Bill Text: NY A09424 | 2015-2016 | General Assembly | Amended

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Bill Title: Enacts provisions to establish standards for audits of pharmacies by entities that pay for or reimburse the pharmacy for the cost of pharmaceuticals and health care services.

Spectrum: Slight Partisan Bill (Democrat 17-7)

Status: (Introduced - Dead) 2016-04-05 - print number 9424a [A09424 Detail]

Download: New_York-2015-A09424-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                         9424--A
                   IN ASSEMBLY
                                      March 3, 2016
                                       ___________
        Introduced  by  M. of A. LAVINE, DUPREY -- read once and referred to the
          Committee on Health -- committee  discharged,  bill  amended,  ordered
          reprinted as amended and recommitted to said committee
        AN  ACT to amend the public health law, in relation to audits of pharma-
          cies
          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 a new section
     2  280-b to read as follows:
     3    § 280-b.  Pharmacy audits. 1. Definitions. As used  in  this  section,
     4  the following terms shall have the following meanings:
     5    (a)  "Audit"  means  a  review  of  the records of a pharmacy by or on
     6  behalf of an entity that pays for or reimburses the cost  of  pharmaceu-
     7  tical  products and health care services that is conducted at a pharmacy
     8  or from a remote location other than a pharmacy.
     9    (b) "Entity" means:
    10    (i) a pharmacy benefits manager;
    11    (ii) a health plan;
    12    (iii) a state agency, except the  office  of  the  Medicaid  inspector
    13  general;
    14    (iv) an insurer;
    15    (v) a third party administrator;
    16    (vi) a managed care organization; or
    17    (vii)  a  company, group or agent that represents or is engaged by any
    18  of these.
    19    (c) "Pharmacy benefits manager" means an entity  that  contracts  with
    20  pharmacies  or  pharmacy  contracting agents on behalf of a health plan,
    21  state agency, insurer, managed care organization, or other  third  party
    22  payer to provide pharmacy benefit services or administration.
    23    (d)  "Pharmacy" has the same meaning as set forth in section six thou-
    24  sand eight hundred two of the education law.
    25    (e) "Fraud" means an intentional deception or  misrepresentation  made
    26  by  a  person with the knowledge that the deception could result in some
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14134-02-6