Bill Text: NY A08975 | 2013-2014 | General Assembly | Introduced

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Bill Title: Provides for the insurance coverage of the synchronization of multiple prescriptions and dispensing fee standardization.

Spectrum: Partisan Bill (Democrat 10-0)

Status: (Introduced - Dead) 2014-03-06 - referred to insurance [A08975 Detail]

Download: New_York-2013-A08975-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
           S. 6763                                                  A. 8975
                             S E N A T E - A S S E M B L Y
                                     March 6, 2014
                                      ___________
       IN SENATE -- Introduced by Sen. LANZA -- read twice and ordered printed,
         and when printed to be committed to the Committee on Insurance
       IN ASSEMBLY -- Introduced by M. of A. QUART -- read once and referred to
         the Committee on Insurance
       AN  ACT  to  amend  the insurance law, in relation to synchronization of
         multiple prescriptions and dispensing fee standardization
         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. The insurance law is amended by adding a new section 3224-d
    2  to read as follows:
    3    S  3224-D.  PRESCRIPTION SYNCHRONIZATION AND DISPENSING FEE STANDARDI-
    4  ZATION. (A) EVERY INDIVIDUAL OR GROUP HEALTH INSURANCE POLICY  PROVIDING
    5  PRESCRIPTION DRUG COVERAGE SHALL PERMIT AND APPLY A PRO-RATED COST-SHAR-
    6  ING  RATE  TO PRESCRIPTIONS THAT ARE DISPENSED BY A NETWORK PHARMACY FOR
    7  LESS THAN A THIRTY DAY SUPPLY, IF THE PRESCRIBER OR PHARMACIST INDICATES
    8  THAT THE FILL OR REFILL COULD BE IN THE BEST  INTEREST  OF  THE  COVERED
    9  INDIVIDUAL  OR  IS FOR THE PURPOSE OF SYNCHRONIZING THE COVERED INDIVID-
   10  UAL'S CHRONIC MEDICATIONS.
   11    (B)  NO  INDIVIDUAL  OR  GROUP  HEALTH  INSURANCE   POLICY   PROVIDING
   12  PRESCRIPTION DRUG COVERAGE SHALL DENY COVERAGE FOR THE DISPENSING OF ANY
   13  DRUG  PRESCRIBED  FOR THE TREATMENT OF A CHRONIC ILLNESS THAT IS MADE IN
   14  ACCORDANCE WITH A PLAN  ESTABLISHED  AMONG  THE  COVERED  INDIVIDUAL,  A
   15  HEALTH  CARE  PRACTITIONER AND A PHARMACIST TO SYNCHRONIZE THE REFILLING
   16  OF MULTIPLE PRESCRIPTIONS FOR THE COVERED INDIVIDUAL.
   17    (C)  NO  INDIVIDUAL  OR  GROUP  HEALTH  INSURANCE   POLICY   PROVIDING
   18  PRESCRIPTION  DRUG  COVERAGE  SHALL USE PAYMENT STRUCTURES INCORPORATING
   19  PRO-RATED DISPENSING FEES DETERMINED BY CALCULATION OF THE DAYS'  SUPPLY
   20  OF  MEDICATION  DISPENSED. DISPENSING FEES SHALL BE DETERMINED SOLELY ON
   21  THE TOTAL NUMBER OF PRESCRIPTIONS DISPENSED.
   22    (D) NOTHING IN THIS SECTION SHALL BE DEEMED  TO  REQUIRE  HEALTH  CARE
   23  PRACTITIONERS  AND  PHARMACISTS TO SYNCHRONIZE THE REFILLING OF MULTIPLE
   24  PRESCRIPTIONS FOR A COVERED INDIVIDUAL.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD14035-03-4
       S. 6763                             2                            A. 8975
    1    S 2. The insurance law is amended by adding a new  section  4303-a  to
    2  read as follows:
    3    S  4303-A.  PRESCRIPTION SYNCHRONIZATION AND DISPENSING FEE STANDARDI-
    4  ZATION.   (A) EVERY HOSPITAL  SERVICE  CORPORATION  AND  HEALTH  SERVICE
    5  CORPORATION  PROVIDING PRESCRIPTION DRUG COVERAGE SHALL PERMIT AND APPLY
    6  A PRO-RATED COST-SHARING RATE TO PRESCRIPTIONS THAT ARE DISPERSED  BY  A
    7  NETWORK PHARMACY FOR LESS THAN A THIRTY DAY SUPPLY, IF THE PRESCRIBER OR
    8  PHARMACIST INDICATES THAT THE FILL OR REFILL COULD BE IN THE BEST INTER-
    9  EST OF THE COVERED INDIVIDUAL OR IS FOR THE PURPOSE OF SYNCHRONIZING THE
   10  COVERED INDIVIDUAL'S CHRONIC MEDICATIONS.
   11    (B)  NO  HOSPITAL  SERVICE  CORPORATION  OR HEALTH SERVICE CORPORATION
   12  PROVIDING  PRESCRIPTION  DRUG  COVERAGE  SHALL  DENY  COVERAGE  FOR  THE
   13  DISPENSING OF ANY DRUG PRESCRIBED FOR THE TREATMENT OF A CHRONIC ILLNESS
   14  THAT  IS  MADE  IN  ACCORDANCE WITH A PLAN ESTABLISHED AMONG THE COVERED
   15  INDIVIDUAL, A HEALTH CARE PRACTITIONER AND A PHARMACIST  TO  SYNCHRONIZE
   16  THE REFILLING OF MULTIPLE PRESCRIPTIONS FOR THE COVERED INDIVIDUAL.
   17    (C)  NO  HOSPITAL  SERVICE  CORPORATION  OR HEALTH SERVICE CORPORATION
   18  PROVIDING PRESCRIPTION DRUG COVERAGE SHALL USE PAYMENT STRUCTURES INCOR-
   19  PORATING PRO-RATED DISPENSING FEES  DETERMINED  BY  CALCULATION  OF  THE
   20  DAYS'  SUPPLY  OF MEDICATION DISPENSED.  DISPENSING FEES SHALL BE DETER-
   21  MINED SOLELY ON THE TOTAL NUMBER OF PRESCRIPTIONS DISPENSED.
   22    (D) NOTHING IN THIS SECTION SHALL BE DEEMED  TO  REQUIRE  HEALTH  CARE
   23  PRACTITIONERS  AND  PHARMACISTS TO SYNCHRONIZE THE REFILLING OF MULTIPLE
   24  PRESCRIPTIONS FOR A COVERED INDIVIDUAL.
   25    S 3. This act shall take effect on the one hundred twentieth day after
   26  it shall have become a law.