LD 572
PUBLIC Law, Chapter 91

on - Session - 127th Maine Legislature
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An Act To Ensure Appropriate Health Insurance Coverage for Prescription Eye Drops

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 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.

Effective 90 days following adjournment of the 127th Legislature, First Regular Session, unless otherwise indicated.

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