senate Bill S2786A

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

  • 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.

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Bill Details

Versions:
S2786
S2786A
Legislative Cycle:
2013-2014
Current Committee:
Senate Rules
Law Section:
Social Services Law
Laws Affected:
Amd ยง367-a, Soc Serv L
Versions Introduced in 2011-2012 Legislative Cycle:
S4749

Sponsor Memo

BILL NUMBER:S2786A

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.

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- Effective date.

JUSTIFICATION: Co-payments for prescription drugs in the State
Medicaid program were implemented in New York State in 1995. It is the
current policy that Medicaid and 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. 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 are currently paid one of the lowest
rates in the country. This hardship is exacerbated by the losses
incurred through uncollectible co-payments in the program. This
situation is inequitable and also jeopardizes access to pharmacy
services for all New Yorkers.

Recently, the pharmacy benefit under Medicaid 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 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--A

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 23, 2013
                               ___________

Introduced by Sens. DeFRANCISCO, GOLDEN, LARKIN, RANZENHOFER, RITCHIE --
  read  twice  and  ordered printed, and when printed to be committed to
  the Committee on Health -- recommitted to the Committee on  Health  in
  accordance  with Senate Rule 6, sec. 8 -- reported favorably from said
  committee and committed to  the  Committee  on  Finance  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

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  9  of
part C of chapter 60 of the laws of 2014, 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 or,
for managed care providers operating pursuant to section  three  hundred
sixty-four-j  of  this title, for each brand name prescription drug on a
managed care provider's formulary that such provider has designated as a
preferred  drug,  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. 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.
                                                           LBD07805-02-4

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