assembly Bill A5502B

Signed by Governor

Prohibits health insurers from requiring insureds purchase prescribed drugs from mail order pharmacy

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Sponsor

HEASTIE

Co-Sponsors

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Multi-Sponsors

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed by Governor
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actions

  • 22 / Feb / 2011
    • REFERRED TO INSURANCE
  • 25 / Apr / 2011
    • AMEND AND RECOMMIT TO INSURANCE
  • 25 / Apr / 2011
    • PRINT NUMBER 5502A
  • 17 / May / 2011
    • AMEND AND RECOMMIT TO INSURANCE
  • 17 / May / 2011
    • PRINT NUMBER 5502B
  • 24 / May / 2011
    • REPORTED
  • 26 / May / 2011
    • ADVANCED TO THIRD READING CAL.462
  • 15 / Jun / 2011
    • PASSED ASSEMBLY
  • 15 / Jun / 2011
    • DELIVERED TO SENATE
  • 15 / Jun / 2011
    • REFERRED TO RULES
  • 20 / Jun / 2011
    • SUBSTITUTED FOR S3510B
  • 20 / Jun / 2011
    • 3RD READING CAL.1383
  • 20 / Jun / 2011
    • PASSED SENATE
  • 20 / Jun / 2011
    • RETURNED TO ASSEMBLY
  • 30 / Nov / 2011
    • DELIVERED TO GOVERNOR
  • 12 / Dec / 2011
    • SIGNED CHAP.597
  • 12 / Dec / 2011
    • APPROVAL MEMO.14

Summary

Prohibits health insurers from requiring the insured purchase prescribed drugs from a mail order pharmacy or pay a co-payment fee when such purchases are not made from a mail order pharmacy if a similar fee is not charged for drugs from a mail order pharmacy.

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Bill Details

See Senate Version of this Bill:
S3510B
Versions:
A5502
A5502A
A5502B
Legislative Cycle:
2011-2012
Law Section:
Insurance Law
Laws Affected:
Amd ยงยง3216, 3221 & 4303, Ins L
Versions Introduced in Previous Legislative Cycles:
2009-2010: A1267A, S6007
2007-2008: A2808, A2808
view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5502--B

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 22, 2011
                               ___________

Introduced by M. of A. HEASTIE, GOTTFRIED, COLTON, ROSENTHAL, M. MILLER,
  CYMBROWITZ,  MOYA,  O'DONNELL, THIELE, GALEF, CASTRO, DenDEKKER, BENE-
  DETTO, GUNTHER, SCHROEDER, MAISEL, SPANO, SCHIMEL,  V. LOPEZ,  WEISEN-
  BERG,  LAVINE,  WEPRIN,  ENGLEBRIGHT, SWEENEY, PAULIN, DINOWITZ, MENG,
  RODRIGUEZ, HOYT, GABRYSZAK, TITONE -- Multi-Sponsored by -- M.  of  A.
  ABBATE,  ABINANTI,  BOYLE, BURLING, CASTELLI, CERETTO, CORWIN, CRESPO,
  CROUCH, DUPREY, GIGLIO, GRAF, HAYES, JACOBS, KATZ, LATIMER,  P. LOPEZ,
  LOSQUADRO,   MALLIOTAKIS,  J. MILLER,  MONTESANO,  MURRAY,  PALMESANO,
  PEOPLES-STOKES,  RA,  RAIA,  P. RIVERA,  ROBERTS,  SALADINO,  SAYWARD,
  SMARDZ  --  read  once  and  referred to the Committee on Insurance --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted  to  said  committee -- again reported from said committee
  with amendments, ordered reprinted as amended and recommitted to  said
  committee

AN  ACT  to  amend  the  insurance  law,  in relation to the purchase of
  prescription drugs

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
amended by adding a new paragraph 28 to read as follows:
  (28) ANY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION  DRUGS  SHALL
PERMIT  EACH PARTICIPANT TO FILL ANY MAIL ORDER COVERED PRESCRIPTION, AT
HIS OR HER OPTION, AT ANY MAIL ORDER PHARMACY OR  NETWORK  PARTICIPATING
NON-MAIL  ORDER  RETAIL  PHARMACY  IF THE NETWORK PARTICIPATING NON-MAIL
ORDER RETAIL PHARMACY OFFERS TO ACCEPT A PRICE  THAT  IS  COMPARABLE  TO
THAT  OF THE MAIL ORDER PHARMACY. ANY POLICY WHICH PROVIDES COVERAGE FOR
PRESCRIPTION DRUGS SHALL NOT IMPOSE A CO-PAYMENT FEE OR OTHER  CONDITION
ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM A NETWORK PARTICIPATING
NON-MAIL  ORDER  RETAIL  PHARMACY  WHICH IS NOT ALSO IMPOSED ON INSUREDS
ELECTING TO PURCHASE  DRUGS  FROM  A  DESIGNATED  MAIL  ORDER  PHARMACY;
PROVIDED,  HOWEVER, THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPER-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09145-06-1

A. 5502--B                          2

SEDE THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY
THAT IS THE RESULT OF  A  COLLECTIVE  BARGAINING  AGREEMENT  BETWEEN  AN
EMPLOYER AND A RECOGNIZED OR CERTIFIED EMPLOYEE ORGANIZATION.
  S 2. Subsection (1) of section 3221 of the insurance law is amended by
adding a new paragraph 18 to read as follows:
  (18)  ANY  INSURER  DELIVERING  A GROUP OR BLANKET POLICY OR ISSUING A
GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES COVER-
AGE FOR PRESCRIPTION DRUGS SHALL PERMIT EACH  PARTICIPANT  TO  FILL  ANY
MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT ANY MAIL ORDER
PHARMACY  OR NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY IF THE
NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY OFFERS TO ACCEPT  A
PRICE  THAT IS COMPARABLE TO THAT OF THE MAIL ORDER PHARMACY. ANY POLICY
WHICH PROVIDES COVERAGE  FOR  PRESCRIPTION  DRUGS  SHALL  NOT  IMPOSE  A
CO-PAYMENT  FEE OR OTHER CONDITION ON ANY INSURED WHO ELECTS TO PURCHASE
DRUGS FROM A NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY  WHICH
IS NOT ALSO IMPOSED ON INSUREDS ELECTING TO PURCHASE DRUGS FROM A DESIG-
NATED  MAIL  ORDER  PHARMACY;  PROVIDED, HOWEVER, THAT THE PROVISIONS OF
THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF  A  COLLECTIVE  BARGAINING
AGREEMENT  OR  APPLY  TO  A  POLICY  THAT  IS THE RESULT OF A COLLECTIVE
BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOGNIZED  OR  CERTIFIED
EMPLOYEE ORGANIZATION.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (hh) to read as follows:
  (HH) ANY POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY  CORPORATION,  A
HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH SERVICES CORPORATION WHICH
PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL PERMIT  EACH  PARTICIPANT
TO  FILL  ANY  MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT
ANY MAIL ORDER PHARMACY OR NETWORK PARTICIPATING NON-MAIL  ORDER  RETAIL
PHARMACY  IF  THE  NETWORK  PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY
OFFERS TO ACCEPT A PRICE THAT IS COMPARABLE TO THAT OF  THE  MAIL  ORDER
PHARMACY.  ANY  POLICY  WHICH  PROVIDES  COVERAGE FOR PRESCRIPTION DRUGS
SHALL NOT IMPOSE A COPAYMENT FEE OR OTHER CONDITION ON ANY  INSURED  WHO
ELECTS  TO  PURCHASE  DRUGS  FROM A NETWORK PARTICIPATING NON-MAIL ORDER
RETAIL PHARMACY WHICH IS  NOT  ALSO  IMPOSED  ON  INSUREDS  ELECTING  TO
PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER,
THAT  THE  PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A
COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY THAT IS THE  RESULT
OF  A  COLLECTIVE  BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOG-
NIZED OR CERTIFIED EMPLOYEE ORGANIZATION.
  S 4.  If any clause, subparagraph, subsection, section or  other  part
of  this  act,  or the   application thereof be held to be invalid, such
holding shall not affect, impair or invalidate  the  remainder  of  this
act, or the application of such section or part of a section held inval-
id.
  S  5.  This  act shall take effect on the thirtieth day after it shall
have become a law and shall apply to all policies and contracts  issued,
renewed, modified, altered or amended on or after such effective date.

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