HP0396
LD 572
Session - 127th Maine Legislature
C "A", Filing Number H-81, Sponsored by
LR 1566
Item 2
Bill Tracking, Additional Documents Chamber Status

Amend the bill by striking out everything after the enacting clause and before the summary and inserting the following:

Sec. 1.

Sec. . 24-A MRSA §4314-A  is enacted to read:

§ 4314-A Coverage for early refills of prescription eye drops

1 Required coverage.   A carrier offering a health plan in this State shall provide coverage for one early refill of a prescription for eye drops if the following criteria are met:
A The enrollee requests the refill no earlier than the date on which 70% of the days of use authorized by the prescribing health care provider have elapsed;
B The prescribing health care provider indicated on the original prescription that a specific number of refills are authorized;
C The refill requested by the enrollee does not exceed the number of refills indicated on the original prescription;
D The prescription has not been refilled more than once during the period authorized by the prescribing health care provider prior to the request for an early refill; and
E The prescription eye drops are a covered benefit under the enrollee's health plan.
2 Cost sharing.   A carrier may impose a deductible, copayment or coinsurance requirement for an early refill under this section as permitted under the health plan.

Sec. 2. Application. The requirements of this Act apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2016. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.’

Summary

This amendment replaces the bill. Like the bill, the amendment requires all health insurance carriers offering health plans to provide coverage for early refills of prescription eye drop medication under certain circumstances. Unlike the bill, under the amendment the enrollee must request the refill no earlier than the date on which 70% of the days of use authorized by the prescribing health care provider have elapsed. Like the bill, the amendment applies to all policies and contracts issued or renewed on or after January 1, 2016.


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