Mandated Health Benefits – Prescription Eye Drops

On January 13, 2017, Massachusetts Governor Charlie Baker signed legislation (H.B. 4195) regarding insurance coverage for prescription eye drops. Pursuant to the bill, any policy, contract, agreement, plan, or certificate of insurance issued, delivered, or renewed in Massachusetts on or after April 13, 2017 that provides coverage for prescription eye drops must also provide coverage for refills. This refill coverage is in accordance with Medicare Part D guidelines on early refills of topical ophthalmic products when the health care practitioner indicates on the original prescription that additional quantities of the prescription eye drops are needed, the refill requested does not exceed the number of additional quantities indicated on the original prescription, and the eye drops are a covered benefit.

Read H.B. 4195