Bill S1430-2011

Relates to coverage for refills of prescription eye drops

Requires coverage for the authorized refill of any prescription eye drop medication under certain circumstances when such refill is requested prior to expiration of the period of usage.

Details

Actions

  • Jun 2, 2011: SUBSTITUTED BY A1219
  • Mar 23, 2011: ADVANCED TO THIRD READING
  • Mar 22, 2011: 2ND REPORT CAL.
  • Mar 21, 2011: 1ST REPORT CAL.238
  • Jan 7, 2011: REFERRED TO INSURANCE

Votes

VOTE: COMMITTEE VOTE: - Insurance - Mar 21, 2011
Ayes (17): Seward, Flanagan, Golden, Grisanti, Lanza, Larkin, LaValle, Martins, Saland, Young, Breslin, Diaz, Espaillat, Kennedy, Kruger, Peralta, Smith
Nays (1): Parker

Memo

BILL NUMBER:S1430

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-eight 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 seventeen 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 (hh) 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 oftheir 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:

2009-2010: S.7001B Passed Senate

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

This act shall take effect immediately.


Text

STATE OF NEW YORK ________________________________________________________________________ 1430 2011-2012 Regular Sessions IN SENATE January 7, 2011 ___________
Introduced by Sens. SALAND, BONACIC -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to prescription coverage for eye drops THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 28 to read as follows: (28) NOTWITHSTANDING TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW OR ANY OTHER LAW TO THE CONTRARY, EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL, WITH REGARD TO EYE DROP MEDICATION REQUIRING A PRESCRIPTION THAT HAS BEEN APPROVED BY THE INSUR- ER FOR COVERAGE, ALLOW FOR THE LIMITED REFILLING OF THE PRESCRIPTION PRIOR TO THE LAST DAY OF THE APPROVED DOSAGE PERIOD WITHOUT REGARD TO ANY COVERAGE RESTRICTIONS ON EARLY REFILL OF RENEWALS. PROVIDED, HOWEV- ER, THAT ANY REFILL DISPENSED PRIOR TO THE EXPIRATION OF THE PRESCRIBED AND APPROVED COVERAGE PERIOD PURSUANT TO THIS PARAGRAPH, SHALL, TO THE EXTENT PRACTICABLE, BE LIMITED IN QUANTITY SO AS NOT TO EXCEED THE REMAINING DOSAGE INITIALLY APPROVED FOR COVERAGE. PROVIDED, FURTHER, THAT SUCH LIMITED REFILLING SHALL NOT LIMIT OR RESTRICT COVERAGE WITH REGARD TO ANY PREVIOUSLY OR SUBSEQUENTLY APPROVED PRESCRIPTION FOR EYE DROP MEDICATION AND SHALL BE SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY OTHERWISE APPLICABLE TO THIS COVERAGE. PROVIDED, FURTHER, THAT A PHARMACIST MAY CONTACT THE PRESCRIBING PHYSICIAN OR HEALTH CARE PROVIDER TO VERIFY THE PRESCRIPTION. S 2. Subsection (k) of section 3221 of the insurance law is amended by adding a new paragraph 17 to read as follows: (17) NOTWITHSTANDING TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW OR ANY OTHER LAW TO THE CONTRARY, EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL, WITH REGARD TO EYE DROP MEDICATION REQUIRING A PRESCRIPTION THAT HAS BEEN APPROVED BY THE INSUR-
ER FOR COVERAGE, ALLOW FOR THE LIMITED REFILLING OF THE PRESCRIPTION PRIOR TO THE LAST DAY OF THE APPROVED DOSAGE PERIOD WITHOUT REGARD TO ANY COVERAGE RESTRICTIONS ON EARLY REFILL OF RENEWALS. PROVIDED, HOWEV- ER, THAT ANY REFILL DISPENSED PRIOR TO THE EXPIRATION OF THE PRESCRIBED AND APPROVED COVERAGE PERIOD PURSUANT TO THIS PARAGRAPH, SHALL, TO THE EXTENT PRACTICABLE, BE LIMITED IN QUANTITY SO AS NOT TO EXCEED THE REMAINING DOSAGE INITIALLY APPROVED FOR COVERAGE. PROVIDED, FURTHER, THAT SUCH LIMITED REFILLING SHALL NOT LIMIT OR RESTRICT COVERAGE WITH REGARD TO ANY PREVIOUSLY OR SUBSEQUENTLY APPROVED PRESCRIPTION FOR EYE DROP MEDICATION AND SHALL BE SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY OTHERWISE APPLICABLE TO THIS COVERAGE. PROVIDED, FURTHER, THAT A PHARMACIST MAY CONTACT THE PRESCRIBING PHYSICIAN OR HEALTH CARE PROVIDER TO VERITY THE PRESCRIPTION. S 3. Section 4303 of the insurance law is amended by adding a new subsection (hh) to read as follows: (HH) NOTWITHSTANDING TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW OR ANY OTHER LAW TO THE CONTRARY, EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL, WITH REGARD TO EYE DROP MEDICATION REQUIRING A PRESCRIPTION THAT HAS BEEN APPROVED BY THE INSUR- ER FOR COVERAGE, ALLOW FOR THE LIMITED REFILLING OF THE PRESCRIPTION PRIOR TO THE LAST DAY OF THE APPROVED DOSAGE PERIOD WITHOUT REGARD TO ANY COVERAGE RESTRICTIONS ON EARLY REFILL OF RENEWALS. PROVIDED, HOWEV- ER, THAT ANY REFILL DISPENSED PRIOR TO THE EXPIRATION OF THE PRESCRIBED AND APPROVED COVERAGE PERIOD PURSUANT TO THIS SUBSECTION, SHALL, TO THE EXTENT PRACTICABLE, BE LIMITED IN QUANTITY SO AS NOT TO EXCEED THE REMAINING DOSAGE INITIALLY APPROVED FOR COVERAGE. PROVIDED, FURTHER, THAT SUCH LIMITED REFILLING SHALL NOT LIMIT OR RESTRICT COVERAGE WITH REGARD TO ANY PREVIOUSLY OR SUBSEQUENTLY APPROVED PRESCRIPTION FOR EYE DROP MEDICATION AND SHALL BE SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY OTHERWISE APPLICABLE TO THIS COVERAGE. PROVIDED, FURTHER, THAT A PHARMACIST MAY CONTACT THE PRESCRIBING PHYSICIAN OR HEALTH CARE PROVIDER TO VERITY THE PRESCRIPTION. S 4. This act shall take effect immediately and shall apply to poli- cies issued, reissued, renewed, modified or amended on and after such date.

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