A contract, plan or agreement issued by an insurer pursuant to this article for prescription topical eye medication may not deny coverage for the refilling of a prescription for topical eye medication when:
(1) The medication is to treat a chronic condition of the eye;
(2) The refill is requested by the insured prior to the last day of the prescribed dosage period and after at least 70% of the predicted days of use; and
(3) A person licensed under chapter thirty and authorized to prescribe topical eye medication indicates on the original prescription that refills are permitted and that the early refills requested by the insured do not exceed the total number of refills prescribed.
Structure West Virginia Code
Article 25A. Health Maintenance Organization Act
§33-25A-1. Short Title and Purpose
§33-25A-3. Application for Certificate of Authority
§33-25A-4. Issuance of Certificate of Authority
§33-25A-5. Powers of Health Maintenance Organizations
§33-25A-7a. Provider Contracts
§33-25A-8a. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing
§33-25A-8b. Third Party Reimbursement for Rehabilitation Services
§33-25A-8c. Third Party Payment for Child Immunization Services
§33-25A-8d. Coverage of Emergency Services
§33-25A-8e. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-25A-8f. Required Coverage for Reconstruction Surgery Following Mastectomies
§33-25A-8g. Required Use of Mail-Order Pharmacy Prohibited
§33-25A-8h. Third-Party Reimbursement for Kidney Disease Screening
§33-25A-8i. Third-Party Reimbursement for Dental Anesthesia Services
§33-25A-8j. Coverage for Diagnosis and Treatment of Autism Spectrum Disorders
§33-25A-8k. Maternity Coverage
§33-25A-8l. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-25A-8m. Eye Drop Prescription Refills
§33-25A-8n. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-25A-8p. Lyme Disease to Be Covered by All Health Insurance Policies
§33-25A-8q. Coverage for Amino Acid-Based Formulas
§33-25A-8r. Substance Use Disorder
§33-25A-8s. Prior Authorization
§33-25A-8t. Fairness in Cost-Sharing Calculation
§33-25A-8u. Mental Health Parity
§33-25A-8v. Incorporation of the Health Benefit Plan Access and Adequacy Act
§33-25A-8w. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-25A-10. Information to Enrollees
§33-25A-11. Open Enrollment Period
§33-25A-12. Grievance Procedure
§33-25A-14. Prohibited Advertising Practices
§33-25A-14a. Other Prohibited Practices
§33-25A-15. Agent Licensing and Appointment Required; Regulation of Marketing
§33-25A-16. Powers of Insurers and Hospital and Medical Service Corporations
§33-25A-17a. Quality Assurance
§33-25A-18. Suspension or Revocation of Certificate of Authority
§33-25A-19. Rehabilitation, Liquidation or Conservation of Health Maintenance Organization
§33-25A-21. Administrative Procedures
§33-25A-23. Penalties and Enforcement
§33-25A-23a. Civil Penalty Imposed by Commissioner
§33-25A-24. Scope of Provisions; Applicability of Other Laws
§33-25A-25. Filings and Reports as Public Documents
§33-25A-26. Confidentiality of Medical Information
§33-25A-27. Authority to Contract With Health Maintenance Organizations Under Medicaid
§33-25A-28. Required Health Maintenance Organization Option
§33-25A-31. Policies Discriminating Among Health Care Providers
§33-25A-34. Ambulance Services
§33-25A-35. Rural Health Maintenance Organizations
§33-25A-36. Assignment of Certain Benefits in Dental Care Insurance Coverage