NY State Senate Bill 2021-S431A

Senate Bill S431A

2021-2022 Legislative Session

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

download bill text pdf

Archive: Last Bill Status Via A187 - Passed Senate

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
May 16, 2022	returned to assembly passed senate 3rd reading cal.513 substituted for s431a
May 16, 2022	substituted by a187
Feb 17, 2022	advanced to third reading
Feb 16, 2022	2nd report cal.
Feb 15, 2022	1st report cal.513
Jan 24, 2022	print number 431a
Jan 24, 2022	amend and recommit to health
Jan 05, 2022	referred to health
Jan 06, 2021	referred to health

Votes

- May 16, 2022 - Floor Vote
  A187
  
  61
  
  Aye
  
  0
  
  Nay
  
  0
  
  Absent
  
  2
  
  Excused
  
  0
  
  Abstained
  - - Floor Vote: May 16, 2022
      
      aye (61)
      
      Addabbo Jr.
      
      Akshar
      
      Bailey
      
      Biaggi
      
      Borrello
      
      Boyle
      
      Breslin
      
      Brisport
      
      Brooks
      
      Cleare
      
      Comrie
      
      Cooney
      
      Felder
      
      Gallivan
      
      Gaughran
      
      Gianaris
      
      Gounardes
      
      Griffo
      
      Harckham
      
      Helming
      
      Hinchey
      
      Hoylman-Sigal
      
      Jackson
      
      Jordan
      
      Kaminsky
      
      Kaplan
      
      Kavanagh
      
      Kennedy
      
      Krueger
      
      Lanza
      
      Liu
      
      Mannion
      
      Martucci
      
      Mattera
      
      May
      
      Mayer
      
      Myrie
      
      O'Mara
      
      Oberacker
      
      Ortt
      
      Palumbo
      
      Parker
      
      Persaud
      
      Ramos
      
      Rath III
      
      Reichlin-Melnick
      
      Ritchie
      
      Rivera
      
      Ryan
      
      Salazar
      
      Savino
      
      Sepúlveda
      
      Serino
      
      Serrano
      
      Skoufis
      
      Stavisky
      
      Stec
      
      Stewart-Cousins
      
      Tedisco
      
      Thomas
      
      Weik
      
      excused (2)
      
      Brouk
      
      Sanders Jr.
  Feb 15, 2022 - Health Committee Vote
  S431A
  
  14
  
  Aye
  
  0
  
  Nay
  
  1
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: Feb 15, 2022
      
      aye (14)
      
      Biaggi
      
      Boyle
      
      Brouk
      
      Cleare
      
      Gallivan
      
      Hoylman-Sigal
      
      Kaminsky
      
      May
      
      Oberacker
      
      Rath III
      
      Rivera
      
      Ryan
      
      Salazar
      
      Thomas
      
      aye wr (1)
      
      Stec

Bill Amendments

Original

A (Active)

2021-S431 - Details

See Assembly Version of this Bill:: A187
Law Section:: Social Services Law
Laws Affected:: Amd §§367-a & 364-j, Soc Serv L
Versions Introduced in 2019-2020 Legislative Session:: S7109, A9012

2021-S431 - Summary

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

2021-S431 - Sponsor Memo

                                
 
BILL NUMBER: S431

SPONSOR: HOYLMAN
 
TITLE OF BILL:

An act to amend the social services law, in relation to synchronization
of multiple prescriptions

 
PURPOSE OR GENERAL IDEA OF BILL:

To allow pharmacists to synchronize the dispensing of multiple
prescriptions for Medicaid recipients so they may pick up multiple
prescription refills at the same time.

 
SUMMARY OF SPECIFIC PROVISIONS:

This bill would allow synchronized dispensing of medications when it is
agreed among the patient, his or her prescriber and the pharmacist,
under certain conditions. The bill requires fee-for-service and managed
care benefit coverage for a partial fill and would allow a pharmacy to
over-ride denial codes indicating that a prescription is being too

refilled too soon.  The bill would permit pro-rated cost-sharing but
keep the dispensing fee whole. A given prescription may be synchronized
only once unless the prescriber changes the doses or frequency or
prescribes a different drug.

 
JUSTIFICATION:

Medication synchronization enables a partial-fill so that later refills
are coordinated with other prescriptions a patient may have, in order to
maximize convenience and compliance, reduce waste from unnecessary fills
and ensure that patients receive only the medication they need. Normal-
ly, a partial fill is blocked during the claim submission process
because the claim is for less than a 30-day supply. Patients may be
required to pay a full months' copayment for a month's supply, even if
questions remain about the medication's effectiveness or the likelihood
of an adverse event.

Since 2014, Medicare Part D plans are required to facilitate pro-rated
co-payments for dispensing in less than a 30 day supply when medications
are being synchronized. To date, 18 states have enabled commercial
health plan coverage for synchronization, and two have provided Medicaid
beneficiaries access to synchronization. It is estimated that 76% of
Americans aged 60 and over use two or more medicines and 37% take five
or more. Nothing in this bill requires medication synchronization. It
simply establishes a mechanism for medication synchronization for
patients with chronic illness when there is a voluntary agreed-upon plan
between the patient, the health care provider and the pharmacist.

 
PRIOR LEGISLATIVE HISTORY:

S.7109 of 2020 (Hoylman): Advanced to Third Reading

A.9012 of 2020 Gottfried): Died in Ways and Means

S.3118-A 2019 (Hoylman): Vetoed Memo.243 S.5622-A 2018 (Hannon): Died in
Rules S.5622 2017 (Hannon): Died in Health

 
FISCAL IMPLICATIONS:
Potential Medicaid savings.

 
EFFECTIVE DATE:
This act shall take effect on the one hundred twentieth day after it
shall have become a law.

2021-S431 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    431
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sen. HOYLMAN -- read twice and ordered printed, and when
   printed to be committed 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, NOR A SCHEDULE III
 CONTROLLED SUBSTANCE THAT CONTAINS 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
 THE PURPOSE OF SYNCHRONIZING THE PATIENT'S MEDICATIONS. WHEN  APPLICABLE
 TO  PERMIT SYNCHRONIZATION, THE DEPARTMENT OF HEALTH SHALL ALLOW A PHAR-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD00492-02-1

 S. 431                              2
 
 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,  NOR  A  SCHEDULE  III
 CONTROLLED SUBSTANCE THAT CONTAINS 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
 MEDICATION SYNCHRONIZATION SHALL BE  PAID  IN  FULL  AND  SHALL  NOT  BE
 PRORATED.

 S. 431                              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.  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 addi-
 tion, amendment and/or repeal of any rule or  regulation  necessary  for
 the  implementation  of this act on its effective date are authorized to
 be made on or before such date.

2021-S431A (ACTIVE) - Details

See Assembly Version of this Bill:: A187
Law Section:: Social Services Law
Laws Affected:: Amd §§367-a & 364-j, Soc Serv L
Versions Introduced in 2019-2020 Legislative Session:: S7109, A9012

2021-S431A (ACTIVE) - Summary

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

2021-S431A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S431A

SPONSOR: HOYLMAN
 
TITLE OF BILL:

An act to amend the social services law, in relation to synchronization
of multiple prescriptions

 
PURPOSE OR GENERAL IDEA OF BILL:

To allow pharmacists to synchronize the dispensing of multiple
prescriptions for Medicaid recipients so they may pick up multiple
prescription refills at the same time.

 
SUMMARY OF SPECIFIC PROVISIONS:

This bill would allow synchronized dispensing of medications when it is
agreed among the patient, his or her prescriber and the pharmacist,
under certain conditions. The bill requires fee-for-service and managed
care benefit coverage for a partial fill and would allow a pharmacy to
over-ride denial codes indicating that a prescription is being too
refilled too soon. The bill would permit pro-rated cost-sharing but keep

the dispensing fee whole. A given prescription may be synchronized only
once unless the prescriber changes the doses or frequency or prescribes
a different drug.

 
JUSTIFICATION:

Medication synchronization enables a partial-fill so that later refills
are coordinated with other prescriptions a patient may have, in order to
maximize convenience and compliance, reduce waste from unnecessary fills
and ensure that patients receive only the medication they need. Normal-
ly, a partial fill is blocked during the claim submission process
because the claim is for less than a 30-day supply. Patients may be
required to pay a full months' copayment for a month's supply, even if
questions remain about the medication's effectiveness or the likelihood
of an adverse event.

Since 2014, Medicare Part D plans are required to facilitate pro-rated
co-payments for dispensing in less than a 30 day supply when medications
are being synchronized. To date, 18 states have enabled commercial
health plan coverage for synchronization, and two have provided Medicaid
beneficiaries access to synchronization. It is estimated that 76% of
Americans aged 60 and over use two or more medicines and 37% take five
or more. Nothing in this bill requires medication synchronization. It
simply establishes a mechanism for medication synchronization for
patients with chronic illness when there is a voluntary agreed-upon plan
between the patient, the health care provider and the pharmacist.

 
PRIOR LEGISLATIVE HISTORY:

S.7109 of 2020 (Hoylman): Advanced to Third Reading

A.9012 of 2020 Gottfried): Died in Ways and Means

S.3118-A 2019 (Hoylman): Vetoed Memo.243 S.5622-A 2018 (Hannon): Died in
Rules S.5622 2017 (Hannon): Died in Health

 
FISCAL IMPLICATIONS:
Potential Medicaid savings.

 
EFFECTIVE DATE:
This act shall take effect on the one hundred twentieth day after it
shall have become a law.

2021-S431A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  431--A
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sen. HOYLMAN -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health --  recommitted  to
   the  Committee  on  Health in accordance with Senate Rule 6, sec. 8 --
   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,  NOR  A  SCHEDULE  III
 CONTROLLED SUBSTANCE THAT CONTAINS 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.

                                                            LBD00492-03-2
 S. 431--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,  NOR  A  SCHEDULE  III
 CONTROLLED SUBSTANCE THAT CONTAINS 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
 S. 431--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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