S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7598
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 18, 2021
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the social services law and the public  health  law,  in
   relation to protecting access to pharmacy services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Subdivision 4 of section 364-j of the social  services  law
 is amended by adding two new paragraphs (w) and (x) to read as follows:
   (W)  NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, ADMINISTRA-
 TIVE FEES PAID TO A MANAGED CARE PROVIDER OR A PHARMACY BENEFIT  MANAGER
 UNDER THE MEDICAL ASSISTANCE PROGRAM SHALL BE REDUCED FOR THE PURPOSE OF
 INCREASING  REIMBURSEMENT  RATES TO RETAIL PHARMACIES UNDER THE MEDICAID
 MANAGED CARE PROGRAM. BEGINNING ON AND AFTER JULY  FIRST,  TWO  THOUSAND
 TWENTY-ONE,  ALL  REIMBURSEMENT  PAID  BY MEDICAID MANAGED CARE PLANS TO
 RETAIL PHARMACIES SHALL INCLUDE A PROFESSIONAL DISPENSING  FEE  AND  THE
 DRUG ACQUISITION COST FOR EACH OUTPATIENT DRUG DISPENSED AT NO LESS THAN
 THE  AMOUNT ESTABLISHED UNDER THE FEE-FOR-SERVICE PROGRAM, AS DEFINED IN
 SECTION THREE HUNDRED SIXTY-SEVEN-A OF THIS TITLE, REGARDLESS OF WHETHER
 SUCH REIMBURSEMENT IS PAID DIRECTLY BY THE MEDICAID MANAGED CARE PLAN OR
 PASSED THROUGH  A  PHARMACY  BENEFIT  MANAGER  OR  OTHER  ENTITY.    THE
 REIMBURSEMENT  PROVIDED  FOR UNDER THIS PARAGRAPH SHALL NOT APPLY TO ANY
 EXISTING REIMBURSEMENT ARRANGEMENTS INVOLVING AN ELIGIBLE PROVIDER UNDER
 SECTION 340B OF THE FEDERAL PUBLIC HEALTH SERVICES ACT OR  A  COMPREHEN-
 SIVE  HIV SPECIAL NEEDS PLAN UNDER SECTION FORTY-FOUR HUNDRED THREE-C OF
 THE PUBLIC HEALTH LAW UNDER THE MEDICAL ASSISTANCE PROGRAM.  NO  MANAGED
 CARE  PROVIDER  OR  PHARMACY  BENEFIT MANAGER SHALL REIMBURSE A PHARMACY
 OWNED BY OR AFFILIATED WITH SUCH ENTITY AT A HIGHER RATE THAN THAT  PAID
 BY  SUCH ENTITY TO A PHARMACY IT DOES NOT OWN OR IS NOT OTHERWISE AFFIL-
 IATED WITH.
   (X) NOTWITHSTANDING ANY PROVISION OF LAW TO THE  CONTRARY,  A  MANAGED
 CARE  PROVIDER  OR  PHARMACY  BENEFIT  MANAGER  ACTING ON ITS BEHALF, AS
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD11345-01-1

 A. 7598                             2
 
 DEFINED IN SECTION TWO HUNDRED EIGHTY-A OF THE PUBLIC HEALTH LAW,  SHALL
 NOT  DENY  ANY RETAIL PHARMACY THE OPPORTUNITY TO PARTICIPATE IN ANOTHER
 PROVIDER'S PHARMACY NETWORK UNDER  THE  MEDICAL  ASSISTANCE  PROGRAM  AT
 PREFERRED  PARTICIPATION  STATUS,  PROVIDED  THAT  SUCH  RETAIL PHARMACY
 AGREES TO THE SAME REIMBURSEMENT AMOUNT, AS DEFINED IN PARAGRAPH (W)  OF
 THIS  SUBDIVISION,  AND  IS  ABLE  TO FILL AND DISPENSE PRESCRIPTION AND
 OVER-THE-COUNTER MEDICATIONS FOR THOSE ENROLLED IN THE  MEDICAL  ASSIST-
 ANCE PROGRAM.
   § 2. Section 280-a of the public health law is amended by adding a new
 subdivision 5 to read as follows:
   5.  NOTWITHSTANDING  ANY PROVISION OF LAW TO THE CONTRARY, NO PHARMACY
 BENEFIT MANAGER SHALL LIMIT  THE  OPTION  FOR  AN  INDIVIDUAL  RECEIVING
 PRESCRIPTION OR OVER-THE-COUNTER MEDICATIONS TO RECEIVE SUCH MEDICATIONS
 FROM THEIR LOCAL, NON-MAIL ORDER PHARMACY OF CHOICE VIA DELIVERY INCLUD-
 ING  IN-PERSON  DELIVERY,  UNITED STATES POSTAL SERVICE OR OTHER MAIL OR
 COURIER SERVICE. NO RESTRICTIONS, PROHIBITIONS  OR  PRIOR  AUTHORIZATION
 REQUIREMENTS  SHALL BE BASED ON THE INDIVIDUAL'S CHOICE IN DELIVERY TYPE
 OR DISTANCE FROM A PHARMACY.
   § 3. This act shall take effect on the thirtieth day  after  it  shall
 have become a law; provided, however, that the amendments to subdivision
 4  of  section  364-j  of the social services law made by section one of
 this act shall take effect July 1, 2021; provided further that  if  this
 act  shall  have become a law after such date it shall take effect imme-
 diately and shall be deemed to have been in full force and effect on and
 after July 1, 2021; provided further that the amendments to  subdivision
 4  of  section  364-j  of the social services law made by section one of
 this act shall not affect the repeal of such section and shall be deemed
 repealed therewith.