Relates to coverage for refills of prescription eye drops

BILL NUMBER:S7001B

Title of bill

An act to amend the insurance law, in relation to prescription coverage for eye drops

Purpose

This bill amends certain sections of the insurance law to allow for the refill of prescription eye drops when the refill is requested prior to the expiration of the period of suggested use.

Summary of provisions

Section 1. Amends section 3216 subsection (i) of the insurance law to add a new paragraph twenty-seven to allow for the limited refilling of the prescription eye drops when the refill is requested prior to the last day of the approved dosage period without regard to any coverage restrictions on early refill of renewals. A pharmacist may contact the physician or health care provider to verify the prescription. Section 2. Amends section 3221 subsection (k) of the insurance law to add a new paragraph sixteen to allow for the limited refilling of the prescription eye drops when the refill is requested prior to the last day of the approved dosage period without regard to any coverage restrictions on early refill of renewals. A pharmacist may contact the physician or health care provider to verify the prescription.

Section 3. Amends section 4303 of the insurance law to add a new subsection (gg) to allow for the limited refilling of the prescription eye drops when the refill is requested prior to the last day of the approved dosage period without regard to any coverage restrictions on early refill of renewals. A pharmacist may contact the physician or health care provider to verify the prescription.

Section 4. Sets forth the effective date.

Justification

Many patients rely on a variety of prescription eye medications for the preservation of sight. Particularly, those suffering from glaucoma and other degenerative eye diseases require prescription eye drops on a daily basis The effectiveness of prescription eye drops relies heavily upon continuity of treatment, specifically consistent daily usage by the patient.

Presently, many patients run out of their prescription eye drops well before the expiration of the intended period of use denoted on the prescription label. This is particularly problematic for elderly patients with unsteady hands. However, even those using the utmost care in storing and using the eye drops find it nearly impossible to ration the medication to last the period of intended use. When a patient runs out of their prescription prior to the expiration of the intended period of use and returns to their pharmacist seeking a refill of the prescription, coverage is denied by the insurance company and the patient is turned away empty handed.

Furthermore, many of these medications are not yet available in generic form and are very costly, thereby prohibiting patients from paying for the necessary prescription out of pocket which

disproportionately burdens our elderly and infirm. Unfortunately many patients are unable to utilize the entirety of the medication because of shaky hands or a defect in the products' dispensing mechanism. This bill would correct the problem by allowing for authorized refills of the product.

Failing to provide sensible refill and insurance coverage policies, prohibits continuity of care and puts patients at risk. Therefore, to ensure that patients who have prescription drug coverage continue to receive this important treatment it is necessary to require coverage for the limited refilling of prescription eye drops without regard to coverage restrictions for early refill of renewals. This legislation will provide much needed protections for those who rely on prescription eye drops for preservation of sight.

Legislative history

None

Fiscal implications

None.

Effective date

This act shall take effect immediately.