NY State Senate Bill 2015-S1800

Senate Bill S1800

2015-2016 Legislative Session

Prohibits insurance companies from limiting the quantity of drugs dispensed pursuant to a prescription and increases the quantity that may be prescribed to 90 days

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2016	referred to insurance
Jan 14, 2015	referred to insurance

2015-S1800 (ACTIVE) - Details

See Assembly Version of this Bill:: A3120
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §3216, Ins L; amd §§3332, 3333 & 3339, Pub Health L; amd §365-a, Soc Serv L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S3030, A5299
2011-2012: S3909, A4155
2013-2014: S4237, A6098

2015-S1800 (ACTIVE) - Summary

Prohibits insurance companies from limiting the quantity of drugs dispensed pursuant to a prescription; increases the quantity of drugs that may be prescribed from a thirty day supply to a ninety day supply.

2015-S1800 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S1800

TITLE OF BILL:

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

PURPOSE:

To extend limit on the quantity of prescription drugs issued by an
authorized provider from 30 day supply to 90 day supply.

SUMMARY OF PROVISIONS:

Section 1. Amends subsection (i) of section 3216 of the insurance law
by adding a new paragraph 32.

Section 2. Amends subdivision 3 of section 3332 of the public health
law, to change thirty to ninety.

Section 3. Amends subdivision 1 of the section 3333 of the public
health law, to change thirty to ninety.

Section 4. Amends subdivision 2 of section 3339 of the public health
law, to change thirty to ninety.

Section 5. Amends paragraph (g-1) of subdivision 2 of section 365-a of
the social services law, to change thirty to ninety.

Section 6. Sets for the effective date.

JUSTIFICATION:

The purpose of this bill is to extend the quantity dispensed by
prescription from 30 day to 90 day supply. The limit on the quantity
of prescription drugs to a 30 day supply causes patients to pay
additional co-payments to receive the quantity prescribed. Additional
trips and co-payments to the pharmacists sometimes overburden the
patient, especially elderly patients. With the advancement of medical
science there has become an ever increasing reliance on prescription
medications, particularly as the population is living longer and
longer. The purpose of this bill is to alleviate some of the burdens
on those who rely on prescription medication for their continued
health and well-being.

LEGISLATIVE HISTORY:

S.4237/A.6098 2013-14;
S.3909/A.4155 2011-12;
S.3030/A 5299 2009-10;
S.3299/A.6100, 2007-08;
S.1779/A.3460, 2005-06;
S.1794-A/A.4108A, 2003-04;
S.3639-A/A.11359, 2001-02.


FISCAL IMPLICATIONS:

None to the State

EFFECTIVE DATE:

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.

2015-S1800 (ACTIVE) - Bill Text download pdf

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

                                  1800

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 14, 2015
                               ___________

Introduced  by  Sens. LAVALLE, LIBOUS -- read twice and ordered printed,
  and when printed to be committed 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 32 to read as follows:
  (32) 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:
  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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03153-01-5

S. 1800                             2

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
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

S. 1800                             3

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 5 of part C of  chapter  60  of  the
laws of 2014, 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 more than a ten day supply of the previously dispensed
amount should remain  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-pa-
tient basis for which a recipient is charged or a claim is made  in  the
case  of  a  prescription  drug,  in  excess of the maximum reimbursable
amounts to be established by department regulations in  accordance  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.

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