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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit plan coverage for accelerated refills of |
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certain prescription eye drops. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 1369, Insurance Code, is |
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amended by adding Section 1369.0041 to read as follows: |
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Sec. 1369.0041. ACCELERATED REFILLS OF CERTAIN |
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PRESCRIPTION EYE DROPS. (a) Subject to Subsection (b), a health |
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benefit plan that covers prescription eye drops to treat a chronic |
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eye disease or condition may not deny coverage for a refill of the |
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eye drops because the prescription is being refilled before the |
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date established by the plan's general prescription refill |
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guidelines if: |
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(1) the original prescription states that additional |
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quantities of the eye drops are needed; and |
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(2) the refill does not exceed the total quantity of |
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dosage units authorized by the prescribing provider on the original |
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prescription, including refills. |
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(b) A health benefit plan must provide coverage for the |
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refill of a prescription for eye drops described by Subsection (a) |
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that is dispensed on or before the last day of the prescribed dosage |
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period and: |
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(1) not earlier than the 21st day after the date a |
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prescription for a 30-day supply of eye drops is dispensed; |
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(2) not earlier than the 42nd day after the date a |
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prescription for a 60-day supply of eye drops is dispensed; or |
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(3) not earlier than the 63rd day after the date a |
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prescription for a 90-day supply of eye drops is dispensed. |
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SECTION 2. Section 1369.0041, Insurance Code, as added by |
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this Act, applies only to a health benefit plan delivered, issued |
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for delivery, or renewed on or after January 1, 2018. A health |
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benefit plan delivered, issued for delivery, or renewed before |
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January 1, 2018, is governed by the law as it existed immediately |
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before the effective date of this Act, and that law is continued in |
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effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2017. |