2017 - 2018 LEGISLATURE
January 29, 2018 - Introduced by Representatives Jagler, Rohrkaste, Spiros,
Skowronski, Anderson, Berceau, Billings, Fields, Kolste, Pope, Spreitzer,
Subeck, Horlacher and R. Brooks, cosponsored by Senators Roth,
Carpenter and Vinehout. Referred to Committee on Insurance.
1An Act to amend
632.895 (16t) of the statutes; relating
2to: coverage of prescription eye drop refills.
Analysis by the Legislative Reference Bureau
This bill requires health insurance policies, known in the bill as disability
insurance policies, and self-insured governmental and school district health plans
that cover prescription eye drops to cover refills of prescription eye drops that 1) are
allowed under the prescription; 2) do not exceed the prescribed number of refills; and
3) are requested by the insured or plan participant when 75 percent or more of the
days have elapsed from the later of the original distribution date or the date of the
most recent refill.
This proposal may contain a health insurance mandate requiring a social and
financial impact report under s. 601.423, stats.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
609.83 of the statutes is amended to read:
4609.83 Coverage of drugs and devices.
Limited service health 5
organizations, preferred provider plans, and defined network plans are subject to s. 6ss.
632.853 and 632.895 (16t)
632.895 (16t) of the statutes is created to read:
632.895 (16t) Prescription eye drops.
Every disability insurance policy and 3
every self-insured health plan of the state or of a county, city, town, village, or school 4
district that provides coverage of prescription eye drops shall cover a refill of the 5
prescription eye drops that satisfies all of the following:
(a) The refill is requested by the insured or plan participant when 75 percent 7
or more of the days have elapsed from the later of the original date the prescription 8
was distributed to the insured or plan participant or the date on which the most 9
recent refill was distributed to the insured or plan participant.
(b) The prescription allows for a refill of the prescription eye drops.
(c) The requested refill does not exceed the number of refills allowed by the 12
(1) Prescription eye drops.
(a) For policies and plans containing provisions inconsistent with this act, the 16
act first applies to policy or plan years beginning on January 1 of the year following 17
the year in which this paragraph takes effect, except as provided in paragraph (b).
(b) For policies or plans that are affected by a collective bargaining agreement 19
containing provisions inconsistent with this act, this act first applies to policy or plan 20
years beginning on the effective date of this paragraph or on the day on which the 21
collective bargaining agreement is newly established, extended, modified, or 22
renewed, whichever is later.
This act takes effect on the first day of the 4th month beginning after 2