13-R398
2013 -- S 0537 SUBSTITUTE A
Enacted 07/11/13
J O I N T R E S
O L U T I O N
RESPECTFULLY
REQUESTING THE OFFICE OF THE HEALTH INSURANCE COMMISSIONER TO ENSURE THAT RHODE
GUIDELINES FOR
ALL COVERED INDIVIDUALS
Introduced By: Senators Felag, Lynch, Ciccone, Lombardi, and Ottiano
Date Introduced: February 28, 2013
WHEREAS, According to the World Health Organization (WHO), there are
an estimated
45 million persons with open angle glaucoma and this
figure is projected to rise to 59 million
respectively by 2020; and
WHEREAS The National Eye
Institute estimates the prevalence of open angle glaucoma
in the
WHEREAS Increased risk factors for open angle glaucoma include age,
family history,
national heritage (for example African American or Latino
American heritage), having had
serious eye injury or eye surgery in the past, or the taking
of a corticosteroid medication;
WHEREAS, Early detection
and treatment is critical to preventing serious vision loss as a
result of glaucoma;
WHEREAS, Eye drops are
often used in the treatment of certain chronic diseases such as
glaucoma;
WHEREAS, Eye drops are
also used to reduce the risk of infection, reduce inflammation
after surgeries, and to relieve conjunctivitis and dry
eyes;
WHEREAS, This General
Assembly strongly supports early refill of prescription eye
drops necessary to ensure continued access to effective treatments
for individuals with eye
diseases;
WHEREAS, The Centers for
Medicare & Medicaid Services (CMS) have issued
regulations that authorize refills, for inadvertent spillage at a
rate of 70% in a 30 day time period,
allowing patients to refill at day 21 for the essential
topical ophthalmic treatments; and
WHEREAS, The major insurers in
their pharmacy policies allow for early refills similar to
or consistent with the CMS regulations;
and
WHEREAS, Health care
professionals interested in ensuring proper dosage for treatment
of eye disease may work with pharmaceutical companies
that manufacture and distribute
ophthalmic products to seek additional safeguards and allowances
for spillage by patients,
including our most vulnerable populations;
WHEREAS, Rhode Island
healthcare providers and pharmacists may work together to
continue to inform patients about coverage for early refill of
medication and proper usage as
prescribed and needed to ensure effective treatment and positive
health outcomes; and
WHEREAS, While the
Patient Protection and Accountability Act (PPACA) allows states
to mandate health benefits for qualified health plans;
however, effective January 1, 2014, the
PPACA will assess costs to the states for additional
benefits that are mandated after December
31, 2011; now therefore be it
RESOLVED,
The General Assembly respectfully requests that the Office of the Health
Insurance Commissioner
continues to ensure that
treatment early refills in a manner similar to or consistent
with the Centers for Medicare &
Medicaid Services
regulations for all covered individuals; and be it further
RESOLVED,
That the Secretary of State be and is hereby
authorized and directed to
transmit duly certified copies of this resolution to the
Governor, the Director of the Department of
Health, the Office of the
Health Insurance Commissioner, the
Physicians
and Surgeons, and the
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LC01311/SUB A
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