ORS 743B.601: Synchronization of prescription drug refills.

(1) As used in this section:

      (a) “Health plan” means:

      (A) A “health benefit plan” as defined in ORS 743B.005; and

      (B) A self-insured health plan offered by the Oregon Health and Science University.

      (b) “Synchronization policy” means a procedure for aligning the refill dates of a patient’s prescription drugs so that drugs that are refilled at the same frequency may be refilled concurrently.

      (2) A health plan that includes prescription drug coverage shall implement a synchronization policy for the dispensing of prescription drugs to the plan’s enrollees.

      (3) A health plan shall reimburse the cost of prescription drugs dispensed in accordance with the plan’s synchronization policy.

      (4) If a drug is dispensed in less than a 30-day supply for the purpose of synchronizing a patient’s prescription drug refills, a health plan shall:

      (a) Prorate the copayment; or

      (b) Adjust the copayment using a method approved by the Department of Consumer and Business Services.

      (5) A health plan shall fully reimburse the dispensing fee for partially filled or refilled prescription drugs.

      (6) This section does not apply to prescription drugs that:

      (a) Are in unit-of-use packaging for which synchronization is not possible;

      (b) Are controlled substances; or

      (c) Have been identified by the United States Drug Enforcement Administration as having a high risk of diversion.

      (7) The coverage required by this section may be limited by formulary restrictions applied to a prescription drug by a health plan.

      (8)(a) This section does not apply to a prepaid group practice health plan with at least 200,000 enrollees in this state.

      (b) As used in this subsection, “prepaid group practice health plan” means a health care service contractor that provides physician services to its enrollees through an integrated health care delivery system using, primarily, a single group of physicians contracted on a prepaid, capitated basis.