HB417

SECTION 1. The legislature finds that many patients require prescription eye drops for in-home treatment of their medical conditions. When patients self-administer these eye medications, a certain amount of the medication typically goes unused due to spills or other factors. Eye drops are notoriously hard to administer, even for those with steady hands. The inadvertent wastage of eye drops is a common problem among patients who cannot see, are elderly, or have arthritis, or otherwise have difficulty administering eye drops.

Patients who run out of their eye drop medications prior to the end of a prescription period may desire early refills. However, some insurers deny early refills because the insurers do not take into account the wastage factor in counting the number of drops needed for a prescription period.

At least seventeen states have enacted "drop bills", legislation that allow patients to refill eye drop medication prescriptions early under certain conditions. These states are: Illinois, Iowa, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Oregon, Texas, West Virginia, and Wisconsin.

The legislature recognizes that self-administration of eye drops may involve some reasonable amount of waste and that early prescription refills may be appropriate in some circumstances. Furthermore, access to those eye drops is particularly important as drug developers seek to make more treatments available in eye drop form.

Accordingly, the purpose of this Act is to prohibit health insurers from denying coverage for early refills of topical eye medication prescriptions under certain conditions.

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to part I of article 10A to be appropriately designated and to read as follows:

"§431:10A- Topical eye medication prescription coverage; refills. No individual policy of accident and health or sickness insurance issued in this State that provides coverage for prescription topical eye medication may deny coverage for the refilling of a prescription for topical eye medication if:

(1) The medication is prescribed by a physician licensed under chapter 453 or an optometrist licensed under chapter 459 to treat a chronic condition of the eye;

(2) The refill is requested by the insured prior to the last day of the prescribed dosage period and after at least seventy-five per cent of the predicted days of use have passed;

(3) The original prescription indicates that refills are permitted; and

(4) The early refill requested by the insured does not exceed the total number of refills prescribed."

SECTION 3. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to part II of article 10A to be appropriately designated and to read as follows:

"§431:10A- Topical eye medication prescription coverage; refills. No group policy of accident and health or sickness insurance issued in this State that provides coverage for prescription topical eye medication may deny coverage for the refilling of a prescription for topical eye medication if:

(1) The medication is prescribed by a physician licensed under chapter 453 or an optometrist licensed under chapter 459 to treat a chronic condition of the eye;

(2) The refill is requested by the insured prior to the last day of the prescribed dosage period and after at least seventy-five per cent of the predicted days of use have passed;

(3) The original prescription indicates that refills are permitted; and

(4) The early refill requested by the insured does not exceed the total number of refills prescribed."

SECTION 4. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to part VI of article 1 to be appropriately designated and to read as follows:

"§432:1- Topical eye medication prescription coverage; refills. No individual or group hospital and medical service plan contract or medical service corporation contract issued in this State that provides coverage for prescription topical eye medication may deny coverage for the refilling of a prescription for topical eye medication if:

(1) The medication is prescribed by a physician licensed under chapter 453 or an optometrist licensed under chapter 459 to treat a chronic condition of the eye;

(2) The refill is requested by the member prior to the last day of the prescribed dosage period and after at least seventy-five per cent of the predicted days of use have passed;

(3) The original prescription indicates that refills are permitted; and

(4) The early refill requested by the member does not exceed the total number of refills prescribed."

SECTION 5. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-140, , and 431:10A-134, and chapter 431M."

SECTION 6. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

SECTION 7. New statutory material is underscored.

SECTION 8. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	417
THIRTIETH LEGISLATURE, 2019
STATE OF HAWAII