SECTION 8JJ. Coverage for long-term antibiotic therapy for patients with Lyme disease

[Text of section added by 2016, 183, Sec. 2. See also, Section 8JJ added by 2016, 454, Sec. 4, below.]

Section 8JJ. (a) For the purposes of this section, ''long-term antibiotic therapy'' and ''Lyme disease'' shall have the meaning ascribed to them in section 12DD of chapter 112.

(b) A contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within the commonwealth shall provide coverage for long-term antibiotic therapy for a patient with Lyme disease when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results or response to treatment. An experimental drug shall be covered as a long-term antibiotic therapy if it is approved for an indication by the United States Food and Drug Administration; provided, however, that a drug, including an experimental drug, shall be covered for an off-label use in the treatment of Lyme disease if the drug has been approved by the United States Food and Drug Administration.

Chapter 176A: Section 8JJ. Coverage for refills of prescription eye drops

[Text of section added by 2016, 454, Sec. 4. See also, Section 8JJ added by 2016, 183, Sec. 2, above.]

Section 8JJ. A contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth that provides coverage for prescription eye drops shall provide coverage for refills of prescription eye drops in accordance with the Medicare Part D guidelines on early refills of topical ophthalmic products when: (i) the prescribing health care practitioner indicates on the original prescription that additional quantities of the prescription eye drops are needed; (ii) the refill requested by the insured does not exceed the number of additional quantities indicated on the original prescription by the prescribing health care practitioner; and (iii) the prescription eye drops prescribed by the health care practitioner are a covered benefit under the policy or contract of the insured.