23 CAR § 150-103. Requirements to provide early refills of prescription eye drops

A healthcare insurer that provides coverage for prescription eye drops under a health benefit plan shall provide coverage for early refills of prescription eye drops to a covered person on and after January 1, 2022, if: (1) For a thirty-day supply: (A) The amount of time has passed after which a covered person should have used seventy percent (70%) of the dosage of the prescription eye drops according to a healthcare professional's instructions on the prescription; or (B) Twenty-two (22) days have passed from: (i) The original date the prescription eye drops were distributed to a covered person; or (ii) The date the most recent refill of the prescription eye drops was distributed to a covered person; (2) The healthcare professional indicates on the original prescription that additional quantities of the prescription eye drops are needed; (3) A refill request of a covered person for prescription eye drops does not exceed the number of additional quantities needed as described in subdivision (2) of this section; and (4) The prescription eye drops prescribed by a healthcare professional are a covered benefit under the health benefit plan of the covered person.