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40-4623. Same; required information on card; use of social security number as cardholder identification number prohibited; issuance of card.

40-4623

Chapter 40.--INSURANCE
Article 46.--MANAGED CARE

      40-4623.   Same; required information on card;use of social security number as cardholder identification number prohibited;issuance of card.(a) A health benefit plan that provides coverage forprescription drugs or devices and issues a card for claims processing and anadministrator of any such plan, including, but not limited to, a pharmacybenefits manager and a third-party administrator shall issue acard containing uniform prescription drug information to each person entitledto such card under the health benefit plan. If required for claimsadjudication, the uniform prescription drug information card shall specificallyidentify and display the following information:

      (1)   ANSI-BIN number;

      (2)   processor control number or group number or both;

      (3)   card issuer identifier;

      (4)   prescription claims processor, if different from card issuer;

      (5)   cardholder identification number;

      (6)   cardholder or insured name;

      (7)   claims submission names and addresses; and

      (8)   help desk telephone numbers.

      (b)   A uniform prescription drug information card shall be issued by a healthbenefit plan to each person entitled to such card under the health benefit planupon enrollment and reissued uponany change in such person's coverage that affects one or more mandatory dataelements contained on the card.

      (c)   Notwithstanding the foregoing provision, any health benefit plan oradministrator of such plan may utilize, in lieu of such card, electronictechnology which contains all of the information required for claimsadjudication, as long as such electronic technology is provided by the healthbenefit plan or administrator of such plan to the pharmacies which willadjudicate the prescription drug claims.

      (d)   On and after July 1, 2006: (1) Nocardholder's socialsecurity number shall be printed or encoded on or into anycard issued under this section.

      (2)   Any cardholder identification number or otherdistinguishing identifier assigned to the card issued to acardholder shall be a combination of numbers or letters orboth, which is unique to the cardholder.

      (3)   A cardholder's identification number or otherdistinguishing identifier assigned to such insured's policy card shall not, inany way, be based onor depend on the cardholder's social security number.

      History:   L. 2003, ch. 89, § 3;L. 2004, ch. 157, § 6; July 1.

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