Legislature(2013 - 2014)BARNES 124

03/27/2013 03:15 PM House LABOR & COMMERCE


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 175 ELECTRONIC POSTING OF INSURANCE POLICIES TELECONFERENCED
Moved CSHB 175(L&C) Out of Committee
*+ HB 125 TOPICAL EYE MEDS PRESCRIPTION REFILLS TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+= HB 74 AIDEA: LNG PROJECT; DIVIDENDS; FINANCING TELECONFERENCED
Moved CSHB 74(L&C) Out of Committee
          HB 125-TOPICAL EYE MEDS PRESCRIPTION REFILLS                                                                      
                                                                                                                                
3:55:16 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON  announced that  the next order  of business  would be                                                              
HOUSE  BILL NO. 125,  "An Act  prohibiting a  health care  insurer                                                              
from  denying  coverage  for an  additional  limited  quantity  of                                                              
prescription    topical     eye    medication     under    certain                                                              
circumstances."                                                                                                                 
                                                                                                                                
3:55:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  LINDSEY  HOLMES,   Alaska  State  Legislature,  as                                                              
sponsor, stated  that the optometrists and  ophthalmologists agree                                                              
with  the  changes in  HB  125.    She related  she  is  currently                                                              
working  with the  insurance industry  on some  slight changes  to                                                              
the bill.                                                                                                                       
                                                                                                                                
3:56:42 PM                                                                                                                    
                                                                                                                                
CHRISSY  MCNALLY,  Staff, Representative  Lindsey  Holmes,  Alaska                                                              
State  Legislature,  on  behalf  of  the  sponsor,  Representative                                                              
Lindsey Holmes, stated  HB 125 would allow patients  with glaucoma                                                              
and other  related  eye diseases  to receive  a limited refill  of                                                              
prescription  eye drops if  an individual  runs out of  medication                                                              
before the  prescribed refill  date.   Prescription medication  is                                                              
dispensed in  a specific number  of dosages  and eye drops  are no                                                              
exception; however, when  a medication comes in a pill  form it is                                                              
still  usable if  it is  dropped, but  in contrast,  if a  patient                                                              
blinks  away an  eye drop,  the dose is  lost.   For patients  who                                                              
suffer  from degenerative  eye  diseases,  such as  glaucoma,  who                                                              
have  unsteady  hands this  may  mean  running out  of  medication                                                              
prior  to the  prescribed  refill  date  and these  require  daily                                                              
treatment from prescription  eye drops to maintain  proper vision,                                                              
which can worsen without regular application of drops.                                                                          
                                                                                                                                
MS.  MCNALLY  explained that  this  bill  will allow  patients  to                                                              
receive  a  limited  refill  of   prescription  eye  drops  if  an                                                              
individual  runs out of  medication before  the prescribed  refill                                                              
date so  long as  the doctor  agrees.   Currently, some  insurance                                                              
plans restrict  patients from  refilling medications  earlier than                                                              
the  typical  single month  or  90-day  refill  date.   A  typical                                                              
insurance  provider  will pay  for  a  standardized one  month  or                                                              
three  month  supply of  medication.    This  is not  an  uncommon                                                              
provision  for Medicare;  however,  a  gap exists  within  private                                                              
coverage  and simply  put, patients  who are  insured by  carriers                                                              
within that  gap run the risk  of running out of  their medication                                                              
before  the  refill is  allowed.    This  bill would  allow  their                                                              
doctor to extend the prescription and help keep them healthy.                                                                   
                                                                                                                                
3:58:31 PM                                                                                                                    
                                                                                                                                
MICHAEL  LEVITT, American  Academy of  Ophthalmology, stated  that                                                              
similar  legislation  has been  enacted  in  a number  of  states,                                                              
including  Connecticut, New  Mexico, and  Maryland.  The  proposed                                                              
changes  have  been  vetted through  fiscal  committees  in  those                                                              
states  with little  or no  impact  to the  state.   This bill  is                                                              
focused  on a  narrow  band of  patients,  not including  Medicare                                                              
patients  since the  provision  is already  covered  by a  similar                                                              
policy.   The goal  of this  bill is  to ensure patients  continue                                                              
their care for chronic diseases that are potentially blinding.                                                                  
                                                                                                                                
4:00:18 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON  asked for the number  of states that  currently offer                                                              
the proposed provisions for refills.                                                                                            
                                                                                                                                
MR. LEVITT  answered four or  five states.   This effort  began in                                                              
2009, with some  states being more active than others  in terms of                                                              
proactive   legislation;   however,   the  American   Academy   of                                                              
Ophthalmology  has  had  a  high success  rate  when  the  state's                                                              
ophthalmological  society  decides   to  focus  on  this  specific                                                              
issue.                                                                                                                          
                                                                                                                                
CHAIR  OLSON asked  whether  any states  that  have adopted  these                                                              
changes have withdrawn from the changes.                                                                                        
                                                                                                                                
MR. LEVITT answered none.                                                                                                       
                                                                                                                                
4:01:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER asked whether  Mr. Levitt anticipated  any                                                              
increase  in the  cost for  eye  medication with  passage of  this                                                              
bill.                                                                                                                           
                                                                                                                                
MR.  LEVITT  responded  that  he  has  not  seen  any  reports  of                                                              
increases.   He reiterated that this  is focused on a  very narrow                                                              
but  serious problem;  however, there  have not  been any  reports                                                              
from insurance companies of an explosion in costs.                                                                              
                                                                                                                                
4:02:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  asked whether there  is any risk  of abuse                                                              
of eye medication.                                                                                                              
                                                                                                                                
MR.  LEVITT explained  these are  chronic diseases.   He  surmised                                                              
that  any abuse  should  come to  the  attention  of a  physician.                                                              
Typically, the drugs  are used to treat glaucoma,  are anti-viral,                                                              
or are  antibiotics  and doctors  have not reported  this  type of                                                              
problem to date.                                                                                                                
                                                                                                                                
4:03:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER related  the bill  provides for a  limited                                                              
refill  of topical  prescription  medicine  and he  asked  whether                                                              
this has  been quantified  to be  limited to a  number of  days or                                                              
weeks left in the prescription.                                                                                                 
                                                                                                                                
MR.  LEVITT answered  this  is one  of the  issues  that is  being                                                              
discussed.                                                                                                                      
                                                                                                                                
REPRESENTATIVE HOLMES  answered that she  has been working  on one                                                              
potential  change to  the bill,  which would  limit the number  of                                                              
refills.                                                                                                                        
                                                                                                                                
4:04:58 PM                                                                                                                    
                                                                                                                                
SHEELA TALLMAN,  Senior Manager, Legislative Policy,  Premera Blue                                                              
Cross/Blue  Shield  of  Alaska   (Premera),  stated  that  Premera                                                              
provides  coverage   to  over  100,000   members  in   Alaska,  to                                                              
individuals, families,  small employers, large employers,  as well                                                              
as provides service  to larger self-funded employer  groups in the                                                              
state.   She advised that Premera  has an early  refill medication                                                              
policy for  members.   Initially, Premera  had concerns  about the                                                              
early  refill   of  refills   of  prescription  eye   medications.                                                              
However,  she   has  appreciated  the  sponsor's   willingness  to                                                              
address   Premera's  concerns,   which  she   believed  would   be                                                              
addressed  in  subsequent changes  to  HB  125 the  committee  may                                                              
choose to adopt.                                                                                                                
                                                                                                                                
4:06:39 PM                                                                                                                    
                                                                                                                                
[HB 125 was held over.]                                                                                                         

Document Name Date/Time Subjects
HB175 ver C.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB175 Sponsor Statement.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB175 Fiscal Note-DCCED-DOI-03-22-13.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB175 Supporting Documents-AK PGR Policy Contract.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB175 Supporting Documents-Letter NAMIC 3-26-2013.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB175 Supporting Documents-Sample Declaration Page.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB175 Supporting Documents-Written Testimony of Joshua M Zielaskiewicz.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB175 Draft Proposed CS ver O.pdf HL&C 3/27/2013 3:15:00 PM
HB 175
HB125 ver N.pdf HL&C 3/27/2013 3:15:00 PM
HB 125
HB125 Sponsor Statement.pdf HL&C 3/27/2013 3:15:00 PM
HB 125
HB125 Fiscal Note-DCCED-DOI-03-26-13.pdf HL&C 3/27/2013 3:15:00 PM
HB 125
HB125 Fiscal Note-DOA-DRB-3-22-13.pdf HL&C 3/27/2013 3:15:00 PM
HB 125
HB125 Supporting Documents-Letter Alaska Optometric Association 2-26-2013.pdf HL&C 3/27/2013 3:15:00 PM
HB 125
HB125 Supporting Documents-Letter Amerian Academy of Opthalmology 2-25-2013.pdf HL&C 3/27/2013 3:15:00 PM
HB 125
HB125 Opposing Documents-Letter Premera 3-12-2013.pdf HL&C 3/27/2013 3:15:00 PM
HB 125
HB74 Draft Proposed CS ver N.PDF HL&C 3/27/2013 3:15:00 PM
HB 74
HB74 Supporting Documents-Letter Heatherdale Resources 3-25-2013.pdf HL&C 3/27/2013 3:15:00 PM
HB 74
HB74 Supporting Documents-Letter Ucore 3-26-2013.PDF HL&C 3/27/2013 3:15:00 PM
HB 74
HB175 Draft Proposed Amendment O.1.PDF HL&C 3/27/2013 3:15:00 PM
HB 175