A bill sponsored by Senator Joe Pittman concerning prescription eye drops was signed into law by Governor Tom Wolf yesterday.
Senate Bill 1201 now requires health insurance policies issued or renewed in Pennsylvania to provide coverage for prescription eye drop refills at 70% of the prescribed duration. That means that early refills will be covered at 21 days for a 30-day supply, 42 days for a 60-day supply or 63 days for a 90-day supply.
Pittman says that Pennsylvania joins 29-other states who have passed similar legislation that follows guidance from the Centers for Medicare and Medicaid Services. He says that when people self-administer eye drops, there is some of the medicine that is lost due to spills or other factors. Before the bill was signed, if a person ran out of medicine before the expiration of the intended period of use and seeks a refill, coverage may be denied, and the refill would not be available. This caused people to either ration the medicine or go without.
A requirement of the bill is that the eye drops must be prescribed by a health care practitioner and be a covered benefit, and the number of refills cannot exceed the number indicated on the original prescription.
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