Bill Text: NY A05787 | 2021-2022 | General Assembly | Introduced
Bill Title: Provides that prescriptions covered by insurance, that would otherwise be required to be filled by mail order, may be filled at a retail pharmacy under certain circumstances.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2022-01-05 - referred to insurance [A05787 Detail]
Download: New_York-2021-A05787-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 5787 2021-2022 Regular Sessions IN ASSEMBLY February 25, 2021 ___________ Introduced by M. of A. JOYNER, COOK -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to coverage of prescriptions obtained by mail order or at a non-retail pharmacy The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The opening paragraph of paragraph 28 of subsection (i) of 2 section 3216 of the insurance law, as added by chapter 589 of the laws 3 of 2011, is designated subparagraph (A) and a new subparagraph (B) is 4 added to read as follows: 5 (B) Notwithstanding any other provision of this paragraph, if a pres- 6 criber, after consulting with the insurer regarding the appropriateness 7 of mail order delivery given: (i) the residence or delivery location of 8 the insured; (ii) the medical condition of the insured; (iii) the stor- 9 age requirements of the drug; (iv) the availability of the insured to 10 receive the prescription; or (v) the insured's ability to comprehend 11 pharmaceutical guidance and support over the telephone, determines that 12 a drug as prescribed on an individual basis is most appropriately filled 13 at a retail location, provided that an in-network retail pharmacy of the 14 patient's choosing agrees to the same reimbursement amount and is able 15 to fill the prescription, the prescriber's determination shall be final. 16 § 2. The opening paragraph of paragraph 18 of subsection (l) of 17 section 3221 of the insurance law is designated subparagraph (A) and a 18 new subparagraph (B) is added to read as follows: 19 (B) Notwithstanding any other provision of this paragraph, if a pres- 20 criber, after consulting with the insurer regarding the appropriateness 21 of mail order delivery given: (i) the residence or delivery location of 22 the insured; (ii) the medical condition of the insured; (iii) the stor- 23 age requirements of the drug; (iv) the availability of the insured to 24 receive the prescription; or (v) the insured's ability to comprehend 25 pharmaceutical guidance and support over the telephone, determines that EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD03532-01-1A. 5787 2 1 a drug as prescribed on an individual basis is most appropriately filled 2 at a retail location, provided that an in-network retail pharmacy of the 3 patient's choosing agrees to the same reimbursement amount and is able 4 to fill the prescription, the prescriber's determination shall be final. 5 § 3. The opening paragraph of subsection (kk) of section 4303 of the 6 insurance law is designated paragraph 1 and a new paragraph 2 is added 7 to read as follows: 8 (2) Notwithstanding any other provision of this subsection, if a pres- 9 criber, after consulting with the insurer regarding the appropriateness 10 of mail order delivery given: (A) the residence or delivery location of 11 the covered person; (B) the medical condition of the covered person; (C) 12 the storage requirements of the drug; (D) the availability of the 13 covered person to receive the prescription; or (E) the covered person's 14 ability to comprehend pharmaceutical guidance and support over the tele- 15 phone, determines that a drug as prescribed on an individual basis is 16 most appropriately filled at a retail location, provided that an in-net- 17 work retail pharmacy of the patient's choosing agrees to the same 18 reimbursement amount and is able to fill the prescription, the 19 prescriber's determination shall be final. 20 § 4. This act shall take effect immediately.