HOUSE CONCURRENT RESOLUTION NO. 136

(By Delegates Ellington, Householder, Arvon, Cooper, Hill, Kurcaba, Pasdon, Rohrbach, Sobonya, Stansbury, Waxman, Westfall, Fleischauer, Campbell, Longstreth, Moore, Pushkin and Rodighiero)

[Originating in the Committee on Health and Human Resources; Reported March 10, 2015]

Requesting the Joint Committee on Government and Finance study that insurers cover topical ophthalmic treatment early refills in a manner similar to or consistent with CMS guidelines for all covered individuals.

            WHEREAS, Early detection and prevention is critical to preventing serious vision loss as a result of glaucoma; and

            WHEREAS, According to the World Health Organization (WHO), there are an estimated 45 million persons currently having open angle glaucoma and 16 million having angle closure glaucoma, these figures are projected to rise 59 and 21 million respectively by 2020; and

            WHEREAS, The National Eye Institute estimates the prevalence of open angle glaucoma in the U.S. population aged 40 and older at 1.86%; and

            WHEREAS, Risk factors for open angle glaucoma include age, family history, being of African or Latin heritage, have had serious eye injury or surgery, or are taking corticosteroid medication; and

            WHEREAS, West Virginia healthcare providers and pharmacists may work together to continue to inform patients of the ability for early refill of medication and proper usage as prescribed and needed to ensure effective treatment and positive health outcomes; and

            WHEREAS, The Centers for Medicare and Medicaid (CMS) have issued regulations that authorize refills, for inadvertent spillage at a rate of 70% in a thirty day time period, allowing patients to refill at day 21 - for the essential topical ophthalmic treatments; and

            WHEREAS, While the Patient Protection and Accountability Act (PPACA) allows states to mandate health benefits for qualified health plans; however, effective January 1^st, 2014, the PPACA will access costs to the states for additional benefits that are mandated after December 31, 2011; therefore, be it

            WHEREAS, The Legislature shall study early refills of prescription eye drops necessary to allow continued access and treatment for individuals in order to effectively treat eye disease; therefore, be it

Resolved by the Legislature of West Virginia:

            That the Joint Committee on Government and Finance is requested to study the feasibility of permitting the office of the Health Insurance Commissioner to continue to ensure that West Virginia insurers cover topical ophalmic treatment early refills in a manner similar to or consistent with the CMS regulations for all covered individuals; and, be it
            Further Resolved, That Joint Committee on Government and Finance report to the regular session of the Legislature, 2016, on its findings, conclusions and recommendations, together with drafts of any legislation necessary to effectuate its recommendations; and, be it
            Further Resolved, That the expenses necessary to conduct this study, to prepare a report and to draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.