senate Bill S7384A

Directs the commissioner of health to develop a standard prior prescription drug authorization request form for managed care providers

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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

  • 02 / May / 2012
    • REFERRED TO HEALTH
  • 11 / Jun / 2012
    • REPORTED AND COMMITTED TO RULES
  • 12 / Jun / 2012
    • AMEND (T) AND RECOMMIT TO RULES
  • 12 / Jun / 2012
    • PRINT NUMBER 7384A
  • 20 / Jun / 2012
    • ORDERED TO THIRD READING CAL.1441
  • 20 / Jun / 2012
    • SUBSTITUTED BY A10248B

Summary

Directs the commissioner of health to develop a standard prior prescription drug authorization form for managed care providers.

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Bill Details

See Assembly Version of this Bill:
A10248B
Versions:
S7384
S7384A
Legislative Cycle:
2011-2012
Law Section:
Social Services Law
Laws Affected:
Amd ยง364-j, Soc Serv L

Sponsor Memo

BILL NUMBER:S7384A

TITLE OF BILL:
An act
to amend the social services law, in relation to directing the
commissioner of health to develop a standard
prior prescription drug
authorization request
form for managed care providers

PURPOSE:
This bill directs the Department of Health to develop a standard prior
authorization request form or forms for prescription drug benefits
within Medicaid Managed Care.

SUMMARY OF PROVISIONS:
The bill would add new subdivision 26 of section 364-j of the social
services law, which would direct the Department of Health to develop
a standard prior authorization request form or forms to be used by
Medicaid managed care providers to determine coverage of prescription
drug benefits.

JUSTIFICATION:
The 2011-12 New York State Budget, as part of a comprehensive redesign
of the Medicaid program, moved the overwhelming majority of
prescription drug coverage from the Medicaid fee-for-service program
into Medicaid Managed Care. As a result of this change, health care
providers now have more than twenty formularies and prior
authorization processes to contend with when writing prescriptions
for their Medicaid patients. Navigating this system has proven to be
a significant administrative burden for health care providers who are
already stretched thin when providing critical safety net services to
New York's most vulnerable populations.

This bill directs the Department of Health to develop a standard form
or forms to be used for prior authorizations related to the
prescription drug benefit within Medicaid Managed Care. By
standardizing this process, health care providers will be relieved of
a substantial administrative burden and will be better able to spend
their time caring for patients.

LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately.

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

                                 7384--A

                            I N  S E N A T E

                               May 2, 2012
                               ___________

Introduced  by  Sens.  HANNON, LARKIN -- read twice and ordered printed,
  and when printed to  be  committed  to  the  Committee  on  Health  --
  reported  favorably from said committee and committed to the Committee
  on Rules -- committee discharged, bill amended, ordered  reprinted  as
  amended and recommitted to said committee

AN  ACT  to  amend the social services law, in relation to directing the
  commissioner of health to develop a standard prior  prescription  drug
  authorization request form for managed care providers

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

  Section 1. Section 364-j of the social  services  law  is  amended  by
adding a new subdivision 26 to read as follows:
  26. THE COMMISSIONER OF HEALTH SHALL DEVELOP A STANDARD PRIOR AUTHORI-
ZATION  REQUEST FORM OR FORMS TO BE UTILIZED BY ALL MANAGED CARE PROVID-
ERS FOR PURPOSES OF SUBMITTING A REQUEST FOR A UTILIZATION REVIEW DETER-
MINATION FOR COVERAGE OF PRESCRIPTION DRUG BENEFITS  UNDER  THIS  TITLE.
THE  MANAGED  CARE  PROVIDER SHALL MAKE THE STANDARD PRIOR AUTHORIZATION
REQUEST FORM OR FORMS AVAILABLE TO, AND SHALL ACCEPT IT  OR  THEM  FROM,
PRESCRIBING PROVIDERS IN PAPER AND ELECTRONIC FORM.
  S  2.  This act shall take effect immediately; provided, however, that
the amendment to section 364-j of  the  social  services  law,  made  by
section  one of this act shall not affect the repeal of such section and
shall be deemed repealed therewith.




 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15724-03-2

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