17B:27A-7.19 Individual health benefits plan to provide coverage for prescription eye drops.
6. a. An individual health benefits plan which provides hospital or medical expense benefits that include coverage for prescription eye drops under a contract delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for expenses incurred for refills of prescription eye drops in accordance with the Guidance for Early Refill Edits of Topical Ophthalmic Products provided to Medicare Part D plan sponsors by the Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services, provided that:
(1)the prescribing health care practitioner indicates on the original prescription that additional quantities of the prescription eye drops are needed; and
(2)the refill requested by the covered person does not exceed the number of additional quantities indicated on the original prescription by the prescribing health care practitioner.
b.The provisions of this section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium.
L.2013, c.50, s.6.
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Last modified: October 11, 2016