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REFERENCE TITLE: insurance; prescription eye drops; refills |
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State of Arizona House of Representatives Fifty-second Legislature Second Regular Session 2016
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HB 2264 |
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Introduced by Representatives Brophy McGee: Carter
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AN ACT
Amending title 20, chapter 4, article 3, Arizona Revised Statutes, by adding section 20-841.11; amending title 20, chapter 4, article 9, Arizona Revised Statutes, by adding section 20-1057.16; amending title 20, chapter 6, article 4, Arizona Revised Statutes, by adding section 20-1376.08; amending title 20, chapter 6, article 5, Arizona Revised Statutes, by adding section 20-1406.08; relating to health insurance.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3, Arizona Revised Statutes, is amended by adding section 20-841.11, to read:
20-841.11. Prescription eye drops; refills
A. Any contract that is issued, delivered or renewed by a corporation on or after the effective date of this section and that provides coverage for prescription eye drops may not deny coverage for a refill of a prescription for eye drops if all of the following apply:
1. The subscriber requests the refill:
(a) For a thirty-day supply, at least twenty‑one days and less than thirty days from the later of:
(i) The original date that the prescription was distributed to the subscriber.
(ii) The date of the most recent refill that was distributed to the subscriber.
(b) For a sixty-day supply, at least forty‑two days and less than sixty days from the later of:
(i) The original date that the prescription was distributed to the subscriber.
(ii) The date of the most recent refill that was distributed to the subscriber.
(c) For a ninety-day supply, at least sixty‑three days and less than ninety days from the later of:
(i) The original date that the prescription was distributed to the subscriber.
(ii) The date of the most recent refill that was distributed to the subscriber.
2. The prescription eye drops prescribed by the health care provider are a covered benefit under the subscriber's contract.
3. The prescribing health care provider indicates on the original prescription that additional quantities of the prescription eye drops are needed.
4. The refill requested by the subscriber does not exceed the number of additional quantities prescribed.
B. To the extent practicable, the requirements of this section are limited in quantity to the remaining dosage initially approved for coverage, except that any limited refilling may not limit or restrict coverage to any previously or subsequently approved prescription eye drops and is subject to the terms and conditions of the contract that are applicable to this coverage.
Sec. 2. Title 20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding section 20-1057.16, to read:
20-1057.16. Prescription eye drops; refills
A. Any evidence of coverage that is issued, delivered or renewed by a health care services organization on or after the effective date of this section and that provides coverage for prescription eye drops may not deny coverage for a refill of a prescription for eye drops if all of the following apply:
1. The enrollee requests the refill:
(a) For a thirty-day supply, at least twenty‑one days and less than thirty days from the later of:
(i) The original date that the prescription was distributed to the enrollee.
(ii) The date of the most recent refill that was distributed to the enrollee.
(b) For a sixty-day supply, at least forty‑two days and less than sixty days from the later of:
(i) The original date that the prescription was distributed to the enrollee.
(ii) The date of the most recent refill that was distributed to the enrollee.
(c) For a ninety-day supply, at least sixty‑three days and less than ninety days from the later of:
(i) The original date that the prescription was distributed to the enrollee.
(ii) The date of the most recent refill that was distributed to the enrollee.
2. The prescription eye drops prescribed by the health care provider are a covered benefit under the enrollee's evidence of coverage.
3. The prescribing health care provider indicates on the original prescription that additional quantities of the prescription eye drops are needed.
4. The refill requested by the enrollee does not exceed the number of additional quantities prescribed.
B. To the extent practicable, the requirements of this section are limited in quantity to the remaining dosage initially approved for coverage, except that any limited refilling may not limit or restrict coverage to any previously or subsequently approved prescription eye drops and is subject to the terms and conditions of the evidence of coverage that are applicable to this coverage.
Sec. 3. Title 20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding section 20-1376.08, to read:
20-1376.08. Prescription eye drops; refills
A. Any policy that is issued, delivered or renewed by a disability insurer on or after the effective date of this section and that provides coverage for prescription eye drops may not deny coverage for a refill of a prescription for eye drops if all of the following apply:
1. The insured requests the refill:
(a) For a thirty-day supply, at least twenty‑one days and less than thirty days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
(b) For a sixty-day supply, at least forty‑two days and less than sixty days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
(c) For a ninety-day supply, at least sixty‑three days and less than ninety days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
2. The prescription eye drops prescribed by the health care provider are a covered benefit under the insured's policy.
3. The prescribing health care provider indicates on the original prescription that additional quantities of the prescription eye drops are needed.
4. The refill requested by the insured does not exceed the number of additional quantities prescribed.
B. To the extent practicable, the requirements of this section are limited in quantity to the remaining dosage initially approved for coverage, except that any limited refilling may not limit or restrict coverage to any previously or subsequently approved prescription eye drops and is subject to the terms and conditions of the policy that are applicable to this coverage.
Sec. 4. Title 20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding section 20-1406.08, to read:
20-1406.08. Prescription eye drops; refills
A. Any policy that is issued, delivered or renewed by a group or blanket disability insurer on or after the effective date of this section and that provides coverage for prescription eye drops may not deny coverage for a refill of a prescription for eye drops if all of the following apply:
1. The insured requests the refill:
(a) For a thirty-day supply, at least twenty‑one days and less than thirty days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
(b) For a sixty-day supply, at least forty‑two days and less than sixty days from the later of:
(i) The original date that the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
(c) For a ninety-day supply, at least sixty‑three days and less than ninety days from the later of:
(i) The original date the prescription was distributed to the insured.
(ii) The date of the most recent refill that was distributed to the insured.
2. The prescription eye drops prescribed by the health care provider are a covered benefit under the insured's policy.
3. The prescribing health care provider indicates on the original prescription that additional quantities of the prescription eye drops are needed.
4. The refill requested by the insured does not exceed the number of additional quantities prescribed.
B. To the extent practicable, the requirements of this section are limited in quantity to the remaining dosage initially approved for coverage, except that any limited refilling may not limit or restrict coverage to any previously or subsequently approved prescription eye drops and is subject to the terms and conditions of the policy that are applicable to this coverage.