CHAPTER 326
SB 401-FN - FINAL VERSION
03/03/2016 0597s
06/01/2016 1989EBA
2016 SESSION
16-2795
01/10
SENATE BILL 401-FN
AN ACT relative to insurance coverage for prescription eye drops.
SPONSORS: Sen. Carson, Dist 14; Sen. Stiles, Dist 24; Sen. Fuller Clark, Dist 21; Rep. Sherman, Rock. 24; Rep. Fothergill, Coos 1
COMMITTEE: Commerce
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ANALYSIS
This bill provides for insurance coverage for early refills of prescription eye drops.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/03/2016 0597s 16-2795
06/01/2016 1989EBA 01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Sixteen
AN ACT relative to insurance coverage for prescription eye drops.
Be it Enacted by the Senate and House of Representatives in General Court convened:
326:1 New Section; Accident and Health Insurance; Individual; Coverage for Early Refills of Prescription Eye Drops. Amend RSA 415 by inserting after section 6-t the following new section:
415:6-u Coverage for Early Refills of Prescription Eye Drops.
I. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for one early refill of a prescription for eye drops if the following criteria are met:
(a) For prescription eye drops dispensed as a 30-day supply, the enrollee requests the refill no earlier than 21 days after the later of the following dates:
(1) The date the original prescription was dispensed to the enrollee; or
(2) The date that the most recent refill of the prescription was dispensed to the enrollee;
(b) For prescription eye drops dispensed as a 90-day supply, the enrollee requests the refill no earlier than 63 days after the later of the following dates:
(1) The date the original prescription was dispensed to the enrollee; or
(2) The date that the most recent refill of the prescription was dispensed to the enrollee;
(c) The prescribing health care provider indicated on the original prescription that a specific number of refills are authorized;
(d) The refill requested by the enrollee does not exceed the number of refills indicated on the original prescription;
(e) The prescription has not been refilled more than once during the 30-day or 90-day period prior to the request for an early refill; and
(f) The prescription eye drops are a covered benefit under the enrollee’s health plan.
II. Benefits provided under this section shall not be subject to any greater copayment, deductible, or coinsurance than any other similar benefits provided by the insurer.
326:2 New Section; Accident and Health Insurance; Group; Coverage for Early Refills of Prescription Eye Drops. Amend RSA 415 by inserting after section 18-y the following new section:
415:18-z Coverage for Early Refills of Prescription Eye Drops.
I. Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for one early refill of a prescription for eye drops if the following criteria are met:
(a) For prescription eye drops dispensed as a 30-day supply, the enrollee requests the refill no earlier than 21 days after the later of the following dates:
(1) The date the original prescription was dispensed to the enrollee; or
(2) The date that the most recent refill of the prescription was dispensed to the enrollee;
(b) For prescription eye drops dispensed as a 90-day supply, the enrollee requests the refill no earlier than 63 days after the later of the following dates:
(1) The date the original prescription was dispensed to the enrollee; or
(2) The date that the most recent refill of the prescription was dispensed to the enrollee;
(c) The prescribing health care provider indicated on the original prescription that a specific number of refills are authorized;
(d) The refill requested by the enrollee does not exceed the number of refills indicated on the original prescription;
(e) The prescription has not been refilled more than once during the 30-day or 90-day period prior to the request for an early refill; and
(f) The prescription eye drops are a covered benefit under the enrollee’s health plan.
II. Benefits provided under this section shall not be subject to any greater copayment, deductible, or coinsurance than any other similar benefits provided by the insurer.
326:3 Health Services Corporations; Coverage for Early Refills of Prescription Eye Drops. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:6-u, RSA 415:18, V, RSA 415:18, VII(g), RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-x, RSA 415:18-z, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
326:4 Health Services Corporations; Coverage for Early Refills of Prescription Eye Drops; Effective October 1, 2017. RSA 420-A:2 is repealed and reenacted to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
326:5 Health Services Corporations; Coverage for Early Refills of Prescription Eye Drops; Effective January 1, 2021. RSA 420-A:2 is repealed and reenacted to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
326:6 Health Maintenance Organizations; Coverage for Early Refills of Prescription Eye Drops. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:6-u, RSA 415:18, VII(g), RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-x, RSA 415:18-z, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
326:7 Health Maintenance Organizations; Coverage for Early Refills of Prescription Eye Drops; Effective October 1, 2017. RSA 420-B:20, III is repealed and reenacted to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
326:8 Health Maintenance Organizations; Coverage for Early Refills of Prescription Eye Drops; Effective January 1, 2021. RSA 420-B:20, III is repealed and reenacted to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
326:9 Health Services Corporations; Coverage for Early Refills of Prescription Eye Drops; Effective January 1, 2017. RSA 420-A:2 is repealed and reenacted to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:6-t, RSA 415:6-u, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-x, RSA 415:18-y, RSA 415:18-z, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
326:10 Health Maintenance Organizations; Coverage for Early Refills of Prescription Eye Drops; Effective January 1, 2017. RSA 420-B:20, III is repealed and reenacted to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:6-t, RSA 415:6-u, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-x, RSA 415:18-y, RSA 415:18-z, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
I. Sections 4 and 7 of this act shall take effect October 1, 2017 at 12:02 a.m.
II. Sections 5 and 8 of this act shall take effect January 1, 2021 at 12:01 a.m.
III. Sections 9 and 10 of this act shall take effect January 1, 2017 at 12:01 a.m.
IV. The remainder of this shall take effect 60 days after its passage.
Approved: June 24, 2016
Effective Date: I. Sections 4 and 7 shall take effect October 1, 2017 at 12:02 a.m.
II. Sections 5 and 8 shall take effect January 1, 2021 at 12:01 a.m.
III. Sections 9 and 10 shall take effect January 1, 2017 at 12:01 a.m.
IV. The remainder of this shall take effect August 23, 2016.