exists--
            ``(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.) is amended by adding at the end the 
following new section:

``SEC. 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' is a geographical area in which, and an 
`emergency period' is the period during which, there exists--
            ``(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 of the 
        Internal Revenue Code of 1986 is amended by adding at the end 
        the following new section:

``SEC. 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' is a geographical area in which, and an 
`emergency period' is the period during which, there exists--
            ``(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 of the Internal Revenue Code of 
        1986 is amended by adding at the end the following new item:

``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)).
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