Coverage for Prescription Eye Drops

On Jan. 13, 2017, Gov. Baker signed H 4195 into law, creating Chapter 454. The new law relates to coverage for prescription eye drops. Under the new law, plans that provide coverage for prescription eye drops must provide refills in accordance with Medicare Part D guidance for early refills of topical ophthalmic products in certain situations. The refill requirement applies if the refills requested by the individual do not exceed the number of additional quantities indicated on the original prescription and if the associated health care practitioner indicates that additional quantities of prescription eye drops are necessary on the original prescription.

The new law applies for policies, contracts, agreements, plans or certificates of insurance issued, delivered or renewed in Massachusetts on or after April 1, 2017. The law contains no new employer obligations, but those employers with fully insured plans in Massachusetts should be aware of the new prescription eye drop requirements.

Chapter 454 »