Title: Health Benefit Coverage for Prescription Eye Drop Refills

Summary: Requiring health insurance policies providing coverage for certain prescription eye drops to provide coverage for eye drop prescription refills under certain circumstances; providing applicability of prescription eye drop refill coverage requirements to group health insurance, blanket health insurance, and franchise health insurance, etc.

Full Text:
An act relating to health benefit coverage for prescription eye drop refills; creating s. 627.6411, F.S.; requiring health insurance policies providing coverage for certain prescription eye drops to provide coverage for eye drop prescription refills under certain circumstances; providing that such benefits are subject to the same cost-sharing provisions established for other prescription drug benefits under such policies; amending s. 627.662, F.S.; providing applicability of prescription eye drop refill coverage requirements to group health insurance, blanket health insurance, and franchise health insurance; amending s. 641.31, F.S.; requiring health maintenance contracts providing coverage for certain prescription eye drops to provide coverage for eye drop prescription refills under certain circumstances; providing that such benefits are subject to the same cost-sharing provisions established for other prescription drug benefits under such contracts; providing an effective date. Be It Enacted by the Legislature of the State of Florida: Section 1. Section 627.6411, Florida Statutes, is created to read: 627.6411 Coverage for prescription eye drop refills.  (1) A health insurance policy that provides coverage for prescription eye drops to treat a chronic eye disease or condition must provide coverage for a refill of prescription eye drops if all of the following conditions are met: (a) The refill is dispensed on or before the last day of the prescribed dosage period, and not earlier than: 1. The 24th day after the date a prescription for a 30-day supply of eye drops is dispensed; 2. The 48th day after the date a prescription for a 60-day supply of eye drops is dispensed; or 3. The 72nd day after the date a prescription for a 90-day supply of eye drops is dispensed. (b) The original prescription states that additional quantities are needed and the refill requested by the insured does not exceed such quantities. (2) The prescription eye drop benefits covered under this section are subject to the same annual deductibles, copayments, coinsurance, or other cost-sharing provisions established for all other prescription drug benefits under the health insurance policy. Section 2. Present subsection (15) of section 627.662, Florida Statutes, is redesignated as subsection (16), and a new subsection (15) is added to that section, to read: 627.662 Other provisions applicable. The following provisions apply to group health insurance, blanket health insurance, and franchise health insurance: (15)  Section 627.6411, relating to coverage for prescription eye drop refills.Section 3. Subsection (45) is added to section 641.31, Florida Statutes, to read: 641.31 Health maintenance contracts.  (45)(a)  A health maintenance contract that provides coverage for prescription eye drops to treat a chronic eye disease or condition must provide coverage for a refill of prescription eye drops if all of the following conditions are met: 1.  The refill is dispensed on or before the last day of the prescribed dosage period,and not earlier than:a.  T he 24th day after the date a prescription for a 30-day supply of eye drops is dispensed; b.  T he 48th day after the date a prescription for a 60-day supply of eye drops is dispensed; or c.  T he 72nd day after the date a prescription for a 90-day supply of eye drops is dispensed. 2.  The original prescription states that additional quantities are needed and the refill requested by the subscriber does not exceed such quantities. (b)  The prescription eye drop benefits covered under this sub section are subject to the same annual deductibles, copayme nts, coinsurance, or other cost-sharing provisions established for all other prescription drug benefits under the health maintenance contract. Section 4. This act shall take effect July 1, 2018.