S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1036
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 13, 2023
                                ___________
 
 Introduced  by  M.  of A. BICHOTTE HERMELYN -- read once and referred to
   the Committee on Health
 
 AN ACT to amend the  social  services  law,  in  relation  to  requiring
   managed care providers that provide coverage for prescription drugs to
   provide coverage for home delivery of any covered prescription drug by
   any  non-mail-order  retail  pharmacy  in  the  managed  care provider
   network
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (u)  of  subdivision 4 of section 364-j of the
 social services law, as amended by section 12 of part A of chapter 56 of
 the laws of 2013, is amended to read as follows:
   (u) A managed care provider that provides  coverage  for  prescription
 drugs  shall  permit  each  participant  to  fill any mail order covered
 prescription, at his or her option, at any mail order pharmacy  or  non-
 mail-order  retail  pharmacy  in  the managed care provider network.   A
 MANAGED CARE PROVIDER THAT  PROVIDES  COVERAGE  FOR  PRESCRIPTION  DRUGS
 SHALL   ALSO   PROVIDE   COVERAGE  FOR  HOME  DELIVERY  OF  ANY  COVERED
 PRESCRIPTION DRUG BY ANY NON-MAIL-ORDER RETAIL PHARMACY IN  THE  MANAGED
 CARE  PROVIDER  NETWORK. If the managed care provider has designated one
 or more pharmacies for filling prescriptions for a  particular  drug  or
 drugs,  then  such  prescriptions  may  be  filled, at the participant's
 option, at any other pharmacy in the network, if  the  network  pharmacy
 chosen by the participant offers to accept a price that is comparable to
 that  of  the  pharmacy designated by the managed care provider. For the
 purposes of this section, "mail order pharmacy" means a  pharmacy  whose
 primary business is to receive prescriptions by mail, telefax or through
 electronic  submissions,  and to dispense medication to patients through
 the use of the United States mail or other common  or  contract  carrier
 services,  and  provides  any  consultation with patients electronically
 rather than face to face. Every non-mail-order retail  pharmacy  in  the
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01188-01-3
              

 A. 1036                             2
 
 managed  care  provider's  network with respect to any prescription drug
 shall be deemed to be in the managed care provider's network  for  every
 covered prescription drug.
   § 2. This act shall take effect on the one hundred eightieth day after
 it shall have become a law, and shall apply to all contracts, agreements
 and  leases entered into on or after such date; provided that the amend-
 ments to 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.