SB1589 Summary

• Requires individual and group accident and health insurance policies amended, delivered, issued, or renewed after the effective date to provide coverage for anti-epileptic drugs without waiting periods, deductibles, coinsurance, copayments, or cost-sharing limitations greater than other covered drugs.

• Prohibits pharmacists from substituting generic drugs for anti-seizure prescription drugs, and requires prescribing physicians to document that the specific anti-epileptic drug or formulation is clinically necessary for the patient's optimal care.

• Prevents health care plans from substituting anti-seizure prescription drugs with generic alternatives under pharmacy substitution provisions of the Managed Care Reform and Patient Rights Act.

• Defines "anti-epileptic drug," "epilepsy," and "seizure" for purposes of the insurance and pharmacy practice requirements.

• Removes previous provisions requiring pharmacist notification and patient consent when substituting generic anti-epileptic drugs for brand-name versions.