Bill Text: NY S06296 | 2019-2020 | General Assembly | Introduced
Bill Title: Provides that prescriptions covered by insurance, that would otherwise be required to be filled by mail order, may be filled at a retail pharmacy under certain circumstances.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-01-08 - REFERRED TO INSURANCE [S06296 Detail]
Download: New_York-2019-S06296-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 6296 2019-2020 Regular Sessions IN SENATE June 3, 2019 ___________ Introduced by Sen. SKOUFIS -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the insurance law, in relation to coverage of prescriptions obtained by mail order or at a non-retail pharmacy The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The opening paragraph of paragraph 28 of subsection (i) of 2 section 3216 of the insurance law, as added by chapter 589 of the laws 3 of 2011, is designated subparagraph (A) and a new subparagraph (B) is 4 added to read as follows: 5 (B) Notwithstanding any other provision of this paragraph, if a pres- 6 criber, after consulting with the insurer regarding the appropriateness 7 of mail order delivery given: (i) the residence or delivery location of 8 the insured; (ii) the medical condition of the insured; (iii) the stor- 9 age requirements of the drug; (iv) the availability of the insured to 10 receive the prescription; or (v) the insured's ability to comprehend 11 pharmaceutical guidance and support over the telephone, determines that 12 a drug as prescribed on an individual basis is most appropriately filled 13 at a retail location, provided that an in-network retail pharmacy of the 14 patient's choosing agrees to the same reimbursement amount and is able 15 to fill the prescription, the prescriber's determination shall be final. 16 § 2. The opening paragraph of paragraph 18 of subsection (l) of 17 section 3221 of the insurance law is designated subparagraph (A) and a 18 new subparagraph (B) is added to read as follows: 19 (B) Notwithstanding any other provision of this paragraph, if a pres- 20 criber, after consulting with the insurer regarding the appropriateness 21 of mail order delivery given: (i) the residence or delivery location of 22 the insured; (ii) the medical condition of the insured; (iii) the stor- 23 age requirements of the drug; (iv) the availability of the insured to 24 receive the prescription; or (v) the insured's ability to comprehend 25 pharmaceutical guidance and support over the telephone, determines that EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00064-02-9S. 6296 2 1 a drug as prescribed on an individual basis is most appropriately filled 2 at a retail location, provided that an in-network retail pharmacy of the 3 patient's choosing agrees to the same reimbursement amount and is able 4 to fill the prescription, the prescriber's determination shall be final. 5 § 3. The opening paragraph of subsection (kk) of section 4303 of the 6 insurance law is designated paragraph 1 and a new paragraph 2 is added 7 to read as follows: 8 (2) Notwithstanding any other provision of this subsection, if a pres- 9 criber, after consulting with the insurer regarding the appropriateness 10 of mail order delivery given: (A) the residence or delivery location of 11 the covered person; (B) the medical condition of the covered person; (C) 12 the storage requirements of the drug; (D) the availability of the 13 covered person to receive the prescription; or (E) the covered person's 14 ability to comprehend pharmaceutical guidance and support over the tele- 15 phone, determines that a drug as prescribed on an individual basis is 16 most appropriately filled at a retail location, provided that an in-net- 17 work retail pharmacy of the patient's choosing agrees to the same 18 reimbursement amount and is able to fill the prescription, the 19 prescriber's determination shall be final. 20 § 4. This act shall take effect immediately.
