BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Chapter 33, Title 18 of the Delaware Code by adding as a new "§ 3347. Uniform prescription drug information cards." And "§3348. Requirements for plans; content of cards." as follows:

"§ 3347. Uniform prescription drug information cards.

1. A health benefit plan that provides coverage for prescription drugs or devices and that issues, uses, requires, and/or contracts with or delegates to another entity, including, but not limited to, a pharmacy benefit manager for the issue, use or requirement of, a card or other technology for claims processing and an administrator of such a plan including, but not limited to, third-party administrators for self-insured plans, pharmacy benefits managers and state-administered plans shall issue, use, and/or require from the other entity including, but not limited to a pharmacy benefit manager, for its insureds a uniform card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall be in the format approved by the National Council for Prescription Drug Programs (NCPDP) and shall include all of the fields required by the plan for submission and adjudication of claims for prescription drug or device benefits, or at a minimum contain the following labeled information:

1. the card issuer name or logo on the front of the card;
2. the cardholder's name and identification number, which shall be displayed on the front side of the card;
3. complete information for electronic transaction claims routing including:

1. the international identification number labeled as RxBIN;
2. the processor control number labeled as RxPCN if required for proper routing of electronic claim transactions for prescription benefits;
3. The group number labeled as RxGrp if required for proper routing of electronic claim transactions for prescription benefits.

1. the name and address of the benefits administrator or other entity responsible for prescription claims submission, adjudication or pharmacy provider correspondence for prescription benefit claims; and
2. a help desk telephone number those pharmacy providers may call for pharmacy benefit claims assistance.

1. All information required by subsection (a) that is necessary for submission and adjudication of claims for prescription drug or device benefits, exclusive of information that can be derived from the prescription, shall be included in a clear, readable and understandable manner on the card or other technology issued by the plan, its administrators, or its agents or contractors. The content and format of all information required by subsection (a) must be in the current content and format required by the plan for electronic claims routing, submission and adjudication.
2. A new uniform prescription drug information card or other technology, as required under paragraph (a) shall be issued, used, and/or required by a health benefit plan, and/or by the plan's contracts with or requirement from another entity including, but not limited to, a pharmacy benefit manager, upon enrollment and reissued or required upon any change in the certificate holder's coverage that impacts data in content or format as contained on the card that affects the data content or format required to be on the card or other technology as required by subsection (a) or upon a change in the NCPDP implementation guide or successor document that affects data content or format contained on the card or other technology as required by subsection (a). Newly issued, used or required cards or other technology shall be updated with the latest coverage information and shall conform to the NCPDP standards then in effect and to the implementation guide then in use or the format specified by the Insurance Commissioner. Provided, however, that the plan and/or any entity that the plan contracts with, or requires from, pursuant to the requirements of this law may issue stickers or other methodologies to update cards temporarily as may be acceptable to the Insurance Commissioner.
3. The card or other technology may be used for any and all health insurance coverage. Nothing in this section requires any person issuing, using or requiring the card or other technology to issue, use or require a separate card for prescription coverage, provided that the card or other technology can accommodate the information necessary to process the claim as required by subsection (a).
4. As used in this section, 'health benefit plan' means an accident and health insurance policy or certificate; a nonprofit hospital or medical service corporation contract; a health maintenance organization subscriber contract; a plan provided by a multiple employer welfare arrangement; or a plan provided by another benefit arrangement, to the extent permitted by the Employee Retirement Income Security Act of 1974, as amended, or by any waiver of or other exception to that Act provided under federal law or regulation. Without limitation, 'health benefit plan' does not mean any of the following types of insurance:

1. accident;
2. credit;
3. disability income;
4. specified disease;
5. dental or vision;
6. coverage issued as a supplement to liability insurance;
7. medical payments under automobile or homeowners;
8. insurance under which benefits are payable with or without regard to fault and this is statutorily required to be contained in any liability policy or equivalent self-insurance; and
9. hospital income or indemnity.".

Section 2. This Act is effective six (6) months from passage and applied to health benefit plans that are delivered, issued for delivery, or renewed within two (2) years after enactment. For purposes of this Act, renewal of a health benefit policy, contract or plan is presumed to occur on each anniversary of the date on which coverage was first effective on the person or persons covered by the health benefit plan.

Section 3. Enforcement of this Act shall be the responsibility of the State Insurance Commissioner. The Insurance Commissioner shall promulgate rules necessary to effectuate this Act.".