Bill Text: NY S03510 | 2011-2012 | General Assembly | Amended
Bill Title: Prohibits health insurers from requiring that the insured purchase prescribed drugs from a mail order pharmacy or pay a co-payment fee when such purchases are not made from a mail order pharmacy if a similar fee is not charged for drugs from a mail order pharmacy.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-06-20 - SUBSTITUTED BY A5502B [S03510 Detail]
Download: New_York-2011-S03510-Amended.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 3510--B 2011-2012 Regular Sessions I N S E N A T E February 24, 2011 ___________ Introduced by Sens. MAZIARZ, BRESLIN, ADDABBO, AVELLA, BALL, BONACIC, DUANE, GALLIVAN, GOLDEN, GRIFFO, HANNON, HUNTLEY, JOHNSON, KLEIN, KRUEGER, KRUGER, LANZA, LARKIN, LAVALLE, LIBOUS, MARCELLINO, MARTINS, MONTGOMERY, OPPENHEIMER, PERALTA, PERKINS, RANZENHOFER, STAVISKY, ZELDIN -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said commit- tee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to the purchase of prescription drugs THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 28 to read as follows: 3 (28) ANY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL 4 PERMIT EACH PARTICIPANT TO FILL ANY MAIL ORDER COVERED PRESCRIPTION, AT 5 HIS OR HER OPTION, AT ANY MAIL ORDER PHARMACY OR NETWORK PARTICIPATING 6 NON-MAIL ORDER RETAIL PHARMACY IF THE NETWORK PARTICIPATING NON-MAIL 7 ORDER RETAIL PHARMACY OFFERS TO ACCEPT A PRICE THAT IS COMPARABLE TO 8 THAT OF THE MAIL ORDER PHARMACY. ANY POLICY WHICH PROVIDES COVERAGE FOR 9 PRESCRIPTION DRUGS SHALL NOT IMPOSE A CO-PAYMENT FEE OR OTHER CONDITION 10 ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM A NETWORK PARTICIPATING 11 NON-MAIL ORDER RETAIL PHARMACY WHICH IS NOT ALSO IMPOSED ON INSUREDS 12 ELECTING TO PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; 13 PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPER- 14 SEDE THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY 15 THAT IS THE RESULT OF A COLLECTIVE BARGAINING AGREEMENT BETWEEN AN 16 EMPLOYER AND A RECOGNIZED OR CERTIFIED EMPLOYEE ORGANIZATION. 17 S 2. Subsection (1) of section 3221 of the insurance law is amended by 18 adding a new paragraph 18 to read as follows: EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09145-07-1 S. 3510--B 2 1 (18) ANY INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSUING A 2 GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES COVER- 3 AGE FOR PRESCRIPTION DRUGS SHALL PERMIT EACH PARTICIPANT TO FILL ANY 4 MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT ANY MAIL ORDER 5 PHARMACY OR NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY IF THE 6 NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY OFFERS TO ACCEPT A 7 PRICE THAT IS COMPARABLE TO THAT OF THE MAIL ORDER PHARMACY. ANY POLICY 8 WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL NOT IMPOSE A 9 CO-PAYMENT FEE OR OTHER CONDITION ON ANY INSURED WHO ELECTS TO PURCHASE 10 DRUGS FROM A NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY WHICH 11 IS NOT ALSO IMPOSED ON INSUREDS ELECTING TO PURCHASE DRUGS FROM A DESIG- 12 NATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER, THAT THE PROVISIONS OF 13 THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A COLLECTIVE BARGAINING 14 AGREEMENT OR APPLY TO A POLICY THAT IS THE RESULT OF A COLLECTIVE 15 BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOGNIZED OR CERTIFIED 16 EMPLOYEE ORGANIZATION. 17 S 3. Section 4303 of the insurance law is amended by adding a new 18 subsection (hh) to read as follows: 19 (HH) ANY POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION, A 20 HOSPITAL SERVICE CORPORATION OR A HEALTH SERVICES CORPORATION WHICH 21 PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL PERMIT EACH PARTICIPANT 22 TO FILL ANY MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT 23 ANY MAIL ORDER PHARMACY OR NETWORK PARTICIPATING NON-MAIL ORDER RETAIL 24 PHARMACY IF THE NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY 25 OFFERS TO ACCEPT A PRICE THAT IS COMPARABLE TO THAT OF THE MAIL ORDER 26 PHARMACY. ANY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS 27 SHALL NOT IMPOSE A COPAYMENT FEE OR OTHER CONDITION ON ANY INSURED WHO 28 ELECTS TO PURCHASE DRUGS FROM A NETWORK PARTICIPATING NON-MAIL ORDER 29 RETAIL PHARMACY WHICH IS NOT ALSO IMPOSED ON INSUREDS ELECTING TO 30 PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER, 31 THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A 32 COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY THAT IS THE RESULT 33 OF A COLLECTIVE BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOG- 34 NIZED OR CERTIFIED EMPLOYEE ORGANIZATION. 35 S 4. If any clause, subparagraph, subsection, section or other part 36 of this act, or the application thereof be held to be invalid, such 37 holding shall not affect, impair or invalidate the remainder of this 38 act, or the application of such section or part of a section held inval- 39 id. 40 S 5. This act shall take effect on the thirtieth day after it shall 41 have become a law and shall apply to all policies and contracts issued, 42 renewed, modified, altered or amended on or after such effective date.