Bill Text: NY S02229 | 2009-2010 | General Assembly | Introduced
Bill Title: Relates to pharmaceutical reimbursement under the EPIC program and Medicaid for pharmacies that it is determined dispense on average under two hundred scripts a day.
Spectrum: Moderate Partisan Bill (Republican 7-2)
Status: (Introduced - Dead) 2010-01-06 - REFERRED TO AGING [S02229 Detail]
Download: New_York-2009-S02229-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ S. 2229 A. 5329 2009-2010 Regular Sessions S E N A T E - A S S E M B L Y February 13, 2009 ___________ IN SENATE -- Introduced by Sens. LITTLE, ADDABBO, DIAZ, GOLDEN, GRIFFO, HANNON, LAVALLE, MORAHAN, VOLKER -- read twice and ordered printed, and when printed to be committed to the Committee on Aging IN ASSEMBLY -- Introduced by M. of A. SAYWARD, SCOZZAFAVA, DUPREY, BURLING, BACALLES, GUNTHER, KOLB, CHRISTENSEN, RAIA, MOLINARO, CALHOUN, REILLY -- Multi-Sponsored by -- M. of A. CROUCH, EDDINGTON, McKEVITT, WEISENBERG -- read once and referred to the Committee on Aging AN ACT to amend the elder law and the social services law, in relation to pharmaceutical reimbursement under the EPIC program and Medicaid for certain pharmacies THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Subparagraph 1 of paragraph (b) of subdivision 1 of section 2 250 of the elder law, as amended by section 1 of part A of chapter 58 of 3 the laws of 2008, is amended and a new subparagraph 1-a is added to read 4 as follows: 5 (1) Average wholesale price discounted by sixteen and twenty-five one 6 hundredths percent, plus a dispensing fee as defined in paragraph (c) of 7 this subdivision, [or] 8 (1-A) AVERAGE WHOLESALE PRICE DISCOUNTED BY FOURTEEN PERCENT FOR A 9 SMALL PHARMACY, PLUS A DISPENSING FEE AS DEFINED IN PARAGRAPH (C) OF 10 THIS SUBDIVISION. FOR THE PURPOSES OF THIS SUBPARAGRAPH, A "SMALL PHAR- 11 MACY" SHALL MEAN A PHARMACY, APPROVED BY THE COMMISSIONER OF HEALTH, 12 WHICH IS DETERMINED BY THE COMMISSIONER OF HEALTH TO DISPENSE ON AVERAGE 13 UNDER TWO HUNDRED SCRIPTS A DAY, OR 14 S 2. Subparagraph (ii) of paragraph (b) of subdivision 9 of section 15 367-a of the social services law, as amended by section 4 of part C of 16 chapter 58 of the laws of 2008, is amended and a new paragraph (i) is 17 added to read as follows: EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00965-03-9 S. 2229 2 A. 5329 1 (ii) if the drug dispensed is a multiple source prescription drug or a 2 brand-name prescription drug for which no specific upper limit has been 3 set by such federal agency, the lower of the estimated acquisition cost 4 of such drug to pharmacies, or the dispensing pharmacy's usual and 5 customary price charged to the general public. For sole and multiple 6 source brand name drugs, estimated acquisition cost means the average 7 wholesale price of a prescription drug based upon the package size 8 dispensed from, as reported by the prescription drug pricing service 9 used by the department, less sixteen and twenty-five one hundredths 10 percent thereof, and updated monthly by the department; FOR A SMALL 11 PHARMACY, AS DEFINED IN PARAGRAPH (I) OF THIS SUBDIVISION, ACQUISITION 12 COSTS MEANS THE AVERAGE WHOLESALE PRICE OF A PRESCRIPTION DRUG BASED 13 UPON THE PACKAGE SIZE DISPENSED FROM, AS REPORTED BY THE PRESCRIPTION 14 DRUG PRICING SERVICE USED BY THE DEPARTMENT, LESS FOURTEEN PERCENT THER- 15 EOF, AND UPDATED MONTHLY BY THE DEPARTMENT; or, for a specialized HIV 16 pharmacy, as defined in paragraph (f) of this subdivision, acquisition 17 cost means the average wholesale price of a prescription drug based upon 18 the package size dispensed from, as reported by the prescription drug 19 pricing service used by the department, less twelve percent thereof, and 20 updated monthly by the department. For multiple source generic drugs, 21 estimated acquisition cost means the lower of the average wholesale 22 price of a prescription drug based on the package size dispensed from, 23 as reported by the prescription drug pricing service used by the depart- 24 ment, less twenty-five percent thereof, or the maximum acquisition cost, 25 if any, established pursuant to paragraph (e) of this subdivision; or, 26 for a specialized HIV pharmacy, as defined in paragraph (f) of this 27 subdivision, acquisition cost means the lower of the average wholesale 28 price of a prescription drug based on the package size dispensed from, 29 as reported by the prescription drug pricing service used by the depart- 30 ment, less twelve percent thereof, or the maximum acquisition cost, if 31 any, established pursuant to paragraph (e) of this subdivision. 32 (I) FOR PURPOSES OF THIS SECTION, A SMALL PHARMACY SHALL MEAN A PHAR- 33 MACY WHICH IS INDEPENDENTLY OWNED, APPROVED BY THE COMMISSIONER OF 34 HEALTH, AND WHICH IS DETERMINED BY THE COMMISSIONER OF HEALTH TO 35 DISPENSE ON AVERAGE UNDER TWO HUNDRED SCRIPTS A DAY. 36 S 3. This act shall take effect immediately; provided, however, that 37 the amendments to subdivision 9 of section 367-a of the social services 38 law made by section two of this act shall not affect the expiration of 39 such subdivision and shall be deemed to expire therewith. Effective 40 immediately, the addition, amendment and/or repeal of any rule or regu- 41 lation necessary for the implementation of this act on its effective 42 date is authorized and directed to be made and completed on or before 43 such effective date.