Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jan 12, 2018 |
print number 5196b |
Jan 12, 2018 |
amend and recommit to insurance |
Jan 03, 2018 |
referred to insurance |
May 23, 2017 |
print number 5196a |
May 23, 2017 |
amend (t) and recommit to insurance |
Mar 13, 2017 |
referred to insurance |
Senate Bill S5196B
2017-2018 Legislative Session
Sponsored By
(R, C, IP, RFM) 24th Senate District
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
Actions
Bill Amendments
2017-S5196 - Details
2017-S5196 - Sponsor Memo
BILL NUMBER: S5196 TITLE OF BILL : An act to amend the insurance law, in relation to synchronization of multiple prescriptions and dispensing fee standardization PURPOSE OR GENERAL IDEA OF BILL : Provides for the insurance coverage of the synchronization of multiple prescriptions and dispensing fee standardization. Specifically, this bill would amend the insurance law by adding Article 32, governing for profit commercial health insurance policies, and Article 43, governing nonprofit health insurance policies. The bill would provide coverage for a pharmaceutical claim for less than a 30 day supply for patients enrolling in medication synchronization programs. SUMMARY OF SPECIFIC PROVISIONS : Sections 1 and 2 add the following provisions: (a) Provides that a pro-rated cost-sharing rate shall be permitted and applied to prescriptions that are dispensed for less than a 30 day supply for the purpose of synchronizing the covered individual's chronic medication. (b) Provides that drug coverage shall not be denied for a partial fill
2017-S5196 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5196 2017-2018 Regular Sessions I N S E N A T E March 13, 2017 ___________ Introduced by Sen. LANZA -- 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 synchronization of multiple prescriptions and dispensing fee standardization THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The insurance law is amended by adding a new section 3224-d to read as follows: § 3224-D. PRESCRIPTION SYNCHRONIZATION AND DISPENSING FEE STANDARDI- ZATION. (A) EVERY INDIVIDUAL OR GROUP HEALTH INSURANCE POLICY PROVIDING PRESCRIPTION DRUG COVERAGE SHALL PERMIT AND APPLY A DAILY PRO-RATED COST-SHARING RATE TO PRESCRIPTIONS THAT ARE DISPENSED BY A NETWORK PHAR- MACY FOR LESS THAN A THIRTY DAY SUPPLY, WHEN IT IS AGREED AMONG THE COVERED INDIVIDUAL, A HEALTH CARE PRACTITIONER, AND A PHARMACIST THAT SYNCHRONIZATION OF MULTIPLE PRESCRIPTIONS FOR THE TREATMENT OF A CHRONIC ILLNESS IS IN THE BEST INTEREST OF THE COVERED INDIVIDUAL FOR THE MANAGEMENT OR TREATMENT OF THAT CHRONIC ILLNESS. (B) NO INDIVIDUAL OR GROUP HEALTH INSURANCE POLICY PROVIDING PRESCRIPTION DRUG COVERAGE SHALL DENY COVERAGE FOR THE DISPENSING OF ANY DRUG PRESCRIBED FOR THE TREATMENT OF A CHRONIC ILLNESS THAT IS MADE IN ACCORDANCE WITH A PLAN ESTABLISHED AMONG THE COVERED INDIVIDUAL, A HEALTH CARE PRACTITIONER AND A PHARMACIST TO SYNCHRONIZE THE REFILLING OF MULTIPLE PRESCRIPTIONS FOR THE COVERED INDIVIDUAL. EVERY INDIVIDUAL OR GROUP HEALTH INSURANCE POLICY MUST ALLOW A PHARMACY TO OVERRIDE ANY DENIAL CODES INDICATING THAT A PRESCRIPTION IS BEING REFILLED TOO SOON FOR THE PURPOSES OF MEDICATION SYNCHRONIZATION. (C) NO INDIVIDUAL OR GROUP HEALTH INSURANCE POLICY PROVIDING PRESCRIPTION DRUG COVERAGE SHALL USE PAYMENT STRUCTURES INCORPORATING PRO-RATED DISPENSING FEES. DISPENSING FEES FOR PARTIALLY FILLED OR REFILLED PRESCRIPTIONS SHALL BE PAID IN FULL FOR EACH PRESCRIPTION EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08926-01-7
co-Sponsors
(D) Senate District
2017-S5196A - Details
2017-S5196A - Sponsor Memo
BILL NUMBER: S5196A TITLE OF BILL : An act to amend the insurance law, in relation to synchronization of multiple prescriptions PURPOSE OR GENERAL IDEA OF BILL : Provides for the insurance coverage of the synchronization of multiple prescriptions and dispensing fee standardization. Specifically, this bill would amend the insurance law by adding Article 32, governing for- profit commercial health insurance policies, and Article 43, governing nonprofit health insurance policies. The bill would provide coverage for a pharmaceutical claim for less than a 30 day supply for patients enrolling in medication synchronization programs. SUMMARY OF SPECIFIC PROVISIONS : Sections 1 and 2 add the following provisions: (a) Provides that a pro-rated cost-sharing rate shall be permitted and applied to prescriptions that are dispensed for less than a 30 day supply for the purpose of synchronizing the covered individual's chronic medication.
2017-S5196A - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5196--A 2017-2018 Regular Sessions I N S E N A T E March 13, 2017 ___________ Introduced by Sen. LANZA -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance 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. The insurance law is amended by adding a new section 3224-d to read as follows: § 3224-D. PRESCRIPTION SYNCHRONIZATION. (A) EVERY INDIVIDUAL OR GROUP HEALTH INSURANCE POLICY PROVIDING PRESCRIPTION DRUG COVERAGE WHEN APPLI- CABLE TO PERMIT SYNCHRONIZATION SHALL PERMIT AND APPLY A DAILY PRO-RATED COST-SHARING RATE TO PRESCRIPTIONS THAT ARE DISPENSED BY A NETWORK PHAR- MACY FOR LESS THAN A THIRTY DAY SUPPLY, WHEN IT IS AGREED AMONG THE COVERED INDIVIDUAL, A HEALTH CARE PRACTITIONER, AND A PHARMACIST THAT SYNCHRONIZATION OF MULTIPLE PRESCRIPTIONS FOR THE TREATMENT OF A CHRONIC ILLNESS IS IN THE BEST INTEREST OF THE COVERED INDIVIDUAL FOR THE MANAGEMENT OR TREATMENT OF THAT CHRONIC ILLNESS PROVIDED THAT ALL OF THE FOLLOWING APPLY: (I) THE MEDICATIONS ARE COVERED BY THE POLICY OR PLAN. (II) THE MEDICATIONS ARE USED FOR TREATMENT AND MANAGEMENT OF CHRONIC CONDITIONS THAT ARE SUBJECT TO REFILLS. (III) THE MEDICATIONS ARE NOT A SCHEDULE II CONTROLLED SUBSTANCE OR A SCHEDULE III CONTROLLED SUBSTANCE CONTAINING HYDROCODONE. (IV) THE MEDICATIONS MEET ALL PRIOR AUTHORIZATION CRITERIA SPECIFIC TO MEDICATIONS AT THE TIME OF THE SYNCHRONIZATION REQUEST. (V) THE MEDICATIONS ARE OF A FORMULATION THAT CAN BE EFFECTIVELY SPLIT OVER REQUIRED SHORT FILL PERIODS TO ACHIEVE SYNCHRONIZATION. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08926-03-7
co-Sponsors
(D) Senate District
(D) 32nd Senate District
2017-S5196B (ACTIVE) - Details
2017-S5196B (ACTIVE) - Sponsor Memo
BILL NUMBER: S5196B Revised 01/24/18 SPONSOR: LANZA TITLE OF BILL: An act to amend the insurance law, in relation to synchronization of multiple prescriptions PURPOSE OR GENERAL IDEA OF BILL: Provides for the insurance coverage of the synchronization of multiple prescriptions and dispensing fee standardization. Specifically, this bill would amend the insurance law by adding Article 32, governing for- profit commercial health insurance policies, and Article 43, governing nonprofit health insurance policies. The bill would provide coverage for a pharmaceutical claim for less than a 30 day supply for patients enrolling in medication synchronization programs. SUMMARY OF SPECIFIC PROVISIONS: Sections 1 and 2 add the following provisions:
2017-S5196B (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5196--B 2017-2018 Regular Sessions I N S E N A T E March 13, 2017 ___________ Introduced by Sens. LANZA, AVELLA -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- commit- tee discharged, bill amended, ordered reprinted as amended and recom- mitted to said committee -- recommitted to the Committee on Insurance in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said commit- tee AN ACT to amend the insurance 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. The insurance law is amended by adding a new section 3224-d to read as follows: § 3224-D. PRESCRIPTION SYNCHRONIZATION. (A) EVERY INDIVIDUAL OR GROUP HEALTH INSURANCE POLICY PROVIDING PRESCRIPTION DRUG COVERAGE WHEN APPLI- CABLE TO PERMIT SYNCHRONIZATION SHALL PERMIT AND APPLY A DAILY PRO-RATED COST-SHARING RATE TO PRESCRIPTIONS THAT ARE DISPENSED BY A NETWORK PHAR- MACY FOR LESS THAN A THIRTY DAY SUPPLY, WHEN IT IS AGREED AMONG THE COVERED INDIVIDUAL, A HEALTH CARE PRACTITIONER, AND A PHARMACIST THAT SYNCHRONIZATION OF MULTIPLE PRESCRIPTIONS FOR THE TREATMENT OF A CHRONIC ILLNESS IS IN THE BEST INTEREST OF THE COVERED INDIVIDUAL FOR THE MANAGEMENT OR TREATMENT OF THAT CHRONIC ILLNESS PROVIDED THAT ALL OF THE FOLLOWING APPLY: (I) THE MEDICATIONS ARE COVERED BY THE POLICY OR PLAN. (II) THE MEDICATIONS ARE USED FOR TREATMENT AND MANAGEMENT OF CHRONIC CONDITIONS THAT ARE SUBJECT TO REFILLS. (III) THE MEDICATIONS ARE NOT A SCHEDULE II CONTROLLED SUBSTANCE OR A SCHEDULE III CONTROLLED SUBSTANCE CONTAINING HYDROCODONE. (IV) THE MEDICATIONS MEET ALL PRIOR AUTHORIZATION CRITERIA SPECIFIC TO MEDICATIONS AT THE TIME OF THE SYNCHRONIZATION REQUEST. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08926-05-8
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