S T A T E   O F   N E W   Y O R K
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    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:

  Section 1. Subparagraph 1 of paragraph (b) of subdivision 1 of section
250 of the elder law, as amended by section 1 of part A of chapter 58 of
the laws of 2008, is amended and a new subparagraph 1-a is added to read
as follows:
  (1) Average wholesale price discounted by sixteen and twenty-five  one
hundredths percent, plus a dispensing fee as defined in paragraph (c) of
this subdivision, [or]
  (1-A)  AVERAGE  WHOLESALE  PRICE  DISCOUNTED BY FOURTEEN PERCENT FOR A
SMALL PHARMACY, PLUS A DISPENSING FEE AS DEFINED  IN  PARAGRAPH  (C)  OF
THIS  SUBDIVISION. FOR THE PURPOSES OF THIS SUBPARAGRAPH, A "SMALL PHAR-
MACY" SHALL MEAN A PHARMACY, APPROVED BY  THE  COMMISSIONER  OF  HEALTH,
WHICH IS DETERMINED BY THE COMMISSIONER OF HEALTH TO DISPENSE ON AVERAGE
UNDER TWO HUNDRED SCRIPTS A DAY, OR
  S  2.  Subparagraph  (ii) of paragraph (b) of subdivision 9 of section
367-a of the social services law, as amended by section 4 of part  C  of
chapter  58  of  the laws of 2008, is amended and a new paragraph (i) is
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

  (ii) if the drug dispensed is a multiple source prescription drug or a
brand-name prescription drug for which no specific upper limit has  been
set  by such federal agency, the lower of the estimated acquisition cost
of such drug to pharmacies,  or  the  dispensing  pharmacy's  usual  and
customary  price  charged  to  the general public. For sole and multiple
source brand name drugs, estimated acquisition cost  means  the  average
wholesale  price  of  a  prescription  drug  based upon the package size
dispensed from, as reported by the  prescription  drug  pricing  service
used  by  the  department,  less  sixteen and twenty-five one hundredths
percent thereof, and updated monthly by  the  department;  FOR  A  SMALL
PHARMACY,  AS  DEFINED IN PARAGRAPH (I) OF THIS SUBDIVISION, ACQUISITION
COSTS MEANS THE AVERAGE WHOLESALE PRICE OF  A  PRESCRIPTION  DRUG  BASED
UPON  THE  PACKAGE  SIZE DISPENSED FROM, AS REPORTED BY THE PRESCRIPTION
DRUG PRICING SERVICE USED BY THE DEPARTMENT, LESS FOURTEEN PERCENT THER-
EOF, AND UPDATED MONTHLY BY THE DEPARTMENT; or, for  a  specialized  HIV
pharmacy,  as  defined in paragraph (f) of this subdivision, acquisition
cost means the average wholesale price of a prescription drug based upon
the package size dispensed from, as reported by  the  prescription  drug
pricing service used by the department, less twelve percent thereof, and
updated  monthly  by  the department. For multiple source generic drugs,
estimated acquisition cost means the  lower  of  the  average  wholesale
price  of  a prescription drug based on the package size dispensed from,
as reported by the prescription drug pricing service used by the depart-
ment, less twenty-five percent thereof, or the maximum acquisition cost,
if any, established pursuant to paragraph (e) of this  subdivision;  or,
for  a  specialized  HIV  pharmacy,  as defined in paragraph (f) of this
subdivision, acquisition cost means the lower of the  average  wholesale
price  of  a prescription drug based on the package size dispensed from,
as reported by the prescription drug pricing service used by the depart-
ment, less twelve percent thereof, or the maximum acquisition  cost,  if
any, established pursuant to paragraph (e) of this subdivision.
  (I)  FOR PURPOSES OF THIS SECTION, A SMALL PHARMACY SHALL MEAN A PHAR-
MACY WHICH IS INDEPENDENTLY  OWNED,  APPROVED  BY  THE  COMMISSIONER  OF
HEALTH,  AND  WHICH  IS  DETERMINED  BY  THE  COMMISSIONER  OF HEALTH TO
DISPENSE ON AVERAGE UNDER TWO HUNDRED SCRIPTS A DAY.
  S 3. This act shall take effect immediately; provided,  however,  that
the  amendments to subdivision 9 of section 367-a of the social services
law made by section two of this act shall not affect the  expiration  of
such  subdivision  and  shall  be deemed to expire therewith.  Effective
immediately, the addition, amendment and/or repeal of any rule or  regu-
lation  necessary  for  the  implementation of this act on its effective
date is authorized and directed to be made and completed  on  or  before
such effective date.