Bill Text: NY A08533 | 2019-2020 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Establishes a drug assistance demonstration program and authorizes emergency prescriptions.

Spectrum: Strong Partisan Bill (Democrat 53-5)

Status: (Enrolled - Dead) 2020-12-30 - DELIVERED TO GOVERNOR [A08533 Detail]

Download: New_York-2019-A08533-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          8533

                               2019-2020 Regular Sessions

                   IN ASSEMBLY

                                     August 14, 2019
                                       ___________

        Introduced by M. of A. JOYNER -- read once and referred to the Committee
          on Health

        AN  ACT  to  amend the public health law, in relation to drug assistance
          demonstration and emergency prescriptions; and to amend the  insurance
          law, in relation to capping cost sharing for insulin

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The public health law is amended by adding two new sections
     2  279-a and 279-b to read as follows:
     3    § 279-a. Drug assistance demonstration program. The commissioner shall
     4  develop a demonstration program to ensure access to  insulin  and  other
     5  life  sustaining, maintenance prescription medications identified by the
     6  commissioner for residents of the state who are uninsured, are  ineligi-
     7  ble for Medicaid or other publicly funded health coverage, or are other-
     8  wise  determined to be eligible by the commissioner and depend upon such
     9  medication for their survival. In developing such  program  the  commis-
    10  sioner shall:
    11    1.  consider modeling the drug assistance demonstration program on the
    12  state's HIV/AIDS drug assistance program providing  access  to  eligible
    13  individuals  at  certain  income  thresholds  above  the federal poverty
    14  level;
    15    2. engage  with  pharmaceutical  manufacturers  to  explore  a  public
    16  private partnership designed to bring affordable medications through the
    17  demonstration program to eligible individuals; and
    18    3.  report to the governor, the temporary president of the senate, the
    19  speaker of the assembly, and the  chairs  of  the  senate  and  assembly
    20  health  committees  on the available options to establish a drug assist-
    21  ance demonstration program, various cost  sharing  models  for  eligible
    22  participants  and  the related costs to the state associated with imple-
    23  menting such a program no later than January thirty-first, two  thousand
    24  twenty.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13323-03-9
        A. 8533                             2

     1    § 279-b. Emergency prescriptions. 1. A health care practitioner who is
     2  authorized   to   prescribe   drugs  may  issue  a  non-patient-specific
     3  prescription for pharmacists to dispense an  emergency  prescription  to
     4  refill  an  expired  prescription  pursuant  to  subdivision two of this
     5  section.
     6    2.  A  pharmacist  may dispense insulin and related supplies, or other
     7  life sustaining, maintenance prescription medications identified by  the
     8  commissioner,  through  a non-patient specific prescription, to an indi-
     9  vidual who has had a valid prescription for  any  type  of  insulin,  or
    10  other  medications  identified  by  the  commissioner,  during the prior
    11  twelve month period which has  since  expired,  on  an  emergency  basis
    12  provided the pharmacist:
    13    (a)  first  attempts  to  obtain  an authorization from the authorized
    14  prescriber and cannot obtain the authorization;
    15    (b) believes, that in  the  pharmacist's  professional  judgment,  the
    16  interruption  of  the  therapy  reasonably  might produce an undesirable
    17  health consequence detrimental to the patient's welfare or  cause  phys-
    18  ical or mental discomfort;
    19    (c)  provides  only one refill of the prescription and the quantity of
    20  that refill is in conformity with the prescribed directions for use, but
    21  limited to an amount not to exceed a thirty-day emergency supply; and
    22    (d) notifies, within seventy-two hours of dispensing the  refill,  the
    23  prescriber that an emergency prescription has been dispensed.
    24    §  2.  Subparagraph (B) of paragraph 15-a of subsection (i) of section
    25  3216 of the insurance law, as added by chapter 378 of the laws  of  1993
    26  and  such paragraph as renumbered by chapter 338 of the laws of 2003, is
    27  amended to read as follows:
    28    (B) Such coverage may be subject to annual deductibles and coinsurance
    29  as may be deemed appropriate by the superintendent and as are consistent
    30  with those  established  for  other  benefits  within  a  given  policy;
    31  provided  however, the total amount that a covered person is required to
    32  pay out of pocket for a  covered  prescription  insulin  drug  shall  be
    33  capped  at  an  amount  not to exceed one hundred dollars per thirty-day
    34  supply, regardless of the amount or type of insulin needed to fill  such
    35  covered  person's  prescription  and regardless of the insured's deduct-
    36  ible, copayment, coinsurance, out of pocket maximum or  any  other  cost
    37  sharing requirement.
    38    §  3.  Subparagraph (B) of paragraph 7 of subsection k of section 3221
    39  of the insurance law, as amended by chapter 338 of the laws of 2003,  is
    40  amended to read as follows:
    41    (B) Such coverage may be subject to annual deductibles and coinsurance
    42  as may be deemed appropriate by the superintendent and as are consistent
    43  with  those  established  for  other  benefits  within  a  given policy;
    44  provided however, the total amount that a covered person is required  to
    45  pay  out  of  pocket  for  a  covered prescription insulin drug shall be
    46  capped at an amount not to exceed one  hundred  dollars  per  thirty-day
    47  supply,  regardless of the amount or type of insulin needed to fill such
    48  covered person's prescription and regardless of  the  insured's  deduct-
    49  ible,  copayment,  coinsurance,  out of pocket maximum or any other cost
    50  sharing requirement.
    51    § 4. Paragraph 2 of subsection (u) of section 4303  of  the  insurance
    52  law,  as  amended by chapter 338 of the laws of 2003, is amended to read
    53  as follows:
    54    (2) Such coverage may be subject to annual deductibles and coinsurance
    55  as may be deemed appropriate by the superintendent and as are consistent
    56  with those  established  for  other  benefits  within  a  given  policy;
        A. 8533                             3

     1  provided  however, the total amount that a covered person is required to
     2  pay out of pocket for a  covered  prescription  insulin  drug  shall  be
     3  capped  at  an  amount  not to exceed one hundred dollars per thirty-day
     4  supply,  regardless of the amount or type of insulin needed to fill such
     5  covered person's prescription and regardless of  the  insured's  deduct-
     6  ible,  copayment,  coinsurance,  out of pocket maximum or any other cost
     7  sharing requirement.
     8    § 5. This act shall take effect  immediately;  provided  however  that
     9  sections  two,  three  and four of this act shall take effect January 1,
    10  2020.