senate Bill S1430

Relates to coverage for refills of prescription eye drops

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Sponsor

Co-Sponsors

Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

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

Summary

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.

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Bill Details

See Assembly Version of this Bill:
A1219
Versions:
S1430
Legislative Cycle:
2011-2012
Law Section:
Insurance Law
Laws Affected:
Amd ยงยง3216, 3221 & 4303, Ins L
Versions Introduced in 2009-2010 Legislative Cycle:
S7001B, A10229B

Votes

17
1
17
Aye
1
Nay
0
aye with reservations
0
absent
0
excused
0
abstained
show Insurance committee vote details

Sponsor 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.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1430

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             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-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01084-01-1

S. 1430                             2

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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