NY State Assembly Bill 2017-A7492A

Assembly Bill A7492A

2017-2018 Legislative Session

Provides for the synchronization of multiple prescriptions for recipients of medical assistance

download bill text pdf

Archive: Last Bill Status - In Senate Committee Rules 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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 12, 2018	referred to rules delivered to senate passed assembly ordered to third reading rules cal.100 rules report cal.100
Jun 11, 2018	reported
Jun 07, 2018	reported referred to rules
Jun 05, 2018	reported referred to ways and means
May 25, 2018	print number 7492a
May 25, 2018	amend and recommit to health
Jan 03, 2018	referred to health
Apr 27, 2017	referred to health

Bill Amendments

Original

A (Active)

co-Sponsors

View additional co-sponsors

multi-Sponsors

2017-A7492 - Details

See Senate Version of this Bill:: S5622
Current Committee:: Senate Rules
Law Section:: Social Services Law
Laws Affected:: Amd §§367-a & 364-j, Soc Serv L
Versions Introduced in 2019-2020 Legislative Session:: A2785, S3118

2017-A7492 - Summary

Provides for the synchronization of multiple prescriptions for recipients of medical assistance.

2017-A7492 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7492
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              April 27, 2017
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the social services law, in relation to  synchronization
   of multiple prescriptions
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Subdivision 9 of section 367-a of the social  services  law
 is amended by adding a new paragraph (i) to read as follows:
   (I)(I) THE DEPARTMENT OF HEALTH SHALL ESTABLISH A PROGRAM FOR SYNCHRO-
 NIZATION OF MEDICATIONS WHEN IT IS AGREED AMONG THE RECIPIENT, A PROVID-
 ER  AND  A PHARMACIST THAT SYNCHRONIZATION OF MULTIPLE PRESCRIPTIONS FOR
 THE TREATMENT OF A CHRONIC ILLNESS  IS  IN  THE  BEST  INTEREST  OF  THE
 PATIENT  FOR  THE  MANAGEMENT OR TREATMENT OF A CHRONIC ILLNESS PROVIDED
 THAT THE MEDICATIONS:
   (A) ARE COVERED BY THE DEPARTMENT OF HEALTH PURSUANT TO THIS TITLE;
   (B) ARE USED FOR TREATMENT AND MANAGEMENT OF CHRONIC  CONDITIONS  THAT
 ARE SUBJECT TO REFILLS;
   (C)  ARE  NOT  A  SCHEDULE  II  CONTROLLED SUBSTANCE OR A SCHEDULE III
 CONTROLLED SUBSTANCE CONTAINING HYDROCODONE;
   (D) MEET ALL PRIOR AUTHORIZATION CRITERIA SPECIFIC TO THE  MEDICATIONS
 AT THE TIME OF THE SYNCHRONIZATION REQUEST;
   (E)  ARE  OF A FORMULATION THAT CAN BE EFFECTIVELY SPLIT OVER REQUIRED
 SHORT FILL PERIODS TO ACHIEVE SYNCHRONIZATION; AND
   (F) DO NOT HAVE QUANTITY  LIMITS  OR  DOSE  OPTIMIZATION  CRITERIA  OR
 REQUIREMENTS THAT WOULD BE VIOLATED IN FULFILLING SYNCHRONIZATION.
   (II) THE DEPARTMENT OF HEALTH SHALL NOT DENY COVERAGE FOR THE DISPENS-
 ING  OF  A MEDICATION BY A NETWORK PHARMACY FOR A PARTIAL SUPPLY WHEN IT
 IS FOR THE PURPOSE OF  SYNCHRONIZING  THE  PATIENT'S  MEDICATIONS.  WHEN
 APPLICABLE  TO  PERMIT  SYNCHRONIZATION,  THE DEPARTMENT OF HEALTH SHALL
 ALLOW A  PHARMACY  TO  OVERRIDE  ANY  DENIAL  CODES  INDICATING  THAT  A
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11066-01-7

 A. 7492                             2
 
 PRESCRIPTION  IS  BEING REFILLED TOO SOON FOR THE PURPOSES OF MEDICATION
 SYNCHRONIZATION.
   (III)  TO PERMIT SYNCHRONIZATION, THE DEPARTMENT OF HEALTH SHALL APPLY
 A PRORATED DAILY COST-SHARING RATE TO  ANY  MEDICATION  DISPENSED  BY  A
 NETWORK PHARMACY PURSUANT TO THIS SECTION.
   (IV)  THE  DISPENSING  FEE  PAID  TO  A NETWORK PHARMACY CONTRACTED TO
 PROVIDE SERVICES PURSUANT TO THIS SECTION FOR A PARTIAL  SUPPLY  ASSOCI-
 ATED  WITH  A MEDICATION SYNCHRONIZATION SHALL BE PAID IN FULL AND SHALL
 NOT BE PRORATED.
   (V) THE REQUIREMENT OF THIS  PARAGRAPH  APPLIES  ONLY  ONCE  FOR  EACH
 PRESCRIPTION  DRUG  SUBJECT  TO  MEDICATION  SYNCHRONIZATION EXCEPT WHEN
 EITHER OF THE FOLLOWING OCCURS:
   (I) THE PRESCRIBER CHANGES THE DOSAGE OR FREQUENCY  OF  ADMINISTRATION
 OF THE PRESCRIPTION DRUG SUBJECT TO A MEDICATION SYNCHRONIZATION; OR
   (II) THE PRESCRIBER PRESCRIBES A DIFFERENT DRUG.
   (VI)  NOTHING IN THIS PARAGRAPH SHALL BE DEEMED TO REQUIRE HEALTH CARE
 PRACTITIONERS AND PHARMACISTS TO SYNCHRONIZE THE REFILLING  OF  MULTIPLE
 PRESCRIPTIONS FOR A RECIPIENT.
   §  2.  Subdivision  4  of  section 364-j of the social services law is
 amended by adding a new paragraph (w) to read as follows:
   (W)(I) THE  DEPARTMENT  OF  HEALTH  OR  A  MANAGED  CARE  ORGANIZATION
 CONTRACTED  TO PROVIDE SERVICES PURSUANT TO THIS SECTION SHALL ESTABLISH
 A PROGRAM FOR SYNCHRONIZATION OF MEDICATIONS WHEN IT IS AGREED AMONG THE
 RECIPIENT, A PROVIDER AND A PHARMACIST THAT SYNCHRONIZATION OF  MULTIPLE
 PRESCRIPTIONS  FOR  THE  TREATMENT  OF  A CHRONIC ILLNESS IS IN THE BEST
 INTEREST OF THE PATIENT FOR THE MANAGEMENT OR  TREATMENT  OF  A  CHRONIC
 ILLNESS PROVIDED THAT THE MEDICATIONS:
   (A)  ARE  COVERED  BY MEDICAID SERVICES OR A MANAGED CARE ORGANIZATION
 CONTRACTED TO PROVIDE SERVICES PURSUANT TO THIS CHAPTER;
   (B) ARE USED FOR TREATMENT AND MANAGEMENT OF CHRONIC  CONDITIONS  THAT
 ARE SUBJECT TO REFILLS;
   (C)  ARE  NOT  A  SCHEDULE  II  CONTROLLED SUBSTANCE OR A SCHEDULE III
 CONTROLLED SUBSTANCE CONTAINING HYDROCODONE;
   (D) MEET ALL PRIOR AUTHORIZATION CRITERIA SPECIFIC TO THE  MEDICATIONS
 AT THE TIME OF THE SYNCHRONIZATION REQUEST;
   (E)  ARE  OF A FORMULATION THAT CAN BE EFFECTIVELY SPLIT OVER REQUIRED
 SHORT FILL PERIODS TO ACHIEVE SYNCHRONIZATION; AND
  (F) DO NOT HAVE  QUANTITY  LIMITS  OR  DOSE  OPTIMIZATION  CRITERIA  OR
 REQUIREMENTS THAT WOULD BE VIOLATED IN FULFILLING SYNCHRONIZATION.
   (II)   THE  DEPARTMENT  OF  HEALTH  OR  A  MANAGED  CARE  ORGANIZATION
 CONTRACTED TO PROVIDE SERVICES UNDER THIS SECTION SHALL NOT DENY  COVER-
 AGE  FOR  THE  DISPENSING  OF  A  MEDICATION BY A NETWORK PHARMACY FOR A
 PARTIAL SUPPLY WHEN IT IS FOR THE PURPOSE OF SYNCHRONIZING THE PATIENT'S
 MEDICATIONS. WHEN APPLICABLE TO PERMIT SYNCHRONIZATION,  THE  DEPARTMENT
 OF  HEALTH OR A MANAGED CARE ORGANIZATION CONTRACTED TO PROVIDE SERVICES
 UNDER THIS TITLE SHALL ALLOW A PHARMACY TO  OVERRIDE  ANY  DENIAL  CODES
 INDICATING  THAT  A  PRESCRIPTION  IS  BEING  REFILLED  TOO SOON FOR THE
 PURPOSES OF MEDICATION SYNCHRONIZATION.
   (III) TO PERMIT SYNCHRONIZATION, THE DEPARTMENT OF HEALTH OR A MANAGED
 CARE ORGANIZATION CONTRACTED TO PROVIDE SERVICES PURSUANT TO THIS  TITLE
 SHALL  APPLY  A  PRORATED  DAILY  COST-SHARING  RATE  TO  ANY MEDICATION
 DISPENSED BY A NETWORK PHARMACY PURSUANT TO THIS SECTION.
   (IV) THE DISPENSING FEE PAID  TO  A  NETWORK  PHARMACY  CONTRACTED  TO
 PROVIDE  SERVICES  PURSUANT TO THIS SECTION FOR A PARTIAL SUPPLY ASSOCI-
 ATED WITH A MEDICATION SYNCHRONIZATION SHALL BE PAID IN FULL  AND  SHALL
 NOT BE PRORATED.

 A. 7492                             3
 
   (V)  THE  REQUIREMENT  OF  THIS  PARAGRAPH  APPLIES ONLY ONCE FOR EACH
 PRESCRIPTION DRUG SUBJECT  TO  MEDICATION  SYNCHRONIZATION  EXCEPT  WHEN
 EITHER OF THE FOLLOWING OCCURS:
   (A)  THE  PRESCRIBER CHANGES THE DOSAGE OR FREQUENCY OF ADMINISTRATION
 OF THE PRESCRIPTION DRUG SUBJECT TO A MEDICATION SYNCHRONIZATION; OR
   (B) THE PRESCRIBER PRESCRIBES A DIFFERENT DRUG.
   (VI) NOTHING IN THIS PARAGRAPH SHALL BE DEEMED TO REQUIRE HEALTH  CARE
 PRACTITIONERS  AND  PHARMACISTS TO SYNCHRONIZE THE REFILLING OF MULTIPLE
 PRESCRIPTIONS FOR A COVERED INDIVIDUAL.
   § 3. This act shall take effect on the one hundred twentieth day after
 it shall have become a law, and shall apply to  policies  and  contracts
 issued,  renewed,  modified,  altered  or amended on or after such date;
 provided that:
   (a) the amendments to subdivision 9 of section  367-a  of  the  social
 services  law,  made  by  section  one of this act, shall not affect the
 expiration of such subdivision, and shall expire therewith; and
   (b) the amendments to section 364-j of the social services  law,  made
 by section two of this act, shall not affect the repeal of such section,
 and shall be deemed repealed therewith.

co-Sponsors

View additional co-sponsors

multi-Sponsors

2017-A7492A (ACTIVE) - Details

See Senate Version of this Bill:: S5622
Current Committee:: Senate Rules
Law Section:: Social Services Law
Laws Affected:: Amd §§367-a & 364-j, Soc Serv L
Versions Introduced in 2019-2020 Legislative Session:: A2785, S3118

2017-A7492A (ACTIVE) - Summary

Provides for the synchronization of multiple prescriptions for recipients of medical assistance.

2017-A7492A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7492--A
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              April 27, 2017
                                ___________
 
 Introduced  by  M.  of  A. GOTTFRIED, McDONALD, ABINANTI, PHEFFER AMATO,
   TITONE, SOLAGES, JAFFEE, GARBARINO, RAIA, STECK -- Multi-Sponsored  by
   --  M.  of  A.  HEVESI  --  read once and referred to the Committee on
   Health -- recommitted to the Committee on Health  in  accordance  with
   Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
   reprinted as amended and recommitted to said committee
 
 AN  ACT to amend the social services law, in relation to synchronization
   of multiple prescriptions
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subdivision 9 of section 367-a of the social services law
 is amended by adding a new paragraph (i) to read as follows:
   (I)(I) THE DEPARTMENT OF HEALTH SHALL ESTABLISH A PROGRAM FOR SYNCHRO-
 NIZATION OF MEDICATIONS WHEN IT IS AGREED AMONG THE RECIPIENT, A PROVID-
 ER AND A PHARMACIST THAT SYNCHRONIZATION OF MULTIPLE  PRESCRIPTIONS  FOR
 THE  TREATMENT  OF  A  CHRONIC  ILLNESS  IS  IN THE BEST INTEREST OF THE
 PATIENT FOR THE MANAGEMENT OR TREATMENT OF A  CHRONIC  ILLNESS  PROVIDED
 THAT THE MEDICATIONS:
   (A) ARE COVERED BY THE DEPARTMENT OF HEALTH PURSUANT TO THIS TITLE;
   (B)  ARE  USED FOR TREATMENT AND MANAGEMENT OF CHRONIC CONDITIONS THAT
 ARE SUBJECT TO REFILLS;
   (C) ARE NOT A SCHEDULE II  CONTROLLED  SUBSTANCE  OR  A  SCHEDULE  III
 CONTROLLED SUBSTANCE CONTAINING HYDROCODONE;
   (D)  MEET ALL PRIOR AUTHORIZATION CRITERIA SPECIFIC TO THE MEDICATIONS
 AT THE TIME OF THE SYNCHRONIZATION REQUEST;
   (E) ARE OF A FORMULATION THAT CAN BE EFFECTIVELY SPLIT  OVER  REQUIRED
 SHORT FILL PERIODS TO ACHIEVE SYNCHRONIZATION; AND
   (F)  DO  NOT  HAVE  QUANTITY  LIMITS  OR DOSE OPTIMIZATION CRITERIA OR
 REQUIREMENTS THAT WOULD BE VIOLATED IN FULFILLING SYNCHRONIZATION.
   (II) THE DEPARTMENT OF HEALTH SHALL NOT DENY COVERAGE FOR THE DISPENS-
 ING OF A MEDICATION BY A PHARMACY FOR A PARTIAL SUPPLY WHEN  IT  IS  FOR
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD11066-02-8

 A. 7492--A                          2
 
 THE  PURPOSE OF SYNCHRONIZING THE PATIENT'S MEDICATIONS. WHEN APPLICABLE
 TO PERMIT SYNCHRONIZATION, THE DEPARTMENT OF HEALTH SHALL ALLOW A  PHAR-
 MACY  TO  OVERRIDE  ANY  DENIAL  CODES INDICATING THAT A PRESCRIPTION IS
 BEING REFILLED TOO SOON FOR THE PURPOSES OF MEDICATION SYNCHRONIZATION.
   (III)  TO PERMIT SYNCHRONIZATION, THE DEPARTMENT OF HEALTH SHALL APPLY
 A PRORATED DAILY COST-SHARING RATE TO  ANY  MEDICATION  DISPENSED  BY  A
 PHARMACY PURSUANT TO THIS SECTION.
   (IV)  THE  DISPENSING  FEE  PAID  TO  A PHARMACY CONTRACTED TO PROVIDE
 SERVICES PURSUANT TO THIS SECTION FOR A PARTIAL SUPPLY ASSOCIATED WITH A
 MEDICATION SYNCHRONIZATION SHALL BE  PAID  IN  FULL  AND  SHALL  NOT  BE
 PRORATED.
   (V)  THE  REQUIREMENT  OF  THIS  PARAGRAPH  APPLIES ONLY ONCE FOR EACH
 PRESCRIPTION DRUG SUBJECT  TO  MEDICATION  SYNCHRONIZATION  EXCEPT  WHEN
 EITHER OF THE FOLLOWING OCCURS:
   (I)  THE  PRESCRIBER CHANGES THE DOSAGE OR FREQUENCY OF ADMINISTRATION
 OF THE PRESCRIPTION DRUG SUBJECT TO A MEDICATION SYNCHRONIZATION; OR
   (II) THE PRESCRIBER PRESCRIBES A DIFFERENT DRUG.
   (VI) NOTHING IN THIS PARAGRAPH SHALL BE DEEMED TO REQUIRE HEALTH  CARE
 PRACTITIONERS  AND  PHARMACISTS TO SYNCHRONIZE THE REFILLING OF MULTIPLE
 PRESCRIPTIONS FOR A RECIPIENT.
   § 2. Subdivision 4 of section 364-j of  the  social  services  law  is
 amended by adding a new paragraph (w) to read as follows:
   (W)(I)  THE  DEPARTMENT  OF  HEALTH  OR  A  MANAGED  CARE ORGANIZATION
 CONTRACTED TO PROVIDE SERVICES PURSUANT TO THIS SECTION SHALL  ESTABLISH
 A PROGRAM FOR SYNCHRONIZATION OF MEDICATIONS WHEN IT IS AGREED AMONG THE
 RECIPIENT,  A PROVIDER AND A PHARMACIST THAT SYNCHRONIZATION OF MULTIPLE
 PRESCRIPTIONS FOR THE TREATMENT OF A CHRONIC  ILLNESS  IS  IN  THE  BEST
 INTEREST  OF  THE  PATIENT  FOR THE MANAGEMENT OR TREATMENT OF A CHRONIC
 ILLNESS PROVIDED THAT THE MEDICATIONS:
   (A) ARE COVERED BY MEDICAID SERVICES OR A  MANAGED  CARE  ORGANIZATION
 CONTRACTED TO PROVIDE SERVICES PURSUANT TO THIS CHAPTER;
   (B)  ARE  USED FOR TREATMENT AND MANAGEMENT OF CHRONIC CONDITIONS THAT
 ARE SUBJECT TO REFILLS;
   (C) ARE NOT A SCHEDULE II  CONTROLLED  SUBSTANCE  OR  A  SCHEDULE  III
 CONTROLLED SUBSTANCE CONTAINING HYDROCODONE;
   (D)  MEET ALL PRIOR AUTHORIZATION CRITERIA SPECIFIC TO THE MEDICATIONS
 AT THE TIME OF THE SYNCHRONIZATION REQUEST;
   (E) ARE OF A FORMULATION THAT CAN BE EFFECTIVELY SPLIT  OVER  REQUIRED
 SHORT FILL PERIODS TO ACHIEVE SYNCHRONIZATION; AND
  (F)  DO  NOT  HAVE  QUANTITY  LIMITS  OR  DOSE OPTIMIZATION CRITERIA OR
 REQUIREMENTS THAT WOULD BE VIOLATED IN FULFILLING SYNCHRONIZATION.
   (II)  THE  DEPARTMENT  OF  HEALTH  OR  A  MANAGED  CARE   ORGANIZATION
 CONTRACTED  TO PROVIDE SERVICES UNDER THIS SECTION SHALL NOT DENY COVER-
 AGE FOR THE DISPENSING OF A MEDICATION  BY  A  PHARMACY  FOR  A  PARTIAL
 SUPPLY WHEN IT IS FOR THE PURPOSE OF SYNCHRONIZING THE PATIENT'S MEDICA-
 TIONS.  WHEN  APPLICABLE  TO  PERMIT  SYNCHRONIZATION, THE DEPARTMENT OF
 HEALTH OR A MANAGED CARE ORGANIZATION  CONTRACTED  TO  PROVIDE  SERVICES
 UNDER  THIS  TITLE  SHALL  ALLOW A PHARMACY TO OVERRIDE ANY DENIAL CODES
 INDICATING THAT A PRESCRIPTION  IS  BEING  REFILLED  TOO  SOON  FOR  THE
 PURPOSES OF MEDICATION SYNCHRONIZATION.
   (III) TO PERMIT SYNCHRONIZATION, THE DEPARTMENT OF HEALTH OR A MANAGED
 CARE  ORGANIZATION CONTRACTED TO PROVIDE SERVICES PURSUANT TO THIS TITLE
 SHALL APPLY  A  PRORATED  DAILY  COST-SHARING  RATE  TO  ANY  MEDICATION
 DISPENSED BY A PHARMACY PURSUANT TO THIS SECTION.
   (IV)  THE  DISPENSING  FEE  PAID  TO  A PHARMACY CONTRACTED TO PROVIDE
 SERVICES PURSUANT TO THIS SECTION FOR A PARTIAL SUPPLY ASSOCIATED WITH A

 A. 7492--A                          3
 
 MEDICATION SYNCHRONIZATION SHALL BE  PAID  IN  FULL  AND  SHALL  NOT  BE
 PRORATED.
   (V)  THE  REQUIREMENT  OF  THIS  PARAGRAPH  APPLIES ONLY ONCE FOR EACH
 PRESCRIPTION DRUG SUBJECT  TO  MEDICATION  SYNCHRONIZATION  EXCEPT  WHEN
 EITHER OF THE FOLLOWING OCCURS:
   (A)  THE  PRESCRIBER CHANGES THE DOSAGE OR FREQUENCY OF ADMINISTRATION
 OF THE PRESCRIPTION DRUG SUBJECT TO A MEDICATION SYNCHRONIZATION; OR
   (B) THE PRESCRIBER PRESCRIBES A DIFFERENT DRUG.
   (VI) NOTHING IN THIS PARAGRAPH SHALL BE DEEMED TO REQUIRE HEALTH  CARE
 PRACTITIONERS  AND  PHARMACISTS TO SYNCHRONIZE THE REFILLING OF MULTIPLE
 PRESCRIPTIONS FOR A COVERED INDIVIDUAL.
   § 3. This act shall take effect on the one hundred twentieth day after
 it shall have become a law.  The amendments to subdivision 9 of  section
 367-a of the social services law, made by section one of this act, shall
 not  affect  the expiration of that subdivision, and shall expire there-
 with.
   The amendments to section 364-j of the social services  law,  made  by
 section  two  of  this act, shall not affect the repeal of that section,
 and shall be  deemed  repealed  therewith.  Effective  immediately,  the
 commissioner  of  health  shall  make regulations and take other actions
 reasonably necessary to implement this act on that date.

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Assembly Bill A7492A

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Sponsored By

GOTTFRIED R

Archive: Last Bill Status - In Senate Committee Rules Committee

Bill Amendments

co-Sponsors

John T. McDonald III

Thomas Abinanti

Stacey Pheffer Amato

Matthew Titone

multi-Sponsors

Andrew Hevesi

2017-A7492 - Details

2017-A7492 - Summary

2017-A7492 - Bill Text download pdf

co-Sponsors

John T. McDonald III

Thomas Abinanti

Stacey Pheffer Amato

Matthew Titone

multi-Sponsors

Andrew Hevesi

2017-A7492A (ACTIVE) - Details

2017-A7492A (ACTIVE) - Summary

2017-A7492A (ACTIVE) - Bill Text download pdf

Comments