Bill Text: NY S02809 | 2015-2016 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2016-01-06 - REFERRED TO INSURANCE [S02809 Detail]

Download: New_York-2015-S02809-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
           S. 2809                                                  A. 4036
                              2015-2016 Regular Sessions
                             S E N A T E - A S S E M B L Y
                                   January 29, 2015
                                      ___________
       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  AND SUCH INDIVIDUAL REQUESTS OR AGREES TO LESS THAN A THIRTY
   10  DAY SUPPLY FOR THE PURPOSE OF  SYNCHRONIZING  THE  COVERED  INDIVIDUAL'S
   11  CHRONIC MEDICATIONS.
   12    (B)   NO   INDIVIDUAL  OR  GROUP  HEALTH  INSURANCE  POLICY  PROVIDING
   13  PRESCRIPTION DRUG COVERAGE SHALL DENY COVERAGE FOR THE DISPENSING OF ANY
   14  DRUG PRESCRIBED FOR THE TREATMENT OF A CHRONIC ILLNESS THAT IS  MADE  IN
   15  ACCORDANCE  WITH  A  PLAN  ESTABLISHED  AMONG  THE COVERED INDIVIDUAL, A
   16  HEALTH CARE PRACTITIONER AND A PHARMACIST TO SYNCHRONIZE  THE  REFILLING
   17  OF MULTIPLE PRESCRIPTIONS FOR THE COVERED INDIVIDUAL.
   18    (C)   NO   INDIVIDUAL  OR  GROUP  HEALTH  INSURANCE  POLICY  PROVIDING
   19  PRESCRIPTION DRUG COVERAGE SHALL USE  PAYMENT  STRUCTURES  INCORPORATING
   20  PRO-RATED  DISPENSING FEES DETERMINED BY CALCULATION OF THE DAYS' SUPPLY
   21  OF MEDICATION DISPENSED. DISPENSING FEES SHALL BE DETERMINED  SOLELY  ON
   22  THE TOTAL NUMBER OF PRESCRIPTIONS DISPENSED.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02009-02-5
       S. 2809                             2                            A. 4036
    1    (D)  NOTHING  IN  THIS  SECTION SHALL BE DEEMED TO REQUIRE HEALTH CARE
    2  PRACTITIONERS AND PHARMACISTS TO SYNCHRONIZE THE REFILLING  OF  MULTIPLE
    3  PRESCRIPTIONS FOR A COVERED INDIVIDUAL.
    4    S  2.  The  insurance law is amended by adding a new section 4303-a to
    5  read as follows:
    6    S 4303-A. PRESCRIPTION SYNCHRONIZATION AND DISPENSING  FEE  STANDARDI-
    7  ZATION.    (A)  EVERY  HOSPITAL  SERVICE  CORPORATION AND HEALTH SERVICE
    8  CORPORATION PROVIDING PRESCRIPTION DRUG COVERAGE SHALL PERMIT AND  APPLY
    9  A  PRO-RATED  COST-SHARING RATE TO PRESCRIPTIONS THAT ARE DISPERSED BY A
   10  NETWORK PHARMACY FOR LESS THAN A THIRTY DAY SUPPLY, IF THE PRESCRIBER OR
   11  PHARMACIST INDICATES THAT THE FILL OR REFILL COULD BE IN THE BEST INTER-
   12  EST OF THE COVERED INDIVIDUAL AND SUCH INDIVIDUAL REQUESTS OR AGREES  TO
   13  LESS  THAN  A  THIRTY  DAY  SUPPLY  FOR THE PURPOSE OF SYNCHRONIZING THE
   14  COVERED INDIVIDUAL'S CHRONIC MEDICATIONS.
   15    (B) NO HOSPITAL SERVICE  CORPORATION  OR  HEALTH  SERVICE  CORPORATION
   16  PROVIDING  PRESCRIPTION  DRUG  COVERAGE  SHALL  DENY  COVERAGE  FOR  THE
   17  DISPENSING OF ANY DRUG PRESCRIBED FOR THE TREATMENT OF A CHRONIC ILLNESS
   18  THAT IS MADE IN ACCORDANCE WITH A PLAN  ESTABLISHED  AMONG  THE  COVERED
   19  INDIVIDUAL,  A  HEALTH CARE PRACTITIONER AND A PHARMACIST TO SYNCHRONIZE
   20  THE REFILLING OF MULTIPLE PRESCRIPTIONS FOR THE COVERED INDIVIDUAL.
   21    (C) NO HOSPITAL SERVICE  CORPORATION  OR  HEALTH  SERVICE  CORPORATION
   22  PROVIDING PRESCRIPTION DRUG COVERAGE SHALL USE PAYMENT STRUCTURES INCOR-
   23  PORATING  PRO-RATED  DISPENSING  FEES  DETERMINED  BY CALCULATION OF THE
   24  DAYS' SUPPLY OF MEDICATION DISPENSED.  DISPENSING FEES SHALL  BE  DETER-
   25  MINED SOLELY ON THE TOTAL NUMBER OF PRESCRIPTIONS DISPENSED.
   26    (D)  NOTHING  IN  THIS  SECTION SHALL BE DEEMED TO REQUIRE HEALTH CARE
   27  PRACTITIONERS AND PHARMACISTS TO SYNCHRONIZE THE REFILLING  OF  MULTIPLE
   28  PRESCRIPTIONS FOR A COVERED INDIVIDUAL.
   29    S 3. This act shall take effect on the one hundred twentieth day after
   30  it  shall  have  become  a  law,  and  shall  apply  to all policies and
   31  contracts issued, renewed, modified, altered or amended on or after such
   32  date.