HR 4419 · 105th Congress · Health
Prescription Guarantee Act of 1998
Bill Progress
✓
Introduced2
Committee3
House Vote4
Senate5
EnactedLatest: Referred to the Subcommittee on Employer-Employee Relations.(1998-09-21)
Plain Language Summary
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Prescription Guarantee Act of 1998 - Amends the Public Health Service Act and the Employee Retirement Income Security Act of 1974 to require a group health plan, or a health insurance issuer offering coverage in connection with a group plan, if it covers prescription drugs but limits benefits to (or provides more favorable benefits for) drugs in a formulary, to: (1) make available to the public on request a description of the formulary restrictions; and (2) provide for restriction exceptions when the plan or beneficiary's physician, subject to reasonable plan or issuer review, determines that a non-formulary alternative is medically beneficial based on a therapeutic difference to the patient involved. Allows copayment doubling for nonformulary drugs. Prohibits a plan that provides prescription drug coverage from denying coverage of a drug if the use is included in the labeling authorized under specified provisions of the Federal Food, Drug, and Cosmetic Act. Prohibits a plan or issuer from discriminating against a health professional based on the extent, type, or pattern of prescription drugs. Prohibits a plan or issuer from excluding a pharmacist from its network if the pharmacist…
Summarized by Claude AI · Non-partisan · For informational purposes only