S T A T E   O F   N E W   Y O R K
________________________________________________________________________

    S. 4237                                                  A. 6098

                       2013-2014 Regular Sessions

                      S E N A T E - A S S E M B L Y

                             March 15, 2013
                               ___________

IN  SENATE  --  Introduced  by  Sens.  LAVALLE, LIBOUS -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Insurance

IN  ASSEMBLY -- Introduced by M. of A. MORELLE -- read once and referred
  to the Committee on Insurance

AN  ACT  to  amend  the  insurance  law,  in   relation   to   requiring
  prescriptions  for  drugs  to be filled in the amount indicated by the
  prescription; and to amend  the  public  health  law  and  the  social
  services law, in relation to increasing the number of days for which a
  prescription may be filled

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
amended by adding a new paragraph 30 to read as follows:
  (30) EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
PROVIDE THAT ANY PRESCRIPTION WRITTEN BY AN AUTHORIZED PROVIDER SHALL BE
FILLED  IN  SUCH  EXACT QUANTITY AS INDICATED BY THE PRESCRIPTION WITHIN
AMOUNTS AUTHORIZED BY LAW, PROVIDED THAT NO SUCH QUANTITY SHALL EXCEED A
NINETY DAY SUPPLY. NO POLICY  SHALL  LIMIT  THE  QUANTITY  OF  ANY  DRUG
PRESCRIBED NOR SHALL ANY SUCH POLICY PROVIDE FOR A HIGHER CO-PAYMENT FOR
PRESCRIPTIONS  WRITTEN  AND  DISPENSED IN QUANTITIES ABOVE A SET AMOUNT.
WHERE A PHARMACY IS UNABLE TO PROVIDE THE  FULL  QUANTITY  OF  ANY  DRUG
PRESCRIBED, SUCH PRESCRIPTION SHALL BE FILLED TO THE EXTENT POSSIBLE AND
THE  BALANCE  OF  ANY  UNFILLED  PRESCRIPTION  SHALL  BE PROVIDED TO THE
INSURED  WHEN  IT  BECOMES  AVAILABLE  WITH  NO  ADDITIONAL   CO-PAYMENT
REQUIRED.
  S  2.  Subdivision  3  of  section  3332  of the public health law, as
amended by chapter 178 of the laws  of  2010,  is  amended  to  read  as
follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09791-01-3

              

S. 4237                             2                            A. 6098

  3.  No  such  prescription  shall be made for a quantity of controlled
substances which would exceed  a  [thirty]  NINETY  day  supply  if  the
controlled substance were used in accordance with the directions for use
specified  on  the  prescription.  [A practitioner may, however, issue a
prescription  for  up  to a three month supply of a controlled substance
provided that the controlled substance has been prescribed to treat  one
of the conditions that have been enumerated by the commissioner pursuant
to  regulations  as  warranting the prescribing of greater than a thirty
day supply of a controlled substance and that the practitioner specifies
the  condition  on  the  face  of  the  prescription.]   No   additional
prescriptions for a controlled substance may be issued by a practitioner
to  an  ultimate  user  within  [thirty]  NINETY days of the date of any
prescription previously issued unless and until the  ultimate  user  has
exhausted  all  but  a  seven  day  supply  of  the controlled substance
provided by any previously  issued  prescription.  A  practitioner  may,
however,  issue  a  prescription  for  up  to  a six month supply of any
substance listed in subdivision (h) of Schedule II  of  section  thirty-
three  hundred six of this article provided that such substance has been
prescribed to treat one of the conditions that have been  enumerated  by
the  commissioner  pursuant to regulations as warranting the prescribing
of a six month supply and that the practitioner specifies the  condition
on the prescription or on the electronic prescription.
  S  3.  Subdivision  1  of  section  3333  of the public health law, as
amended by chapter 178 of the laws  of  2010,  is  amended  to  read  as
follows:
  1.  A  licensed pharmacist may, in good faith and in the course of his
or her professional practice, sell and  dispense  to  an  ultimate  user
controlled  substances  only  upon  the delivery of an official New York
state prescription or the receipt of an electronic prescription to  such
pharmacist,  within thirty days of the date such prescription was signed
by an authorized  practitioner;  provided,  however,  a  pharmacist  may
dispense a part or portion of such prescription in accordance with regu-
lations  of  the  commissioner  in consultation with the commissioner of
education. No pharmacy or pharmacist may sell or dispense greater than a
[thirty] NINETY day supply of a controlled substance to an ultimate user
unless and until the ultimate user has exhausted all  but  a  seven  day
supply  of  the controlled substance provided pursuant to any previously
issued prescription, except that a pharmacy or pharmacist  may  sell  or
dispense  up  to a three month supply of a controlled substance if there
appears, on the official  New  York  state  prescription  or  electronic
prescription,  a  statement  that  the  controlled  substance  has  been
prescribed to treat one of the conditions that have been  enumerated  by
the  regulations  of  the  commissioner as warranting the prescribing of
greater than a [thirty] NINETY day supply of a controlled  substance.  A
pharmacy  or pharmacist may sell or dispense up to a six month supply of
any substance listed in subdivision (h) of Schedule II of section  thir-
ty-three  hundred  six of this article if there appears, on the official
New York state prescription or on an electronic prescription,  a  state-
ment  that  the substance has been prescribed to treat one of the condi-
tions that have been enumerated by the regulations of  the  commissioner
as warranting the prescribing of a specified greater supply.
  S  4.  Subdivision  2  of  section  3339  of the public health law, as
amended by section 13 of part A of chapter 58 of the laws  of  2004,  is
amended to read as follows:
  2.  A  prescription,  except for a schedule II controlled substance or
those schedule III  or  schedule  IV  controlled  substances  which  the

S. 4237                             3                            A. 6098

commissioner may require by regulation may be refilled not more than the
number  of  times  specifically  authorized  by  the prescriber upon the
prescription, provided however no such authorization shall be  effective
for  a  period greater than six months from the date the prescription is
signed. In the event that the prescription authorizes the dispensing  of
more  than  a [thirty] NINETY day supply of schedule III, schedule IV or
schedule V  substances  pursuant  to  regulations  of  the  commissioner
enumerating   conditions  warranting  specified  greater  supplies,  the
prescription may be refilled only once.
  S 5. Paragraph (g-1) of subdivision 2 of section 365-a of  the  social
services  law,  as  amended by section 23 of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
  (g-1) drugs provided on an in-patient basis, those drugs contained  on
the  list established by regulation of the commissioner of health pursu-
ant to subdivision four of this section, and those drugs which  may  not
be  dispensed  without a prescription as required by section sixty-eight
hundred ten of the education law and which the  commissioner  of  health
shall determine to be reimbursable based upon such factors as the avail-
ability  of  such  drugs  or  alternatives at low cost if purchased by a
medicaid recipient, or the essential nature of such drugs  as  described
by such commissioner in regulations, provided, however, that such drugs,
exclusive  of long-term maintenance drugs, shall be dispensed in quanti-
ties no greater than a [thirty] NINETY day supply or one hundred  doses,
whichever  is  greater; provided further that the commissioner of health
is authorized to  require  prior  authorization  for  any  refill  of  a
prescription  when  less  than  seventy-five  percent  of the previously
dispensed amount per fill should have been used were the product used as
normally indicated; provided further that the commissioner of health  is
authorized  to  require  prior  authorization of prescriptions of opioid
analgesics in excess of four prescriptions in  a  thirty-day  period  in
accordance  with  section two hundred seventy-three of the public health
law; medical assistance shall not include any  drug  provided  on  other
than  an in-patient basis for which a recipient is charged or a claim is
made in the case of a prescription drug, in excess of the maximum  reim-
bursable  amounts to be established by department regulations in accord-
ance with standards established by the secretary of  the  United  States
department  of  health and human services, or, in the case of a drug not
requiring a prescription, in excess of the maximum  reimbursable  amount
established  by  the commissioner of health pursuant to paragraph (a) of
subdivision four of this section;
  S 6. This act shall take effect immediately and section  one  of  this
act  shall  apply  to  policies  issued,  reissued, renewed, modified or
amended on and after such date.