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

                                  8139

                            I N  S E N A T E

                              June 13, 2016
                               ___________

Introduced  by Sen. MURPHY -- (at request of the Governor) -- read twice
  and ordered printed, and when printed to be committed to the Committee
  on Rules

AN ACT to amend the public health law, in relation to providing training
  in pain management for certain individuals  (Part  A);  to  amend  the
  insurance  law, in relation to providing coverage for medically neces-
  sary inpatient services for the diagnosis and treatment  of  substance
  abuse  disorder  (Part  B); to amend the public health law, the social
  services law, and the insurance law, in relation to  limiting  initial
  prescriptions for opioids to a seven-day supply (Part C); and to amend
  the  mental  hygiene law and the public health law, in relation to the
  dissemination of information by  pharmacists  to  customers  regarding
  controlled   substances  and  counseling  for  individuals  purchasing
  syringes (Part D)

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

  Section  1.  This  act enacts into law major components of legislation
related to the treatment of heroin and opioid addictions. Each component
is wholly contained within a Part identified as Parts A through  D.  The
effective  date for each particular provision contained within such Part
is set forth in the last section of such  Part.  Any  provision  in  any
section  contained  within  a  Part, including the effective date of the
Part, which makes a reference to a section "of this act", when  used  in
connection  with  that particular component, shall be deemed to mean and
refer to the corresponding section of the Part in  which  it  is  found.
Section  three of this act sets forth the general effective date of this
act.

                                 PART A

  Section 1. Section 3309-a of  the  public  health  law,  as  added  by
section  52  of  part D of chapter 56 of the laws of 2012, subparagraphs
(i), (ii), and (iii) of paragraph (b) of subdivision 2 as amended by and
subparagraph (iv) of paragraph (b) of subdivision 2 as added by  section

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

                                                           LBD12080-01-6

S. 8139                             2

1 of part D of chapter 447 of the laws of 2012, and subdivisions 3 and 4
as amended by section 2 of part D of chapter 447 of the laws of 2012, is
amended to read as follows:
  S  3309-a. Prescription pain medication awareness program. 1. There is
hereby established within the department a prescription pain  medication
awareness  program  to  educate the public and health care practitioners
about the  risks  associated  with  prescribing  and  taking  controlled
substance pain medications.
  2.  Within the amounts appropriated, the commissioner, in consultation
with the commissioner of the office of alcoholism  and  substance  abuse
services, shall[:
  (a)  Develop]  DEVELOP  and  conduct  a  public health education media
campaign designed to alert youth, parents  and  the  general  population
about  the  risks  associated with prescription pain medications and the
need to properly dispose of any unused medication.  In  developing  this
campaign,  the  commissioner  shall  consult  with  and  use information
provided by the work group established  pursuant  to  subdivision  [(b)]
FOUR  of this section and other relevant professional organizations. The
campaign shall include an internet  website  providing  information  for
parents,  children and health care professionals on the risks associated
with taking opioids and resources available to those needing  assistance
with  prescription  pain  medication  addiction. Such website shall also
provide information regarding where individuals may properly dispose  of
controlled  substances  in  their  community and include active links to
further information and resources. The campaign  shall  begin  no  later
than September first, two thousand twelve.
  3.  COURSE  WORK  OR  TRAINING IN PAIN MANAGEMENT, PALLIATIVE CARE AND
ADDICTION. (A) EVERY PERSON LICENSED UNDER TITLE EIGHT OF THE  EDUCATION
LAW  TO TREAT HUMANS, REGISTERED UNDER THE FEDERAL CONTROLLED SUBSTANCES
ACT AND IN POSSESSION OF A REGISTRATION NUMBER FROM THE DRUG ENFORCEMENT
ADMINISTRATION, UNITED STATES DEPARTMENT OF  JUSTICE  OR  ITS  SUCCESSOR
AGENCY,  AND  EVERY MEDICAL RESIDENT WHO IS PRESCRIBING UNDER A FACILITY
REGISTRATION NUMBER FROM THE  DRUG  ENFORCEMENT  ADMINISTRATION,  UNITED
STATES  DEPARTMENT  OF  JUSTICE  OR  ITS  SUCCESSOR AGENCY, SHALL, ON OR
BEFORE JULY FIRST, TWO THOUSAND SEVENTEEN AND  ONCE  WITHIN  EACH  THREE
YEAR  PERIOD THEREAFTER, COMPLETE THREE HOURS OF COURSE WORK OR TRAINING
IN PAIN MANAGEMENT, PALLIATIVE  CARE,  AND  ADDICTION  APPROVED  BY  THE
DEPARTMENT.
  (b)  EVERY PERSON LICENSED ON OR AFTER JULY FIRST, TWO THOUSAND SEVEN-
TEEN UNDER TITLE EIGHT OF THE EDUCATION LAW TO TREAT HUMANS,  REGISTERED
UNDER  THE  FEDERAL  CONTROLLED  SUBSTANCES  ACT  AND IN POSSESSION OF A
REGISTRATION NUMBER FROM THE  DRUG  ENFORCEMENT  ADMINISTRATION,  UNITED
STATES  DEPARTMENT OF JUSTICE OR ITS SUCCESSOR AGENCY, AND EVERY MEDICAL
RESIDENT WHO BEGINS PRESCRIBING UNDER  A  FACILITY  REGISTRATION  NUMBER
FROM  THE  DRUG  ENFORCEMENT ADMINISTRATION, UNITED STATES DEPARTMENT OF
JUSTICE OR ITS SUCCESSOR AGENCY ON OR AFTER  JULY  FIRST,  TWO  THOUSAND
SEVENTEEN,  SHALL  COMPLETE SUCH COURSE WORK OR TRAINING WITHIN ONE YEAR
OF SUCH REGISTRATION AND ONCE WITHIN EACH THREE YEAR PERIOD THEREAFTER.
  (C) THE COMMISSIONER, IN CONSULTATION WITH THE DEPARTMENT OF EDUCATION
AND THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, SHALL  ESTAB-
LISH  STANDARDS  AND  REVIEW AND APPROVE COURSE WORK OR TRAINING IN PAIN
MANAGEMENT, PALLIATIVE CARE, AND ADDICTION AND SHALL PUBLISH INFORMATION
RELATED TO SUCH STANDARDS, COURSE WORK OR TRAINING ON  THE  DEPARTMENT'S
WEBSITE.
  (D)  EXISTING COURSE WORK OR TRAINING, INCLUDING COURSE WORK OR TRAIN-
ING DEVELOPED BY  A  NATIONALLY  RECOGNIZED  HEALTH  CARE  PROFESSIONAL,

S. 8139                             3

SPECIALTY,  OR  PROVIDER  ASSOCIATION,  OR  NATIONALLY  RECOGNIZED  PAIN
MANAGEMENT ASSOCIATION, MAY BE CONSIDERED IN IMPLEMENTING THIS  SUBDIVI-
SION.
  (E)  NOTHING  SHALL  PRECLUDE  COURSE  WORK OR TRAINING THAT MEETS THE
REQUIREMENTS OF PARAGRAPH (C) OF THIS SUBDIVISION FROM  COUNTING  TOWARD
THIS REQUIREMENT IF TAKEN ONLINE.
  (F)  COURSE  WORK  OR  TRAINING  SHALL INCLUDE, BUT NOT BE LIMITED TO:
STATE AND FEDERAL REQUIREMENTS FOR  PRESCRIBING  CONTROLLED  SUBSTANCES;
PAIN  MANAGEMENT;  APPROPRIATE PRESCRIBING; MANAGING ACUTE PAIN; PALLIA-
TIVE MEDICINE; PREVENTION, SCREENING AND SIGNS OF  ADDICTION;  RESPONSES
TO ABUSE AND ADDICTION; AND END OF LIFE CARE.
  (G)  EACH  LICENSED  PERSON  REQUIRED  BY THIS SUBDIVISION TO COMPLETE
COURSE WORK OR TRAINING SHALL DOCUMENT TO THE DEPARTMENT BY  ATTESTATION
ON  A  FORM PRESCRIBED BY THE COMMISSIONER THAT SUCH LICENSED PERSON HAS
COMPLETED THE COURSE WORK OR TRAINING REQUIRED BY THIS SUBDIVISION.  FOR
MEDICAL  RESIDENTS  WHO  ARE  PRESCRIBING  UNDER A FACILITY REGISTRATION
NUMBER FROM THE DRUG ENFORCEMENT ADMINISTRATION, UNITED  STATES  DEPART-
MENT  OF JUSTICE OR ITS SUCCESSOR AGENCY, SUCH ATTESTATION SHALL BE MADE
BY THE FACILITY.
  (H) THE DEPARTMENT SHALL INSTITUTE A PROCEDURE FOR APPLICATION FOR  AN
EXEMPTION FROM SAID REQUIREMENT. THE DEPARTMENT MAY PROVIDE AN EXEMPTION
FROM  THE  COURSE  WORK AND TRAINING REQUIRED BY THIS SUBDIVISION TO ANY
SUCH LICENSED PERSON WHO: (I) CLEARLY DEMONSTRATES TO  THE  DEPARTMENT'S
SATISFACTION THAT THERE WOULD BE NO NEED FOR HIM OR HER TO COMPLETE SUCH
COURSE  WORK  OR  TRAINING;  OR (II) THAT HE OR SHE HAS COMPLETED COURSE
WORK OR TRAINING DEEMED BY THE DEPARTMENT TO BE EQUIVALENT TO THE COURSE
WORK OR TRAINING APPROVED BY THE DEPARTMENT PURSUANT  TO  THIS  SUBDIVI-
SION.
  (I) NOTHING HEREIN SHALL PRECLUDE SUCH COURSE WORK OR TRAINING IN PAIN
MANAGEMENT, PALLIATIVE CARE, AND ADDICTION FROM COUNTING TOWARD CONTINU-
ING EDUCATION REQUIREMENTS UNDER TITLE EIGHT OF THE EDUCATION LAW TO THE
EXTENT PROVIDED IN THE REGULATIONS OF THE COMMISSIONER OF EDUCATION.
  (J) NOTHING HEREIN SHALL PRECLUDE SUCH COURSE WORK OR TRAINING IN PAIN
MANAGEMENT, PALLIATIVE CARE, AND ADDICTION FROM COUNTING TOWARD CONTINU-
ING  EDUCATION  REQUIREMENTS OF A NATIONALLY ACCREDITED MEDICAL BOARD TO
THE EXTENT ACCEPTABLE TO SUCH BOARD.
  4. Establish a work group, no later  than  June  first,  two  thousand
twelve,  which  shall be composed of experts in the fields of palliative
and chronic care pain management and addiction medicine. Members of  the
work  group  shall receive no compensation for their services, but shall
be allowed actual and necessary expenses in  the  performance  of  their
duties pursuant to this section. The work group shall:
  [(i)]  (A)  Report  to  the  commissioner regarding the development of
recommendations and model  courses  for  continuing  medical  education,
refresher  courses and other training materials for licensed health care
professionals on appropriate use of prescription pain  medication.  Such
recommendations,  model  courses  and  other training materials shall be
submitted to the commissioner, who shall make such information available
for  the  use  in  medical  education,  residency  programs,  fellowship
programs,  and  for  use  in continuing medication education programs no
later than January first, two thousand  thirteen.  Such  recommendations
also shall include recommendations on: [(A)] (I) educational and contin-
uing  medical  education  requirements  for practitioners appropriate to
address prescription pain medication awareness among health care profes-
sionals; [(B)] (II) continuing education  requirements  for  pharmacists
related  to  prescription  pain  medication  awareness;  and [(C)] (III)

S. 8139                             4

continuing education in palliative care as it relates  to  pain  manage-
ment,  for which purpose the work group shall consult the New York state
palliative care education and training council;
  [(ii)] (B) No later than January first, two thousand thirteen, provide
outreach  and  assistance  to  health care professional organizations to
encourage and facilitate continuing medical education training  programs
for  their  members  regarding appropriate prescribing practices for the
best patient care and the  risks  associated  with  overprescribing  and
underprescribing pain medication;
  [(iii)]  (C)  Provide  information  to the commissioner for use in the
development and continued  update  of  the  public  awareness  campaign,
including  information,  resources,  and active web links that should be
included on the website; and
  [(iv)] (D) Consider other issues deemed relevant by the  commissioner,
including  how  to  protect  and  promote  the access of patients with a
legitimate need  for  controlled  substances,  particularly  medications
needed  for pain management by oncology patients, and whether and how to
encourage or require the use or substitution of opioid drugs that employ
tamper-resistance technology as  a  mechanism  for  reducing  abuse  and
diversion of opioid drugs.
  [3.] 5. On or before September first, two thousand twelve, the commis-
sioner,  in consultation with the commissioner of the office of alcohol-
ism and substance abuse services, the commissioner of education, and the
executive secretary of the state board of pharmacy,  shall  add  to  the
workgroup  such  additional members as appropriate so that the workgroup
may provide guidance in furtherance of the implementation of the  I-STOP
act.  For  such purposes, the workgroup shall include but not be limited
to  consumer  advisory  organizations,  health  care  practitioners  and
providers,  oncologists,  addiction  treatment  providers, practitioners
with experience in pain  management,  pharmacists  and  pharmacies,  and
representatives of law enforcement agencies.
  [4.]  6.  The commissioner shall report to the governor, the temporary
president of the senate and the speaker of the assembly  no  later  than
March first, two thousand thirteen, and annually thereafter, on the work
group's  findings.  The report shall include information on opioid over-
dose deaths, emergency room utilization  for  the  treatment  of  opioid
overdose,  the utilization of pre-hospital addiction services and recom-
mendations to reduce opioid  addiction  and  the  consequences  thereof.
[The  report  shall also include a recommendation as to whether subdivi-
sion two of section thirty-three hundred forty-three-a of  this  article
should  be  amended  to  require practitioners prescribing or dispensing
certain identified schedule V controlled substances to comply  with  the
consultation requirements of such subdivision.]
  S 2. This act shall take effective immediately.

                                 PART B

  Section  1.  Paragraph  30  of  subsection  (i) of section 3216 of the
insurance law, as added by chapter 41 of the laws of 2014, is amended to
read as follows:
  (30)(A) Every policy that provides hospital, major medical or  similar
comprehensive coverage must provide inpatient coverage for the diagnosis
and  treatment  of  substance use disorder, including detoxification and
rehabilitation services. Such INPATIENT COVERAGE SHALL INCLUDE UNLIMITED
MEDICALLY NECESSARY  TREATMENT  FOR  SUBSTANCE  USE  DISORDER  TREATMENT
SERVICES  PROVIDED  IN  RESIDENTIAL  SETTINGS  AS REQUIRED BY THE MENTAL

S. 8139                             5

HEALTH PARITY AND ADDICTION EQUITY ACT OF  2008  (29  U.S.C.  S  1185A).
FURTHER,  SUCH INPATIENT coverage shall not apply financial requirements
or treatment limitations, INCLUDING UTILIZATION REVIEW REQUIREMENTS,  to
inpatient substance use disorder benefits that are more restrictive than
the predominant financial requirements and treatment limitations applied
to  substantially all medical and surgical benefits covered by the poli-
cy.  Further, such coverage shall be provided consistent with the feder-
al Paul Wellstone and Pete Domenici Mental Health Parity  and  Addiction
Equity Act of 2008 (29 U.S.C. S 1185a).
  (B)  Coverage  provided under this paragraph may be limited to facili-
ties in New York state which are certified by the office  of  alcoholism
and  substance  abuse  services and, in other states, to those which are
accredited by the joint commission as alcoholism,  substance  abuse,  or
chemical dependence treatment programs.
  (C)  Coverage  provided  under this paragraph may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
and that are consistent with those imposed on other  benefits  within  a
given policy.
  (D)  THIS  SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE CERTI-
FIED BY THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  THAT  ARE
PARTICIPATING IN THE INSURER'S PROVIDER NETWORK. COVERAGE PROVIDED UNDER
THIS  PARAGRAPH  SHALL  NOT  BE  SUBJECT  TO  PREAUTHORIZATION. COVERAGE
PROVIDED UNDER THIS PARAGRAPH SHALL ALSO NOT BE  SUBJECT  TO  CONCURRENT
UTILIZATION  REVIEW  DURING  THE  FIRST  FOURTEEN  DAYS OF THE INPATIENT
ADMISSION PROVIDED THAT THE FACILITY NOTIFIES THE INSURER  OF  BOTH  THE
ADMISSION AND THE INITIAL TREATMENT PLAN WITHIN FORTY-EIGHT HOURS OF THE
ADMISSION.  THE  FACILITY  SHALL  PERFORM  DAILY  CLINICAL REVIEW OF THE
PATIENT, INCLUDING THE PERIODIC CONSULTATION WITH THE INSURER TO  ENSURE
THAT THE FACILITY IS USING THE EVIDENCE-BASED AND PEER REVIEWED CLINICAL
REVIEW TOOL UTILIZED BY THE INSURER WHICH IS DESIGNATED BY THE OFFICE OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE SERVICES AND APPROPRIATE TO THE AGE OF
THE PATIENT, TO ENSURE THAT THE INPATIENT TREATMENT IS MEDICALLY  NECES-
SARY FOR THE PATIENT. ANY UTILIZATION REVIEW OF TREATMENT PROVIDED UNDER
THIS  SUBPARAGRAPH  MAY INCLUDE A REVIEW OF ALL SERVICES PROVIDED DURING
SUCH INPATIENT TREATMENT, INCLUDING ALL  SERVICES  PROVIDED  DURING  THE
FIRST  FOURTEEN DAYS OF SUCH INPATIENT TREATMENT. PROVIDED, HOWEVER, THE
INSURER SHALL ONLY DENY COVERAGE FOR ANY PORTION OF THE INITIAL FOURTEEN
DAY INPATIENT TREATMENT  ON  THE  BASIS  THAT  SUCH  TREATMENT  WAS  NOT
MEDICALLY  NECESSARY  IF  SUCH  INPATIENT  TREATMENT WAS CONTRARY TO THE
EVIDENCE-BASED AND PEER REVIEWED CLINICAL REVIEW TOOL  UTILIZED  BY  THE
INSURER  WHICH  IS  DESIGNATED BY THE OFFICE OF ALCOHOLISM AND SUBSTANCE
ABUSE SERVICES. AN INSURED SHALL NOT HAVE ANY  FINANCIAL  OBLIGATION  TO
THE  FACILITY  FOR  ANY TREATMENT UNDER THIS SUBPARAGRAPH OTHER THAN ANY
COPAYMENT, COINSURANCE, OR DEDUCTIBLE OTHERWISE REQUIRED UNDER THE POLI-
CY.
  S 2. Paragraph 6 of subsection (l) of section 3221  of  the  insurance
law, as amended by chapter 41 of the laws of 2014, is amended to read as
follows:
  (6)  (A) Every policy that provides hospital, major medical or similar
comprehensive coverage must provide inpatient coverage for the diagnosis
and treatment of substance use disorder,  including  detoxification  and
rehabilitation services. Such INPATIENT COVERAGE SHALL INCLUDE UNLIMITED
MEDICALLY  NECESSARY  TREATMENT  FOR  SUBSTANCE  USE  DISORDER TREATMENT
SERVICES PROVIDED IN RESIDENTIAL SETTINGS  AS  REQUIRED  BY  THE  MENTAL
HEALTH  PARITY  AND  ADDICTION  EQUITY  ACT OF 2008 (29 U.S.C. S 1185A).
FURTHER, SUCH INPATIENT coverage shall not apply financial  requirements

S. 8139                             6

or  treatment limitations, INCLUDING UTILIZATION REVIEW REQUIREMENTS, to
inpatient substance use disorder benefits that are more restrictive than
the predominant financial requirements and treatment limitations applied
to  substantially all medical and surgical benefits covered by the poli-
cy.  Further, such coverage shall be provided consistent with the feder-
al Paul Wellstone and Pete Domenici Mental Health Parity  and  Addiction
Equity Act of 2008 (29 U.S.C. S 1185a).
  (B)  Coverage  provided under this paragraph may be limited to facili-
ties in New York state which are certified by the office  of  alcoholism
and  substance  abuse  services and, in other states, to those which are
accredited by the joint commission as  alcoholism,  substance  abuse  or
chemical dependence treatment programs.
  (C)  Coverage  provided  under this paragraph may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
and that are consistent with those imposed on other  benefits  within  a
given policy.
  (D)  THIS  SUBPARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE CERTI-
FIED BY THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  THAT  ARE
PARTICIPATING IN THE INSURER'S PROVIDER NETWORK. COVERAGE PROVIDED UNDER
THIS  PARAGRAPH  SHALL  NOT  BE  SUBJECT  TO  PREAUTHORIZATION. COVERAGE
PROVIDED UNDER THIS PARAGRAPH SHALL ALSO NOT BE  SUBJECT  TO  CONCURRENT
UTILIZATION  REVIEW  DURING  THE  FIRST  FOURTEEN  DAYS OF THE INPATIENT
ADMISSION PROVIDED THAT THE FACILITY NOTIFIES THE INSURER  OF  BOTH  THE
ADMISSION AND THE INITIAL TREATMENT PLAN WITHIN FORTY-EIGHT HOURS OF THE
ADMISSION.  THE  FACILITY  SHALL  PERFORM  DAILY  CLINICAL REVIEW OF THE
PATIENT, INCLUDING THE PERIODIC CONSULTATION WITH THE INSURER TO  ENSURE
THAT THE FACILITY IS USING THE EVIDENCE-BASED AND PEER REVIEWED CLINICAL
REVIEW TOOL UTILIZED BY THE INSURER WHICH IS DESIGNATED BY THE OFFICE OF
ALCOHOLISM  AND  SUBSTANCE  ABUSE SERVICES AND APPROPRIATE TO THE AGE OF
THE PATIENT, TO ENSURE THAT THE INPATIENT TREATMENT IS MEDICALLY  NECES-
SARY FOR THE PATIENT. ANY UTILIZATION REVIEW OF TREATMENT PROVIDED UNDER
THIS  SUBPARAGRAPH  MAY INCLUDE A REVIEW OF ALL SERVICES PROVIDED DURING
SUCH INPATIENT TREATMENT, INCLUDING ALL  SERVICES  PROVIDED  DURING  THE
FIRST  FOURTEEN DAYS OF SUCH INPATIENT TREATMENT. PROVIDED, HOWEVER, THE
INSURER SHALL ONLY DENY COVERAGE FOR ANY PORTION OF THE INITIAL FOURTEEN
DAY INPATIENT TREATMENT  ON  THE  BASIS  THAT  SUCH  TREATMENT  WAS  NOT
MEDICALLY  NECESSARY  IF  SUCH  INPATIENT  TREATMENT WAS CONTRARY TO THE
EVIDENCE-BASED AND PEER REVIEWED CLINICAL REVIEW TOOL  UTILIZED  BY  THE
INSURER  WHICH  IS  DESIGNATED BY THE OFFICE OF ALCOHOLISM AND SUBSTANCE
ABUSE SERVICES. AN INSURED SHALL NOT HAVE ANY  FINANCIAL  OBLIGATION  TO
THE  FACILITY  FOR  ANY TREATMENT UNDER THIS SUBPARAGRAPH OTHER THAN ANY
COPAYMENT, COINSURANCE, OR DEDUCTIBLE OTHERWISE REQUIRED UNDER THE POLI-
CY.
  S 3. Subsection (k) of section 4303 of the insurance law,  as  amended
by chapter 41 of the laws of 2014, is amended to read as follows:
  (k)(1) Every contract that provides hospital, major medical or similar
comprehensive coverage must provide inpatient coverage for the diagnosis
and  treatment  of  substance use disorder, including detoxification and
rehabilitation services. Such  INPATIENT COVERAGE SHALL INCLUDE UNLIMIT-
ED MEDICALLY NECESSARY TREATMENT FOR SUBSTANCE  USE  DISORDER  TREATMENT
SERVICES  PROVIDED  IN  RESIDENTIAL  SETTINGS  AS REQUIRED BY THE MENTAL
HEALTH PARITY AND ADDICTION EQUITY ACT OF  2008  (29  U.S.C.  S  1185A).
FURTHER,  SUCH INPATIENT coverage shall not apply financial requirements
or treatment limitations, INCLUDING UTILIZATION REVIEW REQUIREMENTS,  to
inpatient substance use disorder benefits that are more restrictive than
the predominant financial requirements and treatment limitations applied

S. 8139                             7

to  substantially  all  medical  and  surgical  benefits  covered by the
contract.  Further, such coverage shall be provided consistent with  the
federal  Paul  Wellstone  and  Pete  Domenici  Mental  Health Parity and
Addiction Equity Act of 2008 (29 U.S.C. S 1185a).
  (2)  Coverage provided under this subsection may be limited to facili-
ties in New York state which are certified by the office  of  alcoholism
and  substance  abuse  services and, in other states, to those which are
accredited by the joint commission as alcoholism,  substance  abuse,  or
chemical dependence treatment programs.
  (3)  Coverage  provided under this subsection may be subject to annual
deductibles and co-insurance as deemed appropriate by the superintendent
and that are consistent with those imposed on other  benefits  within  a
given contract.
  (4)  THIS  PARAGRAPH SHALL APPLY TO FACILITIES IN THIS STATE CERTIFIED
BY THE OFFICE OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE  SERVICES  THAT  ARE
PARTICIPATING  IN  THE CORPORATION'S PROVIDER NETWORK. COVERAGE PROVIDED
UNDER THIS SUBSECTION SHALL NOT BE SUBJECT TO PREAUTHORIZATION. COVERAGE
PROVIDED UNDER THIS SUBSECTION SHALL ALSO NOT BE SUBJECT  TO  CONCURRENT
UTILIZATION  REVIEW  DURING  THE  FIRST  FOURTEEN  DAYS OF THE INPATIENT
ADMISSION PROVIDED THAT THE FACILITY NOTIFIES THE  CORPORATION  OF  BOTH
THE ADMISSION AND THE INITIAL TREATMENT PLAN WITHIN FORTY-EIGHT HOURS OF
THE  ADMISSION.  THE FACILITY SHALL PERFORM DAILY CLINICAL REVIEW OF THE
PATIENT, INCLUDING THE PERIODIC CONSULTATION  WITH  THE  CORPORATION  TO
ENSURE  THAT  THE FACILITY IS USING THE EVIDENCE-BASED AND PEER REVIEWED
CLINICAL REVIEW TOOL UTILIZED BY THE CORPORATION WHICH IS DESIGNATED  BY
THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES AND APPROPRIATE TO
THE  AGE  OF  THE  PATIENT,  TO  ENSURE  THAT THE INPATIENT TREATMENT IS
MEDICALLY NECESSARY FOR THE PATIENT. ANY UTILIZATION REVIEW OF TREATMENT
PROVIDED UNDER THIS PARAGRAPH MAY  INCLUDE  A  REVIEW  OF  ALL  SERVICES
PROVIDED   DURING  SUCH  INPATIENT  TREATMENT,  INCLUDING  ALL  SERVICES
PROVIDED DURING THE FIRST FOURTEEN DAYS  OF  SUCH  INPATIENT  TREATMENT.
PROVIDED,  HOWEVER,  THE  CORPORATION  SHALL  ONLY DENY COVERAGE FOR ANY
PORTION OF THE INITIAL FOURTEEN DAY INPATIENT  TREATMENT  ON  THE  BASIS
THAT SUCH TREATMENT WAS NOT MEDICALLY NECESSARY IF SUCH INPATIENT TREAT-
MENT  WAS  CONTRARY  TO  THE  EVIDENCE-BASED  AND PEER REVIEWED CLINICAL
REVIEW TOOL UTILIZED BY THE  CORPORATION  WHICH  IS  DESIGNATED  BY  THE
OFFICE  OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES. AN INSURED SHALL NOT
HAVE ANY FINANCIAL OBLIGATION TO THE FACILITY FOR  ANY  TREATMENT  UNDER
THIS  PARAGRAPH  OTHER  THAN  ANY  COPAYMENT, COINSURANCE, OR DEDUCTIBLE
OTHERWISE REQUIRED UNDER THE CONTRACT.
  S 4. This act shall take effect on the first of January next  succeed-
ing  the  date  on  which  it shall have become a law and shall apply to
policies and contracts issued, renewed, modified, altered or amended  on
and after such date.

                                 PART C

  Section  1. Subdivision 5 of section 3331 of the public health law, as
amended by chapter 965 of the laws  of  1974,  is  amended  to  read  as
follows:
  5. (A) No more than a thirty day supply or, pursuant to regulations of
the  commissioner  enumerating  conditions  warranting specified greater
supplies, no more than a three month supply of a schedule II, III or  IV
substance, as determined by the directed dosage and frequency of dosage,
may be dispensed by an authorized practitioner at one time.

S. 8139                             8

  (B)  NOTWITHSTANDING  THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDIVI-
SION, A PRACTITIONER, WITHIN THE SCOPE OF HIS OR HER PROFESSIONAL  OPIN-
ION OR DISCRETION, MAY NOT PRESCRIBE MORE THAN A SEVEN-DAY SUPPLY OF ANY
SCHEDULE  II,  III,  OR  IV  OPIOID TO AN ULTIMATE USER UPON THE INITIAL
CONSULTATION  OR TREATMENT OF SUCH USER FOR ACUTE PAIN.  UPON ANY SUBSE-
QUENT CONSULTATIONS FOR THE SAME PAIN, THE PRACTITIONER  MAY  ISSUE,  IN
ACCORDANCE  WITH  PARAGRAPH  (A)  OF  THIS  SUBDIVISION, ANY APPROPRIATE
RENEWAL, REFILL, OR NEW PRESCRIPTION FOR THE OPIOID OR ANY OTHER DRUG.
  (C) FOR THE PURPOSES OF THIS  SUBDIVISION,  "ACUTE  PAIN"  SHALL  MEAN
PAIN,  WHETHER RESULTING FROM DISEASE, ACCIDENTAL OR INTENTIONAL TRAUMA,
OR OTHER CAUSE, THAT THE PRACTITIONER REASONABLY EXPECTS TO LAST ONLY  A
SHORT  PERIOD  OF  TIME.  SUCH TERM SHALL NOT INCLUDE CHRONIC PAIN, PAIN
BEING TREATED AS PART OF CANCER CARE, HOSPICE OR OTHER END-OF-LIFE CARE,
OR PAIN BEING TREATED AS PART OF PALLIATIVE CARE PRACTICES.
  S 2. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 33 to read as follows:
  (33) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE  THAT
PROVIDES  COVERAGE  FOR  PRESCRIPTION DRUGS SUBJECT TO A COPAYMENT SHALL
CHARGE A COPAYMENT FOR A LIMITED INITIAL PRESCRIPTION OF AN OPIOID DRUG,
WHICH IS PRESCRIBED IN ACCORDANCE WITH PARAGRAPH (B) OF SUBDIVISION FIVE
OF SECTION THIRTY-THREE HUNDRED ONE OF THE PUBLIC HEALTH  LAW,  THAT  IS
EITHER  (I)  PROPORTIONAL  BETWEEN THE COPAYMENT FOR A THIRTY-DAY SUPPLY
AND THE AMOUNT OF DRUGS THE PATIENT WAS PRESCRIBED; OR  (II)  EQUIVALENT
TO  THE  COPAYMENT  FOR  A  FULL  THIRTY-DAY  SUPPLY OF THE OPIOID DRUG,
PROVIDED THAT NO ADDITIONAL COPAYMENTS MAY BE CHARGED FOR ANY ADDITIONAL
PRESCRIPTIONS FOR THE REMAINDER OF THE THIRTY-DAY SUPPLY.
  S 3. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 21 to read as follows:
  (21) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
THIS STATE THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS  SUBJECT  TO  A
COPAYMENT SHALL CHARGE A COPAYMENT FOR A LIMITED INITIAL PRESCRIPTION OF
AN  OPIOID DRUG, WHICH IS PRESCRIBED IN ACCORDANCE WITH PARAGRAPH (B) OF
SUBDIVISION FIVE OF SECTION  THIRTY-THREE  HUNDRED  ONE  OF  THE  PUBLIC
HEALTH  LAW, THAT IS EITHER (I) PROPORTIONAL BETWEEN THE COPAYMENT FOR A
THIRTY-DAY SUPPLY AND THE AMOUNT OF DRUGS THE PATIENT WAS PRESCRIBED; OR
(II) EQUIVALENT TO THE COPAYMENT FOR A FULL  THIRTY-DAY  SUPPLY  OF  THE
OPIOID  DRUG,  PROVIDED THAT NO ADDITIONAL COPAYMENTS MAY BE CHARGED FOR
ANY ADDITIONAL PRESCRIPTIONS FOR THE REMAINDER OF THE THIRTY-DAY SUPPLY.
  S 4. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (qq) to read as follows:
  (QQ)  EVERY  MEDICAL  EXPENSE  INDEMNITY CORPORATION, HOSPITAL SERVICE
CORPORATION OR HEALTH SERVICE CORPORATION  THAT  PROVIDES  COVERAGE  FOR
PRESCRIPTION DRUGS SUBJECT TO A COPAYMENT SHALL CHARGE A COPAYMENT FOR A
LIMITED  INITIAL  PRESCRIPTION OF AN OPIOID DRUG, WHICH IS PRESCRIBED IN
ACCORDANCE  WITH  PARAGRAPH  (B)  OF   SUBDIVISION   FIVE   OF   SECTION
THIRTY-THREE  HUNDRED  ONE  OF THE PUBLIC HEALTH LAW, THAT IS EITHER (I)
PROPORTIONAL BETWEEN THE COPAYMENT  FOR  A  THIRTY-DAY  SUPPLY  AND  THE
AMOUNT  OF  DRUGS  THE PATIENT WAS PRESCRIBED; OR (II) EQUIVALENT TO THE
COPAYMENT FOR A FULL THIRTY-DAY SUPPLY OF THE OPIOID DRUG, PROVIDED THAT
NO ADDITIONAL COPAYMENTS MAY BE CHARGED FOR ANY ADDITIONAL PRESCRIPTIONS
FOR THE REMAINDER OF THE THIRTY-DAY SUPPLY.
  S 5. Paragraph (c) of subdivision 6 of section  367-a  of  the  social
services  law  is  amended  by adding a new subparagraph (iv) to read as
follows:
  (IV) WHEN AN INDIVIDUAL IS INITIALLY DISPENSED OR PRESCRIBED  A  SEVEN
OR  FEWER DAYS SUPPLY OF AN OPIOID PURSUANT TO PARAGRAPH (B) OF SUBDIVI-

S. 8139                             9

SION FIVE OF SECTION THREE THOUSAND  THREE  HUNDRED  THIRTY-ONE  OF  THE
PUBLIC  HEALTH LAW, AND IS SUBSEQUENTLY DISPENSED OR PRESCRIBED AN ADDI-
TIONAL SUPPLY OF SUCH OPIOID FOR  THE  SAME  UNDERLYING  CONDITION,  THE
TOTAL  CO-PAYMENT  THAT  MAY  BE  CHARGED  TO SUCH AN INDIVIDUAL FOR THE
INITIAL PRESCRIPTION PLUS ALL  SUBSEQUENT  PRESCRIPTIONS  FOR  THE  SAME
UNDERLYING  CONDITION  FOR  UP  TO A TOTAL OF THIRTY-DAYS SUPPLY OF SUCH
OPIOID SHALL NOT EXCEED THE AMOUNT SET FORTH IN  SUBPARAGRAPH  (III)  OF
THIS PARAGRAPH.
  S  6.  This  act shall take effect on the thirtieth day after it shall
have become a law; provided, that the amendments  to  paragraph  (c)  of
subdivision  6  of  section  367-a  of  the  social services law made by
section five of this act shall not affect the repeal of  such  paragraph
and shall expire and be deemed repealed therewith.

                                 PART D

  Section  1.  Section  19.09  of  the  mental hygiene law is amended by
adding a new subdivision (j) to read as follows:
  (J) (1) THE COMMISSIONER, IN CONSULTATION  WITH  THE  COMMISSIONER  OF
HEALTH, SHALL CREATE OR UTILIZE EXISTING EDUCATIONAL MATERIALS REGARDING
THE  DANGERS  OF  MISUSE AND THE POTENTIAL FOR ADDICTION TO PRESCRIPTION
CONTROLLED SUBSTANCES, TREATMENT RESOURCES AVAILABLE, AND THE PROPER WAY
TO DISPOSE OF UNUSED PRESCRIPTION CONTROLLED  SUBSTANCES  IN  ACCORDANCE
WITH PARAGRAPH TWO OF THIS SUBDIVISION.
  (I) SUCH MATERIALS SHALL BE MADE AVAILABLE TO PHARMACIES REGISTERED IN
THE  STATE,  AND SHALL BE DISTRIBUTED AT THE TIME OF DISPENSING WITH ANY
PRESCRIBED DRUG THAT IS A CONTROLLED SUBSTANCE. INFORMATION DISSEMINATED
PURSUANT TO THIS PARAGRAPH MAY,  AT  THE  OPTION  OF  THE  CONSUMER,  BE
DISTRIBUTED THROUGH ELECTRONIC MEANS.
  (II)  SUCH MATERIALS SHALL ALSO BE POSTED ON THE WEBSITE OF THE OFFICE
OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES  AND  OF  THE  DEPARTMENT  OF
HEALTH,  AND SHALL BE PROVIDED IN LANGUAGES OTHER THAN ENGLISH AS DEEMED
APPROPRIATE BY THE COMMISSIONERS, BUT SHALL INCLUDE THE TEN MOST COMMON-
LY SPOKEN LANGUAGES, ASIDE FROM ENGLISH, IN THE STATE.
  (2) THE EDUCATIONAL MATERIALS REQUIRED IN PARAGRAPH ONE OF THIS SUBDI-
VISION SHALL INCLUDE THE FOLLOWING:
  (A) THE RISKS OF USING OR CONSUMING SUCH CONTROLLED SUBSTANCES;
  (B) THE PHYSICAL, BEHAVIORAL AND ADVANCED WARNING SIGNS  OF  ADDICTION
TO SUCH CONTROLLED SUBSTANCES;
  (C)  THE HOPELINE TELEPHONE CONTRACT NUMBER (1-877-8-HOPE-NY) AND TEXT
(HOPENY) FOR THE HOPELINE OPERATED BY THE OFFICE,  OR  ANY  NUMBER  THAT
SUCCEEDS THE HOPELINE;
  (D)  THE  PROCEDURES  FOR  THE  SAFE  DISPOSAL  OF  UNUSED  CONTROLLED
SUBSTANCES  ESTABLISHED  PURSUANT  TO   SECTION   THIRTY-THREE   HUNDRED
FORTY-THREE-B OF THE PUBLIC HEALTH LAW; AND
  (E)  SUCH  OTHER INFORMATION AS THE COMMISSIONER SHALL DETERMINE TO BE
NECESSARY OR INFORMATIVE RELATING TO THE USE, CONSUMPTION OR  ABUSE  OF,
OR ADDICTION TO CONTROLLED SUBSTANCES.
  (3)  A  PHARMACY MAY ALSO PROVIDE ADDITIONAL INFORMATION REGARDING THE
SAFE DISPOSAL OF CONTROLLED SUBSTANCES, INCLUDING BUT NOT LIMITED TO ANY
DISPOSAL PROGRAM THAT SUCH PHARMACY IS  OPERATING  OR  PARTICIPATING  IN
OUTSIDE OF THE PROGRAMS UNDER SECTION THIRTY-THREE HUNDRED FORTY-THREE-B
OF THE PUBLIC HEALTH LAW.
  S  2.  Paragraphs  (e) and (f) of subdivision 5 of section 3381 of the
public health law, as amended by section 9-a of part B of chapter 58  of
the laws of 2007, are amended to read as follows:

S. 8139                            10

  (e)  A  PHARMACY  REGISTERED UNDER ARTICLE ONE HUNDRED THIRTY-SEVEN OF
THE EDUCATION LAW MAY OFFER COUNSELING AND REFERRAL SERVICES TO  CUSTOM-
ERS  PURCHASING  HYPODERMIC  SYRINGES  FOR  THE  PURPOSE  OF: PREVENTING
INJECTION DRUG ABUSE; THE PROVISION OF DRUG  TREATMENT;  PREVENTING  AND
TREATING  HEPATITIS  C;  PREVENTING DRUG OVERDOSE; TESTING FOR THE HUMAN
IMMUNODEFICIENCY VIRUS; AND PROVIDING PRE-EXPOSURE PROPHYLAXIS AND  NON-
OCCUPATIONAL  POST-EXPOSURE  PROPHYLAXIS. THE CONTENT OF SUCH COUNSELING
AND REFERRAL SHALL BE AT THE PROFESSIONAL DISCRETION OF THE PHARMACIST.
  (F) The commissioner shall promulgate rules and regulations  necessary
to  implement  the  provisions of this subdivision which shall include a
requirement that such pharmacies, health care facilities and health care
practitioners cooperate in a safe disposal of used hypodermic needles or
syringes.
  [(f)] (G) The commissioner may, upon the finding  of  a  violation  of
this  section,  suspend  for  a  determinate  period of time the sale or
furnishing of syringes by a specific entity.
  S 3. This act shall take effect on the one hundred twentieth day after
it shall have become a law; provided, however, that effective immediate-
ly the office of alcoholism and substance abuse services may create  the
educational materials required pursuant to section one of this act.
  S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
sion,  section  or  part  of  this act shall be adjudged by any court of
competent jurisdiction to be invalid, such judgment  shall  not  affect,
impair,  or  invalidate  the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph,  subdivision,  section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the  legislature  that  this  act  would  have been enacted even if such
invalid provisions had not been included herein.
  S 3. This act shall take effect immediately  provided,  however,  that
the  applicable effective date of Parts A through D of this act shall be
as specifically set forth in the last section of such Parts.