Bill Text: NY A08533 | 2019-2020 | General Assembly | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Establishes a drug assistance demonstration program and authorizes emergency prescriptions.
Spectrum: Strong Partisan Bill (Democrat 53-5)
Status: (Enrolled - Dead) 2020-12-30 - DELIVERED TO GOVERNOR [A08533 Detail]
Download: New_York-2019-A08533-Amended.html
Bill Title: Establishes a drug assistance demonstration program and authorizes emergency prescriptions.
Spectrum: Strong Partisan Bill (Democrat 53-5)
Status: (Enrolled - Dead) 2020-12-30 - DELIVERED TO GOVERNOR [A08533 Detail]
Download: New_York-2019-A08533-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 8533--A 2019-2020 Regular Sessions IN ASSEMBLY August 14, 2019 ___________ Introduced by M. of A. JOYNER, O'DONNELL, LENTOL, WILLIAMS, REYES, SEAWRIGHT, SIMON, HEVESI, FERNANDEZ, DINOWITZ, BURKE, MOSLEY, DICKENS, L. ROSENTHAL, ARROYO, FALL, SMITH, McDONOUGH, MONTESANO, ORTIZ, COLTON, THIELE, JAFFEE, GUNTHER, CRUZ, COOK, MAGNARELLI, WALKER, CARROLL, DE LA ROSA, BLAKE, GRIFFIN, D'URSO, BRONSON, DenDEKKER, BENE- DETTO, SAYEGH, JACOBSON, STIRPE, MANKTELOW, GOTTFRIED, BARRON, OTIS, TAYLOR, SIMOTAS -- Multi-Sponsored by -- M. of A. BUCHWALD, TAGUE -- read once and referred to the Committee on Health -- recommitted to the Committee on Health in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to drug assistance demonstration and emergency prescriptions; and to amend the insurance law, in relation to capping cost sharing for insulin The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding two new sections 2 279-a and 279-b to read as follows: 3 § 279-a. Drug assistance demonstration program. The commissioner shall 4 develop a demonstration program to ensure access to insulin and other 5 life sustaining, maintenance prescription medications identified by the 6 commissioner for residents of the state who are uninsured, are ineligi- 7 ble for Medicaid or other publicly funded health coverage, or are other- 8 wise determined to be eligible by the commissioner and depend upon such 9 medication for their survival. In developing such program the commis- 10 sioner shall: 11 1. consider modeling the drug assistance demonstration program on the 12 state's HIV/AIDS drug assistance program providing access to eligible 13 individuals at certain income thresholds above the federal poverty 14 level; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD13323-09-0A. 8533--A 2 1 2. engage with pharmaceutical manufacturers to explore a public 2 private partnership designed to bring affordable medications through the 3 demonstration program to eligible individuals; and 4 3. report to the governor, the temporary president of the senate, the 5 speaker of the assembly, and the chairs of the senate and assembly 6 health committees on the available options to establish a drug assist- 7 ance demonstration program, various cost sharing models for eligible 8 participants and the related costs to the state associated with imple- 9 menting such a program no later than sixty days after the effective date 10 of this section. 11 § 279-b. Emergency prescriptions. 1. A health care practitioner who is 12 authorized to prescribe drugs may issue non-patient-specific 13 prescriptions for pharmacists to dispense emergency prescriptions to 14 refill expired prescriptions pursuant to subdivision two of this 15 section. 16 2. A pharmacist may dispense insulin and related supplies, or other 17 life sustaining, maintenance prescription medications identified by the 18 commissioner, through non-patient-specific prescriptions, to an individ- 19 ual who has had a valid prescription for any types of insulin, or other 20 medications identified by the commissioner, during the prior twelve 21 month period which have since expired, on an emergency basis provided 22 the pharmacist: 23 (a) first attempts to obtain an authorization from the authorized 24 prescriber and cannot obtain the authorization; 25 (b) believes, that in the pharmacist's professional judgment, the 26 interruption of the therapy reasonably might produce an undesirable 27 health consequence detrimental to the patient's welfare or cause phys- 28 ical or mental discomfort; 29 (c) provides refill of the prescription or prescriptions and the quan- 30 tity of that refill or refills is in conformity with the prescribed 31 directions for use, but limited to an amount not to exceed a thirty-day 32 emergency supply; and 33 (d) notifies, within seventy-two hours of dispensing the refill or 34 refills, the prescriber that an emergency prescription or prescriptions 35 have been dispensed. 36 § 2. Subparagraph (B) of paragraph 15-a of subsection (i) of section 37 3216 of the insurance law, as added by chapter 378 of the laws of 1993 38 and such paragraph as renumbered by chapter 338 of the laws of 2003, is 39 amended to read as follows: 40 (B) Such coverage may be subject to annual deductibles and coinsurance 41 as may be deemed appropriate by the superintendent and as are consistent 42 with those established for other benefits within a given policy; 43 provided however, the total amount that a covered person is required to 44 pay out of pocket for covered prescription insulin drugs shall be capped 45 at an amount not to exceed one hundred dollars per thirty-day supply, 46 regardless of the amount or types of insulin needed to fill such covered 47 person's prescriptions and regardless of the insured's deductible, 48 copayment, coinsurance, out of pocket maximum or any other cost sharing 49 requirement. 50 § 3. Subparagraph (B) of paragraph 7 of subsection (k) of section 3221 51 of the insurance law, as amended by chapter 338 of the laws of 2003, is 52 amended to read as follows: 53 (B) Such coverage may be subject to annual deductibles and coinsurance 54 as may be deemed appropriate by the superintendent and as are consistent 55 with those established for other benefits within a given policy; 56 provided however, the total amount that a covered person is required toA. 8533--A 3 1 pay out of pocket for covered prescription insulin drugs shall be capped 2 at an amount not to exceed one hundred dollars per thirty-day supply, 3 regardless of the amount or types of insulin needed to fill such covered 4 person's prescriptions and regardless of the insured's deductible, 5 copayment, coinsurance, out of pocket maximum or any other cost sharing 6 requirement. 7 § 4. Paragraph 2 of subsection (u) of section 4303 of the insurance 8 law, as amended by chapter 338 of the laws of 2003, is amended to read 9 as follows: 10 (2) Such coverage may be subject to annual deductibles and coinsurance 11 as may be deemed appropriate by the superintendent and as are consistent 12 with those established for other benefits within a given policy; 13 provided however, the total amount that a covered person is required to 14 pay out of pocket for covered prescription insulin drugs shall be capped 15 at an amount not to exceed one hundred dollars per thirty-day supply, 16 regardless of the amount or types of insulin needed to fill such covered 17 person's prescriptions and regardless of the insured's deductible, 18 copayment, coinsurance, out of pocket maximum or any other cost sharing 19 requirement. 20 § 5. Subdivision 7 of section 4406-c of the public health law, as 21 added by chapter 536 of the laws of 2010, is amended to read as follows: 22 7. (i) No health maintenance organization which provides coverage for 23 prescription drugs and for which cost-sharing, deductibles or co-insu- 24 rance obligations are determined by category of prescription drugs shall 25 impose cost-sharing, deductibles or co-insurance obligations for any 26 prescription drug that exceeds the dollar amount of cost-sharing, deduc- 27 tibles or co-insurance obligations for non-preferred brand drugs or its 28 equivalent (or brand drugs if there is no non-preferred brand drug cate- 29 gory). 30 (ii) The total amount that a covered person is required to pay out of 31 pocket for covered prescription insulin drugs shall be capped at an 32 amount not to exceed one hundred dollars per thirty-day supply, regard- 33 less of the amount or types of insulin needed to fill such covered 34 person's prescriptions and regardless of the insured's deductible, 35 copayment, coinsurance, out of pocket maximum or any other cost sharing 36 requirement. 37 § 6. This act shall take effect immediately; provided however that 38 sections two, three, four and five of this act shall take effect January 39 1, 2021.