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.]