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2013 -- S 0537 SUBSTITUTE A | |
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LC01311/SUB A | |
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STATE OF RHODE ISLAND | |
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IN GENERAL ASSEMBLY | |
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JANUARY SESSION, A.D. 2013 | |
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J O I N T R E S O L U T I O N | |
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RESPECTFULLY REQUESTING THE OFFICE OF THE HEALTH INSURANCE | |
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COMMISSIONER TO ENSURE THAT RHODE ISLAND INSURERS COVER TOPICAL | |
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OPHTHALMIC TREATMENT EARLY REFILLS IN A MANNER SIMILAR TO OR | |
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CONSISTENT WITH CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) | |
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GUIDELINES FOR ALL COVERED INDIVIDUALS | |
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Introduced By: Senators Felag, Lynch, Ciccone, Lombardi, and Ottiano | |
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Date Introduced: February 28, 2013 | |
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Referred To: Senate Health & Human Services | |
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WHEREAS, According to the World Health Organization (WHO), there are an estimated |
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45 million persons with open angle glaucoma and this figure is projected to rise to 59 million |
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respectively by 2020; and |
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WHEREAS The National Eye Institute estimates the prevalence of open angle glaucoma |
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in the U.S. population aged 40 and older at 1.86 percent; |
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WHEREAS Increased risk factors for open angle glaucoma include age, family history, |
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national heritage (for example African American or Latino American heritage), having had |
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serious eye injury or eye surgery in the past, or the taking of a corticosteroid medication; |
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WHEREAS, Early detection and treatment is critical to preventing serious vision loss as a |
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result of glaucoma; |
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WHEREAS, Eye drops are often used in the treatment of certain chronic diseases such as |
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glaucoma; |
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WHEREAS, Eye drops are also used to reduce the risk of infection, reduce inflammation |
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after surgeries, and to relieve conjunctivitis and dry eyes; |
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WHEREAS, This General Assembly strongly supports early refill of prescription eye |
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drops necessary to ensure continued access to effective treatments for individuals with eye |
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diseases; |
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WHEREAS, The Centers for Medicare & Medicaid Services (CMS) have issued |
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regulations that authorize refills, for inadvertent spillage at a rate of 70% in a 30 day time period, |
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allowing patients to refill at day 21 for the essential topical ophthalmic treatments; and |
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WHEREAS, The major insurers in Rhode Island have provided written assurances that |
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their pharmacy policies allow for early refills similar to or consistent with the CMS regulations; |
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and |
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WHEREAS, Health care professionals interested in ensuring proper dosage for treatment |
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of eye disease may work with pharmaceutical companies that manufacture and distribute |
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ophthalmic products to seek additional safeguards and allowances for spillage by patients, |
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including our most vulnerable populations; |
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WHEREAS, Rhode Island healthcare providers and pharmacists may work together to |
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continue to inform patients about coverage for early refill of medication and proper usage as |
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prescribed and needed to ensure effective treatment and positive health outcomes; and |
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WHEREAS, While the Patient Protection and Accountability Act (PPACA) allows states |
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to mandate health benefits for qualified health plans; however, effective January 1, 2014, the |
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PPACA will assess costs to the states for additional benefits that are mandated after December |
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31, 2011; now therefore be it |
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RESOLVED, The General Assembly respectfully requests that the Office of the Health |
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Insurance Commissioner continues to ensure that Rhode Island insurers cover topical ophthalmic |
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treatment early refills in a manner similar to or consistent with the Centers for Medicare & |
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Medicaid Services regulations for all covered individuals; and be it further |
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RESOLVED, That the Secretary of State be and is hereby authorized and directed to |
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transmit duly certified copies of this resolution to the Governor, the Director of the Department of |
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Health, the Office of the Health Insurance Commissioner, the Rhode Island Society of Eye |
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Physicians and Surgeons, and the Rhode Island Medical Society. |
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LC01311/SUB A | |
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