senate Bill S2786

Amended

Relates to the collection of prescription drug co-payments

download pdf

Sponsor

Co-Sponsors

Bill Status


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

actions

  • 23 / Jan / 2013
    • REFERRED TO HEALTH
  • 04 / Jun / 2013
    • REPORTED AND COMMITTED TO FINANCE
  • 11 / Jun / 2013
    • REPORTED AND COMMITTED TO RULES
  • 11 / Jun / 2013
    • ORDERED TO THIRD READING CAL.1244
  • 21 / Jun / 2013
    • RECOMMITTED TO RULES
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 20 / May / 2014
    • REPORTED AND COMMITTED TO FINANCE
  • 22 / May / 2014
    • AMEND AND RECOMMIT TO FINANCE
  • 22 / May / 2014
    • PRINT NUMBER 2786A
  • 02 / Jun / 2014
    • 1ST REPORT CAL.1067
  • 03 / Jun / 2014
    • 2ND REPORT CAL.
  • 09 / Jun / 2014
    • ADVANCED TO THIRD READING
  • 20 / Jun / 2014
    • COMMITTED TO RULES

Summary

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

do you support this bill?

Bill Details

See Assembly Version of this Bill:
A4740
Versions:
S2786
S2786A
Legislative Cycle:
2013-2014
Current Committee:
Senate Rules
Law Section:
Social Services Law
Laws Affected:
Amd ยงยง367-a & 369-ee, Soc Serv L
Versions Introduced in 2011-2012 Legislative Cycle:
S4749, A7727

Votes

8
5
8
Aye
5
Nay
4
aye with reservations
0
absent
0
excused
0
abstained
show Health committee vote details

Sponsor Memo

BILL NUMBER:S2786

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-pay-
ments 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 situ-
ation 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 phar-
macies 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: S.4749A/A.7727 of 2011-2012

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
________________________________________________________________________

                                  2786

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 23, 2013
                               ___________

Introduced  by  Sens. DeFRANCISCO, LARKIN, RANZENHOFER -- 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.
                                                           LBD07805-01-3

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.