Bill Text: NY S01794 | 2019-2020 | General Assembly | Amended
Bill Title: Provides for coverage for certain medically necessary prescription drugs in Medicaid managed care programs.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-01-08 - REFERRED TO HEALTH [S01794 Detail]
Download: New_York-2019-S01794-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 1794--A 2019-2020 Regular Sessions IN SENATE January 16, 2019 ___________ Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the social services law, in relation to coverage for certain prescription drugs; and to repeal certain provisions of such law relating thereto The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subdivision 25 of section 364-j of the social services law, 2 as added by section 55 of part D of chapter 56 of the laws of 2012, is 3 amended to read as follows: 4 25. [Effective January first, two thousand thirteen, notwithstanding] 5 Notwithstanding any provision of law to the contrary, managed care 6 providers shall cover medically necessary prescription drugs in the 7 anti-depressant, anti-retroviral, antirejection, seizure, epilepsy, 8 endocrine, hematologic, immunologic and atypical antipsychotic therapeu- 9 tic [class] classes, including non-formulary drugs, upon [demonstration] 10 determination by the prescriber under this subdivision. If the prescri- 11 ber, after consulting with the managed care provider, determines that 12 such drugs, in the prescriber's reasonable professional judgment, are 13 medically necessary and warranted, the prescriber's determination shall 14 be final. However, the prescriber's determination shall not be final: 15 (a) where the drug approved by the managed care provider is a generic 16 drug subject to subparagraph (i) of paragraph (a-1) of subdivision four 17 of section three hundred sixty-five-a of this title (mandatory generic 18 substitution), and even if the prescriber has indicated that the 19 prescription shall be dispensed as written; or (b) if it is for the use 20 of a drug that is not consistent with food and drug administration-ap- 21 proved labeling or supported by one or more official Compendia refer- 22 ences, including, but not limited to, the American Hospital Formulary EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD03448-05-9S. 1794--A 2 1 Service (AHFS), the DRUGDEX Drug Information System and the United 2 States Pharmacopeia. 3 § 2. Subdivision 25-a of section 364-j of the social services law is 4 REPEALED. 5 § 3. This act shall take effect on the sixtieth day after it shall 6 have become a law; provided that effective immediately, the commissioner 7 of health may make regulations and take other actions necessary to 8 implement this act on that date; and provided, further, that the amend- 9 ments to section 364-j of the social services law made by section one of 10 this act shall not affect the repeal of such section and shall be deemed 11 repealed therewith.