S T A T E O F N E W Y O R K
________________________________________________________________________
4015
2023-2024 Regular Sessions
I N A S S E M B L Y
February 8, 2023
___________
Introduced by M. of A. ARDILA -- read once and referred to the Committee
on Health
AN ACT to amend the social services law, in relation to synchronization
of multiple prescriptions; and to amend a chapter of the laws of 2022
amending the social services law relating to synchronization of multi-
ple prescriptions, as proposed in legislative bills numbers S. 431-A
and A. 187, in relation to the effectiveness thereof
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph (i) of subdivision 9 of section 367-a of the
social services law, as added by a chapter of the laws of 2022 amending
the social services law relating to synchronization of multiple
prescriptions, as proposed in legislative bills numbers S. 431-A and A.
187, is amended to read as follows:
(i)(i) The department of health shall establish a program for synchro-
nization of medications. UNDER THE SYNCHRONIZATION PROGRAM, A HEALTH
CARE PRACTITIONER MAY PRESCRIBE A REFILL OF ONE OR MORE OF THE PATIENT'S
MEDICATIONS FOR A SHORTER PERIOD THAN WOULD ORDINARILY BE PROVIDED, FOR
THE PURPOSE OF SYNCHRONIZING REFILL DATES OF ONE OR MORE OF THE
PATIENT'S MEDICATIONS SUBJECT TO THE SYNCHRONIZATION when it is agreed
among the recipient, [a provider] THE HEALTH CARE PRACTITIONER and a
pharmacist that synchronization of multiple prescriptions for the treat-
ment of a chronic illness is in the best interest of the patient for the
management or treatment of a chronic illness provided that the FOLLOWING
APPLY TO SUCH medications:
(A) are covered by the department of health pursuant to this title;
(B) are used for treatment and management of A chronic [conditions]
ILLNESS that are subject to refills;
(C) are not a schedule II controlled substance, nor a schedule III
controlled substance that contains hydrocodone OR OTHER OPIOID MEDICA-
TION AS SCHEDULED IN SECTION THIRTY-THREE HUNDRED SIX OF THE PUBLIC
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04021-01-3
A. 4015 2
HEALTH LAW, OR A CONTROLLED SUBSTANCE UNDER THE FEDERAL CONTROLLED
SUBSTANCES ACT;
(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] AND LAWFULLY
ALIGNED over required short fill periods to achieve synchronization; and
(F) do not have quantity limits or dose optimization criteria or STATE
OR FEDERAL requirements that would be violated in fulfilling synchroni-
zation.
(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-
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 DISPENSING FEE PAID TO THE PHARMACY CONTRACTED TO PROVIDE
SERVICES PURSUANT TO THIS SECTION FOR A PARTIAL SUPPLY ASSOCIATED WITH
MEDICATION SYNCHRONIZATION SHALL BE PAID IN ACCORDANCE WITH THE MEDICAID
STATE PLAN AS APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID
SERVICES.
(IV) 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)] (V) Nothing in this paragraph shall be deemed to require health
care practitioners and pharmacists to synchronize the refilling of
multiple prescriptions for a recipient.
(VI) THE PROVISIONS OF THIS PARAGRAPH ARE SUBJECT TO COMPLIANCE WITH
ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS, INCLUDING THE
CENTERS FOR MEDICARE AND MEDICAID SERVICES APPROVED MEDICAID STATE PLAN.
THE COMMISSIONER SHALL APPLY FOR WAIVERS AND SUBMIT STATE MEDICAID PLAN
AMENDMENTS AS ARE NECESSARY TO IMPLEMENT THE PROGRAM FOR SYNCHRONIZATION
OF MEDICATIONS.
§ 2. Paragraph (w) of subdivision 4 of section 364-j of the social
services law, as added by a chapter of the laws of 2022 amending the
social services law relating to synchronization of multiple
prescriptions, as proposed in legislative bills numbers S. 431-A and
A.187, is amended 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. UNDER THE SYNCHRONIZATION
PROGRAM, A HEALTH CARE PRACTITIONER MAY PRESCRIBE A REFILL OF ONE OR
MORE OF THE PATIENT'S MEDICATIONS FOR A SHORTER PERIOD THAN WOULD ORDI-
NARILY BE PROVIDED, FOR THE PURPOSE OF SYNCHRONIZING REFILL DATES OF ONE
OR MORE OF THE PATIENT'S MEDICATIONS SUBJECT TO THE SYNCHRONIZATION,
when it is agreed among the recipient, [a provider] THE HEALTH CARE
PRACTITIONER and a pharmacist that synchronization of multiple
A. 4015 3
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 FOLLOWING APPLY TO SUCH 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 A chronic [conditions]
ILLNESS that are subject to refills;
(C) are not a schedule II controlled substance, nor a schedule III
controlled substance that contains hydrocodone OR OTHER OPIOID MEDICA-
TION AS SCHEDULED IN SECTION THIRTY-THREE HUNDRED SIX OF THE PUBLIC
HEALTH LAW, OR A CONTROLLED SUBSTANCE UNDER THE FEDERAL CONTROLLED
SUBSTANCES ACT;
(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] AND LAWFULLY
ALIGNED over required short fill periods to achieve synchronization; and
(F) do not have quantity limits or dose optimization criteria or STATE
OR FEDERAL requirements that would be violated in fulfilling synchroni-
zation.
(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 medica-
tion 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 DISPENSING FEE PAID TO THE PHARMACY CONTRACTED TO PROVIDE
SERVICES PURSUANT TO THIS SECTION FOR A PARTIAL SUPPLY ASSOCIATED WITH
MEDICATION SYNCHRONIZATION SHALL BE PAID IN ACCORDANCE WITH THE MEDICAID
STATE PLAN AS APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID
SERVICES.
(IV) 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)] (V) 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.
(VI) THE PROVISIONS OF THIS PARAGRAPH ARE SUBJECT TO COMPLIANCE WITH
ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS, INCLUDING THE
CENTERS FOR MEDICARE AND MEDICAID SERVICES APPROVED MEDICAID STATE PLAN.
THE COMMISSIONER SHALL APPLY FOR WAIVERS AND SUBMIT STATE MEDICAID PLAN
AMENDMENTS AS ARE NECESSARY TO IMPLEMENT THE PROGRAM FOR SYNCHRONIZATION
OF MEDICATIONS.
A. 4015 4
§ 3. Section 3 of a chapter of the laws of 2022 amending the social
services law relating to synchronization of multiple prescriptions, as
proposed in legislative bills numbers S. 431-A and A. 187, is amended to
read as follows:
§ 3. This act shall take effect [on the one hundred twentieth day
after it shall have become a law] JANUARY 1, 2024. 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 subdi-
vision, and shall expire therewith.
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.
§ 4. This act shall take effect immediately; provided, however, that
sections one and two of this act shall take effect on the same date and
in the same manner as a chapter of the laws of 2022 amending the social
services law relating to synchronization of multiple prescriptions, as
proposed in legislative bills numbers S. 431-A and A. 187, takes effect.
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 therewith.
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,
including applying for federal waivers and submitting state Medicaid
plan amendments, reasonably necessary to implement this act on that
date.