senate Bill S4749

Relates to the collection of prescription drug co-payments

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Bill Status


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

  • 18 / Apr / 2011
    • REFERRED TO HEALTH
  • 07 / Jun / 2011
    • 1ST REPORT CAL.1142
  • 13 / Jun / 2011
    • 2ND REPORT CAL.
  • 14 / Jun / 2011
    • ADVANCED TO THIRD READING
  • 16 / Jun / 2011
    • PASSED SENATE
  • 16 / Jun / 2011
    • DELIVERED TO ASSEMBLY
  • 16 / Jun / 2011
    • REFERRED TO HEALTH
  • 04 / Jan / 2012
    • DIED IN ASSEMBLY
  • 04 / Jan / 2012
    • RETURNED TO SENATE
  • 04 / Jan / 2012
    • REFERRED TO HEALTH
  • 18 / Jun / 2012
    • COMMITTEE DISCHARGED AND COMMITTED TO RULES
  • 18 / Jun / 2012
    • ORDERED TO THIRD READING CAL.1276
  • 18 / Jun / 2012
    • PASSED SENATE
  • 18 / Jun / 2012
    • DELIVERED TO ASSEMBLY
  • 18 / Jun / 2012
    • REFERRED TO HEALTH

Summary

Requires the collection of prescription drug co-payments at the point of sale in pharmacies.

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Bill Details

See Assembly Version of this Bill:
A7727
Versions:
S4749
Legislative Cycle:
2011-2012
Current Committee:
Assembly Health
Law Section:
Social Services Law
Laws Affected:
Amd ยงยง367-a & 369-ee, Soc Serv L

Sponsor Memo

BILL NUMBER:S4749

TITLE OF BILL:
An act
to amend the social services law, in relation to the collection of
prescription drug co-payments

PURPOSE:
To require patients to pay co-payments for prescription drugs at the
point-of-sale under Medicaid and Family Health Plus

SUMMARY OF PROVISIONS:
Section 1- Amends section 367 -a of the Social Services law to require
the payment of prescription drug co-payments under Medicaid. Section
2- Amends section 369-ee of the Social Services law to require the
payment of prescription drug co-payments under Family Health Plus.
Section 3- Effective date.

JUSTIFICATION:
Co-payments for prescription drugs in the State Medicaid program were
implemented in New York State in 1995. Prescription drug co-payments
were also included when the Family Health Plus program was created.
It is the current policy that Medicaid and Family Health Plus
beneficiaries cannot be denied services if they refuse to pay their
co-payments at the point-of-sale. As a result, pharmacies in the
State of New York have experienced serious financial losses through
the inability to collect the co-payments of $1 for generics and $3
for brand name drugs under Medicaid and $3 for generics and $6 for
brand name drugs under Family Health Plus. Survey data has found that
the statewide average of uncollectible co-payments is 50%, and the
rate is even higher in New York City with some pharmacies
experiencing uncollectible co-payments of 90%.

Unlike other providers which receive funding from bad debt and charity
pools, pharmacies cannot write off their bad debt and do not receive
state assistance to make up for these losses. Uncollectible
co-payments come directly out of the pockets of community pharmacies.
Pharmacies have also recently experienced significant reductions in
reimbursement under Medicaid and Family Health and are currently are
paid one of the lowest rates in the country. This hardship is
exacerbated by the losses
incurred through uncollectible co-payments in these programs. This
situation is inequitable and also jeopardizes access to pharmacy
services for all New Yorkers.

Recently, the pharmacy benefit under Medicaid and Family Health Plus
was changed and will now be administered by private managed care
plans for the majority of beneficiaries. However, the co-payments
remain the same as does the policy regarding pharmacy collection.
This means that pharmacies will continue to lose on average 50% of
co-payments for the prescription drugs filled for approximately four
million New Yorkers.

This inequity would be addressed through this legislation by requiring
Medicaid and Family Health Plus beneficiaries to pay their


co-payments to pharmacies at the point-of-sale when filling their
prescriptions.

LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This act shall take effect one hundred and eighty days after it shall
become law.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4749

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 18, 2011
                               ___________

Introduced  by  Sen.  DeFRANCISCO -- read twice and ordered printed, and
  when printed to be committed to the Committee on Health

AN ACT to amend the social services law, in relation to  the  collection
  of prescription drug co-payments

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

  Section 1. Subparagraph (iii) of paragraph (c)  of  subdivision  6  of
section  367-a  of  the social services law, as amended by section 47 of
part C of chapter 58 of the laws of 2009, is amended to read as follows:
  (iii) Notwithstanding any  other  provision  of  this  paragraph,  co-
payments  charged  for each generic prescription drug dispensed shall be
one dollar and for each brand name prescription drug dispensed shall  be
three  dollars; provided, however, that the co-payments charged for each
brand name prescription drug on  the  preferred  drug  list  established
pursuant to section two hundred seventy-two of the public health law and
the co-payments charged for each brand name prescription drug reimbursed
pursuant  to subparagraph (ii) of paragraph (a-1) of subdivision four of
section three hundred sixty-five-a of this title shall  be  one  dollar.
THE  PAYMENT OF SUCH CO-PAYMENTS SHALL BE MANDATORY AT THE POINT OF SALE
IN PHARMACIES.
  S 2. Paragraph (i) of subdivision 2-a of section 369-ee of the  social
service  law,  as  amended  by section 26 of part E of chapter 63 of the
laws of 2005, is amended to read as follows:
  (i) co-payments charged for each generic prescription  drug  dispensed
shall  be  three  dollars  and  for  each  brand  name prescription drug
dispensed shall be six dollars AND THE PAYMENT OF SUCH CO-PAYMENTS SHALL
BE MANDATORY AT THE POINT OF SALE IN PHARMACIES;
  S 3. This act shall take effect on the one hundred eightieth day after
it shall have become a law, provided, however, that  the  amendments  to
subparagraph (iii) of paragraph (c) of subdivision 6 of section 367-a of
the social services law made by section one of this act shall not affect
the repeal of such paragraph and shall be deemed to repeal therewith.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10938-01-1

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