senate Bill S2949

Amended

Provides that the initial prescription or dispensing of a controlled substance for acute pain shall be limited to a 3 - 10 day supply

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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

  • 25 / Jan / 2013
    • REFERRED TO HEALTH
  • 11 / Jun / 2013
    • COMMITTEE DISCHARGED AND COMMITTED TO RULES
  • 11 / Jun / 2013
    • ORDERED TO THIRD READING CAL.1249
  • 12 / Jun / 2013
    • PASSED SENATE
  • 12 / Jun / 2013
    • DELIVERED TO ASSEMBLY
  • 12 / Jun / 2013
    • REFERRED TO HEALTH
  • 08 / Jan / 2014
    • DIED IN ASSEMBLY
  • 08 / Jan / 2014
    • RETURNED TO SENATE
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 31 / Jan / 2014
    • AMEND AND RECOMMIT TO HEALTH
  • 31 / Jan / 2014
    • PRINT NUMBER 2949A
  • 27 / Feb / 2014
    • 1ST REPORT CAL.202
  • 03 / Mar / 2014
    • 2ND REPORT CAL.
  • 04 / Mar / 2014
    • ADVANCED TO THIRD READING
  • 09 / Jun / 2014
    • PASSED SENATE
  • 09 / Jun / 2014
    • DELIVERED TO ASSEMBLY
  • 09 / Jun / 2014
    • REFERRED TO HEALTH

Summary

Provides that the initial prescription or dispensing of a controlled substance for acute pain shall be limited to a 3-10 day supply; prohibits the imposition of an additional health insurance copayment if a subsequent prescription is issued for an aggregate of not more than a 30 day supply of such controlled substance.

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Bill Details

Versions:
S2949
S2949A
Legislative Cycle:
2013-2014
Current Committee:
Assembly Health
Law Section:
Public Health Law
Laws Affected:
Amd §3331, Pub Health L; amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2011-2012 Legislative Cycle:
S6745

Sponsor Memo

BILL NUMBER:S2949

TITLE OF BILL: An act to amend the public health law, in relation to
limiting the initial prescription of a controlled substance for the
alleviation of acute pain to between a three to ten day supply; and to
amend the insurance law, in relation to coverage of such prescriptions

PURPOSE: This bill would limit the number of schedule II or III
controlled substance pain pills initially prescribed to someone suffer-
ing from acute pain. This serves two important purposes: (1) it encour-
ages patients whose acute pain lasts longer than initially expected to
follow up with a doctor, and (2) it lessens the number of pills left in
medicine cabinets and available for diversion.

SUMMARY OF PROVISIONS:

Section 1 of the bill adds Public Health Law Sec. 3331(5)(b) and (c).
Subsection (b) permits authorized practitioners, within the scope of
their professional opinion or discretion, to dispense between three and
ten days of any schedule II or III controlled substance to a patient
suffering from acute pain. Subsection (c) provides a definition of acute
pain. The term encompasses accidental and intentional pain lasting only
a short or finite period of time. The subsection expressly excludes
chronic pain, cancer pain, or palliative care practices from the defi-
nition of acute pain.

Sections 2 through 4 of the bill amend section 3216, 3221, and 4303 of
the Insurance Law respectively. These sections prohibit additional
co-payments for prescriptions prescribed pursuant to Public Health Law
Sec. 3331(5)(b). The limitation shall apply only to the amount of
prescription drug constituting a thirty day supply, including the limit-
ed supply provided pursuant to Subdivision 5 of section 3331 of the
public health law.

Section 5 of the bill provides for an effective date.

JUSTIFICATION: Prescription drug abuse is a growing crisis in both New
York State and the country at large. In this state, there has been armed
violence, deaths by overdose and suicide, and increasing rates of
addiction. To address this crisis, the Senate Standing Committee on
Health held two Roundtables on the topic in August 2011 and February
2012. The Roundtables included panelists from all aspects of this
debate, including law enforcement, doctors, addiction specialists,
government agencies, and family members who have lost loved ones to
prescription painkiller abuse. A persistent theme from these Roundtables
was the concern regarding the volume of prescription pain medicine
sitting unattended in medicine cabinets throughout the state.

In 2010, there were 22.5 million prescriptions issued for prescription
painkillers, not including refills in New York State. That is more than
two million more prescriptions written than there are citizens in this

state. This bill addresses two major recommendations from the Roundta-
ble, (1) eliminating excess medication for the treatment of acute pain
and (2) decreasing the volume of pills left in medicine cabinets. Treat-
ing acute pain often involves patients recovering from surgical proce-
dures, short-term trauma, or dental procedures. By definition, acute
pain is also finite pain-with the exception of certain situations
involving terminal cancer pain. However, it is riot uncommon for a
doctor to prescribe 30 pills for pain following a dental procedure. Most
patients will use 2-3 pills and the excess sits in their medicine cabi-
nets, where it runs the risk of diversion. Approximately 70% of
prescription painkiller abusers get their drugs from a family member or
friend. Recent news tells the story of teenagers taking whatever pills
are available in the home medicine cabinet and taking or selling them on
the street. Prescription painkillers are a wonderful tool, and allow us
to treat pain as never before in human history, but they are also highly
addictive.

This bill ameliorates the excess volume of pills on the street, while
also providing better continuity of care. Acute pain can be a powerful
diagnostic tool for medical professionals. It is common for this form of
pain to follow various timelines. If pain worsens or lasts for a longer
time, it can be an important signal that something else is happening.
Providing excess medication helps patients dampen their current pain,
but it also prevents them from seeking additional medical help that they
might need. This bill limits the amount of medication, so that patients
feeling additional pain will seek medical intervention earlier. The bill
also ensures patients will only pay a single co-payment for the first 30
days of medication, even if the medication comes in the form of several
prescriptions over the course of those 30 days.

LEGISLATIVE HISTORY: 2012: S.6745 Died in Rules.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: On the sixtieth day after it shall have become law.

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

                                  2949

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 25, 2013
                               ___________

Introduced  by  Sens.  HANNON, LAVALLE, MARTINS, MAZIARZ, ZELDIN -- read
  twice and ordered printed, and when printed to  be  committed  to  the
  Committee on Health

AN  ACT  to  amend  the  public  health law, in relation to limiting the
  initial prescription of a controlled substance for the alleviation  of
  acute  pain  to  between  a  three to ten day supply; and to amend the
  insurance law, in relation to coverage of such prescriptions

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

  Section  1. Subdivision 5 of section 3331 of the public health law, as
amended by chapter 965 of the laws  of  1974,  is  amended  to  read  as
follows:
  5. (A) No more than a thirty day supply or, pursuant to regulations of
the  commissioner  enumerating  conditions  warranting specified greater
supplies, no more than a three month supply of a schedule II, III or  IV
substance, as determined by the directed dosage and frequency of dosage,
may be dispensed by an authorized practitioner at one time.
  (B)  NOTWITHSTANDING  THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDIVI-
SION, AN AUTHORIZED PRACTITIONER, WITHIN THE SCOPE OF HIS OR HER PROFES-
SIONAL OPINION OR DISCRETION, MAY DISPENSE OR  PRESCRIBE  NO  MORE  THAN
BETWEEN  A THREE AND TEN DAY SUPPLY OF ANY SCHEDULE II OR III CONTROLLED
SUBSTANCE TO AN ULTIMATE USER UPON THE INITIAL CONSULTATION OR TREATMENT
OF SUCH USER FOR ACUTE PAIN.  THEREAFTER, THE DISPENSING AND PRESCRIBING
OF THE CONTROLLED SUBSTANCE SHALL BE SUBJECT TO THE PROVISIONS OF  PARA-
GRAPH (A) OF THIS SUBDIVISION.
  (C)  FOR  THE  PURPOSES  OF THIS SUBDIVISION, "ACUTE PAIN" MEANS PAIN,
WHETHER ACCIDENTAL OR INTENTIONAL, THAT LASTS ONLY  A  SHORT  OR  FINITE
PERIOD OF TIME. SUCH TERM SHALL NOT INCLUDE CHRONIC PAIN, CANCER PAIN OR
PALLIATIVE CARE PRACTICES.
  S 2. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 30 to read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02570-01-3

S. 2949                             2

  (30)  NO  POLICY  DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH
PROVIDES COVERAGE FOR PRESCRIPTION DRUGS AND WHICH PROVIDES  FOR  COPAY-
MENTS  BY  COVERED PERSONS, SHALL IMPOSE UPON ANY COVERED PERSON, WHO IS
PRESCRIBED A LIMITED AMOUNT OF A PRESCRIPTION DRUG  FOR  ACUTE  PAIN  IN
ACCORDANCE   WITH   PARAGRAPH   (B)   OF  SUBDIVISION  FIVE  OF  SECTION
THIRTY-THREE HUNDRED THIRTY-ONE OF THE PUBLIC HEALTH LAW, AN  ADDITIONAL
COPAYMENT  IF  AN  AUTHORIZED PRESCRIBER, WITHIN THE SCOPE OF HIS OR HER
PROFESSIONAL OPINION, PRESCRIBES AN ADDITIONAL AMOUNT OF A  PRESCRIPTION
DRUG  FOR  ACUTE  PAIN,  AS DEFINED IN SUCH SUBDIVISION. THIS LIMITATION
SHALL APPLY ONLY TO THE AMOUNT OF PRESCRIPTION DRUG CONSTITUTING A THIR-
TY DAY SUPPLY, INCLUDING THE LIMITED SUPPLY PROVIDED  PURSUANT  TO  SUCH
PARAGRAPH.
  S 3. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19)  NO  GROUP  OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
THE STATE WHICH PROVIDES  COVERAGE  FOR  PRESCRIPTION  DRUGS  AND  WHICH
PROVIDES  FOR  COPAYMENTS  BY  COVERED  PERSONS,  SHALL  IMPOSE UPON ANY
COVERED PERSON, WHO IS PRESCRIBED A LIMITED  AMOUNT  OF  A  PRESCRIPTION
DRUG FOR ACUTE PAIN IN ACCORDANCE WITH PARAGRAPH (B) OF SUBDIVISION FIVE
OF  SECTION THIRTY-THREE HUNDRED THIRTY-ONE OF THE PUBLIC HEALTH LAW, AN
ADDITIONAL COPAYMENT IF AN AUTHORIZED PRESCRIBER, WITHIN  THE  SCOPE  OF
HIS  OR  HER  PROFESSIONAL OPINION, PRESCRIBES AN ADDITIONAL AMOUNT OF A
PRESCRIPTION DRUG FOR ACUTE PAIN, AS DEFINED IN SUCH  SUBDIVISION.  THIS
LIMITATION  SHALL  APPLY ONLY TO THE AMOUNT OF PRESCRIPTION DRUG CONSTI-
TUTING A THIRTY DAY SUPPLY, INCLUDING THE LIMITED SUPPLY PROVIDED PURSU-
ANT TO SUCH PARAGRAPH.
  S 4. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (jj) to read as follows:
  (JJ) NO MEDICAL EXPENSE INDEMNITY CORPORATION, HOSPITAL SERVICE CORPO-
RATION  OR  HEALTH  SERVICE  CORPORATION  WHICH  PROVIDES  COVERAGE  FOR
PRESCRIPTION DRUGS AND WHICH PROVIDES FOR COPAYMENTS BY COVERED PERSONS,
SHALL IMPOSE UPON ANY COVERED PERSON, WHO IS PRESCRIBED A LIMITED AMOUNT
OF A PRESCRIPTION DRUG FOR ACUTE PAIN IN ACCORDANCE WITH  PARAGRAPH  (B)
OF  SUBDIVISION  FIVE  OF SECTION THIRTY-THREE HUNDRED THIRTY-ONE OF THE
PUBLIC HEALTH LAW, AN ADDITIONAL COPAYMENT IF AN AUTHORIZED  PRESCRIBER,
WITHIN THE SCOPE OF HIS OR HER PROFESSIONAL OPINION, PRESCRIBES AN ADDI-
TIONAL  AMOUNT OF A PRESCRIPTION DRUG FOR ACUTE PAIN, AS DEFINED IN SUCH
SUBDIVISION.  THIS  LIMITATION  SHALL  APPLY  ONLY  TO  THE  AMOUNT   OF
PRESCRIPTION DRUG CONSTITUTING A THIRTY DAY SUPPLY, INCLUDING THE LIMIT-
ED SUPPLY PROVIDED PURSUANT TO SUCH PARAGRAPH.
  S  5.  This  act  shall take effect on the sixtieth day after it shall
have become a law.

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