EYE DROPS; INSURANCE COVERAGE                                                     H.B. 4451 (H-1):

                                                                              SUMMARY OF HOUSE-PASSED BILL

                                                                                                         IN COMMITTEE

 

 

 

 

 

 

House Bill 4451 (Substitute H-1 as passed by the House)

Sponsor:  Representative Julie Calley

House Committee:  Health Policy

                             Ways and Means

Senate Committee:  Health Policy and Human Services

 

Date Completed:  10-15-19

 


CONTENT

 

The bill would amend the Insurance Code to prohibit an insurer that delivered, issued for delivery, or renewed in the State a health insurance policy that provided coverage for prescription eye drops from denying coverage for a refill of the prescription if certain conditions applied.

 

The bill would apply to health insurance policies delivered, executed, issued, amended, adjusted, or renewed in the State, or outside of the State if covering residents of the State, beginning 90 days after its enactment.

 

Specifically, an insurer that delivered, issued for delivery, or renewed in the State a health insurance policy that provided coverage for prescription eye drops could not deny coverage for a refill of the prescription if the following applied:

 

 --    For a 30-day supply, the amount of time had passed within which the insured should have used 75% of the dosage units of the drug according to the prescriber's instructions, or 23 days had passed after either: 1) the original date the prescription was distributed to the insured, or 2) the date the most recent refill was distributed to the insured.

 --    The prescriber indicated on the original prescription that additional quantities were needed.

 --    The prescription eye drops prescribed by the prescriber were covered under the health insurance policy.

 

"Prescriber" would mean that term as defined in Section 17708 of the Public Health Code: a licensed dentist, a licensed doctor of medicine, a licensed doctor of osteopathic medicine and surgery, a licensed doctor of podiatric medicine and surgery, a licensed physician's assistant, a licensed optometrist to administer and prescribe therapeutic pharmaceutical agents, an advanced practice registered nurse a licensed veterinarian, or another licensed health professional acting under the delegation and using, recording, or otherwise indicating the name of the delegating licensed doctor of medicine or licensed doctor of osteopathic medicine and surgery.

 

Proposed MCL 500.3406u                                          Legislative Analyst:  Tyler VanHuyse

 

FISCAL IMPACT

 

The bill would have no fiscal impact on State or local government.

 

                                                                           Fiscal Analyst:  Elizabeth Raczkowski

                                                                                                         Steve Angelotti

This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.