PRESCRIPTION EYE DROP EARLY REFILL COVERAGE.

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View NCGA Bill Details2023-2024 Session
House Bill 684 (Public) Filed Tuesday, April 18, 2023
AN ACT TO REQUIRE HEALTH BENEFIT PLANS THAT PROVIDE COVERAGE FOR PRESCRIPTION EYE DROPS TO ALSO PROVIDE COVERAGE FOR EARLY REFILLS.
Intro. by K. Baker, Reeder, Crawford, White.

Status: Ref To Com On Rules and Operations of the Senate (Senate action) (May 2 2023)
H 684

Bill Summaries:

  • Summary date: Apr 26 2023 - View Summary

    House committee substitute to the 1st edition makes the following change.

    Amends proposed GS 58-3-295 by amending the second condition that must be met before a health benefit insurance plan that provides coverage for prescription eye drops cannot deny coverage for a refill of an eye drop prescription to require that the refill requested by the insured would not exceed the limit, if any, on the number of refills for that prescription that the prescribing health care provider indicated on the original prescription (was, the prescribing health care provider indicates on the original prescription that the patient needs additional quantities of eye drops, and the insured patient’s request for a refill of eye drops does not exceed the number of additional quantities needed).


  • Summary date: Apr 18 2023 - View Summary

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    Enacts new GS 58-3-295. Requires every health benefit insurance plan that provides coverage for prescription eye drops to not deny coverage for a refill of an eye drop prescription if both of the following two conditions apply:

    (1) Applies to 30-day supplies. The patient requested the refill after (a) an amount of time after which the patient should have used 70% of the prescription eye drop dosage units according to a health care provider’s instructions or (b) 21 days from (i) the original date the insured patient was given the prescription or (ii) the date of the most recent refill to the insured patient.

    (2) The prescribing health care provider indicates on the original prescription that the patient needs additional quantities of eye drops, and the insured patient’s request for a refill of eye drops does not exceed the number of additional quantities needed.

    Effective October 1, 2023, and applies to contracts issued, renewed, or amended on or after October 1, 2023.