NY State Senate Bill 2009-S121

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2010	referred to health
Mar 19, 2009	print number 121a
Mar 19, 2009	amend and recommit to finance
Mar 17, 2009	reported and committed to finance
Feb 24, 2009	reported and committed to codes
Jan 07, 2009	referred to health

Bill Amendments

Original

A (Active)

2009-S121 - Details

Current Committee:: Senate Health

2009-S121 - Summary

Establishes the prescription drug discount program; establishes that the purpose of the program is to provide access to prescription drugs to participants at a discounted price and to allow for the negotiating of rebates that are exempt from the "best price" rule of the federal social security act; provides for the distribution of rebate funds and repeals a certain provision of the public health law relating thereto.

2009-S121 - Sponsor Memo

                                 BILL NUMBER:  S121

 TITLE OF BILL :
An act to amend the public health law, in relation to creating the
prescription drug discount program and to repeal certain provisions of
the public health law relating thereto


 PURPOSE OR GENERAL IDEA OF BILL :
This bill aims to improve the health of New York residents by making
prescription drugs more accessible and affordable.

 SUMMARY OF SPECIFIC PROVISIONS :
Section 1 sets forth-legislative findings and purpose. It further
declares that the legislature intends to lower enrollment in public
health insurance programs by providing more affordable prescription
drugs and thus be exempt from the "best price" rule of title XIX of
the federal social security act. If further declares that the program
shall help reduce the cost of prescription drugs to those lacking
prescription drug coverage and those facing gaps in coverage.

Section 2 designates sections 270-277 of the article 2-A of the public
health law as Title I and amends it to add a title heading.

Section 3 amends article 2-A of the public health law to add a new
Title II that creates the Prescription Drug Discount Card.

Section 280 of the title defines "Contractor," "Covered Drug,"
"Fiduciary relationship," "Manufacturer," "Participant,"
"Participating retailer," "Program," and "Rebate agreement."

Section 28O-a of the title establishes the program in the department
of health for the purpose of providing access to prescription drugs at
reduced cost, by deriving state revenue from rebates and applying that
revenue to reducing costs for participants. It also directs the
commissioner to apply for any necessary waivers to implement the title
and allows the commissioner to create regulations if necessary.

Section 28O-b describes the procedure through which the board shall
contract with administrators to manage the program.

Section 280-c requires the commissioner to negotiate agreements with
suppliers in which the suppliers pay rebates to the fiscal
administrator of the program for prescription drugs purchased by
participants in the program. It provides that the commissioner may
limit access to drugs covered under the program to those which are
extended a rebate by manufacturers.

Section 280-d sets forth the formula used to set the discounted retail
prices participants in the program pay for prescription drugs.

Section 280-e outlines the distribution of the rebate funds to the
retailers or individual participants, as appropriate.

Section 280-f describes the procedure for participants to register for
the program. It directs the commissioner to advise every participant
that the program does not apply to any drugs where payment is provided
in whole or in part by a third-party payor.  Section 280-g requires
the department of health to promote the program through education and
outreach.

Section 4 of the bill redesignates section 280 of the public health
law, as created by section 75 of Part C of a chapter of the laws of
2008, as section 280-h of the public health law. It also creates a new
subdivision two in section 280-h that directs the commissioner to
enroll anyone who enrolled in the prescription drug discount card
under section 280-h of the public health law into the program created
by Title II of the public health law and cease enrolling people under
section 280-h.

Section 5 provides for the repeal of section 280-h of the public
health law.

Section 6 is a severability clause.

Section 7 of the bill establishes effective dates.

 JUSTIFICATION :
For many people, prescription drugs are necessary for health and life.
Increasing prescription drug costs limit their accessibility,
especially for seniors, who tend to need them most. These costs also
place a burden on health insurance plans and publicly funded medical
assistance programs. This bill intends to alleviate those burdens and
improve access to necessary medication by organizing the collective
market power of New York's prescription drug consumers to negotiate
rebates with suppliers.

 PRIOR LEGISLATIVE HISTORY :
2006: A.6336-B - passed the Assembly
2007: A.3848 - passed Assembly Committee on Health S.8393 Referred to
Health

 FISCAL IMPLICATIONS :
This bill will have no fiscal impact.

 EFFECTIVE DATE :
This act shall take effect immediately; except that section 4 of the
act shall be deemed to have taken effect on the same day as section 75
of Part C of chapter 58 of the laws of 2008. Section 5 shall take
effect 180 days after the act shall become a law

2009-S121 - Bill Text download pdf

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

                                   121

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 7, 2009
                               ___________

Introduced  by  Sen. SAMPSON -- 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  creating  the
  prescription drug discount program and to repeal certain provisions of
  the public health law relating thereto

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

  Section 1. Legislative findings  and  declaration.    The  legislature
hereby  finds and declares that the high and rising cost of prescription
drugs limits access to those of limited means. It makes it  more  likely
that they will become eligible for Medicaid, imposing increased costs on
Medicaid.
  The  legislature  therefore  declares that it is an appropriate public
purpose and in the public interest for New York to exercise  the  powers
of the state to provide its residents with means and methods of reducing
the  high  cost  of  prescription drugs and avoid increased costs to the
Medicaid program, and that  the  prescription  drug  assistance  program
created by this act is consistent with these public purposes.
  The  legislature  further  declares that the purpose of this act is to
help reduce the cost of and improve access  to  prescription  drugs,  by
providing  a  means  to organize and thus maximize the market purchasing
power of consumers to earn revenue from supplier rebates  and  use  that
revenue to make prescription drugs more affordable.
  The  legislature  further  declares  its intent that the program, as a
state prescription drug assistance program and  as  a  program  to  help
avoid  increased costs to the Medicaid program, shall be able to negoti-
ate rebates that are exempt from the "best price" rule of title  XIX  of
the federal social security act.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00356-02-9

S. 121                              2

  S  2. Sections 270 through 277 of article 2-A of the public health law
are designated title I and a new title  heading  is  added  to  read  as
follows:
            PREFERRED DRUG AND CLINICAL DRUG REVIEW PROGRAMS
  S  3.  Article 2-A of the public health law is amended by adding a new
title II to read as follows:
                                 TITLE II
                     PRESCRIPTION DRUG DISCOUNT CARD
SECTION 280.   DEFINITIONS.
        280-A. PRESCRIPTION DRUG DISCOUNT PROGRAM.
        280-B. CONTRACTS.
        280-C. REBATES.
        280-D. RETAIL DISCOUNT PRICES.
        280-E. DISTRIBUTION OF REBATE FUNDS.
        280-F. REGISTRATION OF PARTICIPANTS.
        280-G. EDUCATION AND OUTREACH.
  S 280. DEFINITIONS. FOR PURPOSES OF THIS TITLE,  THE  FOLLOWING  TERMS
SHALL  HAVE  THE  FOLLOWING MEANINGS, UNLESS THE CONTEXT REQUIRES OTHER-
WISE:
  1. "CONTRACTOR" IS ANY PUBLIC, PRIVATE, OR NOT-FOR-PROFIT ENTITY  WITH
WHICH  THE  COMMISSIONER  CONTRACTS FOR THE PURPOSE OF ADMINISTERING ANY
ELEMENT OF THE PROGRAM OR PROVIDING TECHNICAL OR  CLINICAL  SUPPORT  FOR
THE PROGRAM. THERE MAY BE ONE OR MORE CONTRACTORS.
  2.  "COVERED DRUG" MEANS A PRESCRIPTION DRUG THAT IS DESIGNATED BY THE
COMMISSIONER TO BE SUBJECT  TO  PURCHASE  BY  A  PARTICIPANT  UNDER  THE
PROGRAM UNDER SECTION TWO HUNDRED EIGHTY-C OF THIS TITLE.
  3.  "FIDUCIARY  RELATIONSHIP" MEANS A RELATIONSHIP IN WHICH ONE PERSON
OR ENTITY IS UNDER A DUTY TO ACT FOR THE BENEFIT OF THE OTHER PERSON  OR
ENTITY  IN THE RELATIONSHIP ON MATTERS WITHIN THE SCOPE OF THE RELATION-
SHIP, AND OWES A DUTY OF GOOD FAITH, TRUST, CONFIDENCE,  AND  CANDOR  TO
THE OTHER PERSON OR ENTITY.
  4.  "MANUFACTURER"  HAS  THE  SAME  MEANING  ASCRIBED  TO SUCH TERM IN
SECTION NINETEEN HUNDRED TWENTY-SEVEN OF  THE  FEDERAL  SOCIAL  SECURITY
ACT.
  5.  "PARTICIPANT"  MEANS  A  NATURAL  PERSON WHO MEETS THE ELIGIBILITY
GUIDELINES ESTABLISHED IN SECTION TWO HUNDRED EIGHTY-F OF THIS TITLE AND
REGISTERS TO PARTICIPATE IN THE PROGRAM.
  6.  "PARTICIPATING  RETAILER"  MEANS  ANY  PERSON  OR  ENTITY  SELLING
PRESCRIPTION  DRUGS AT RETAIL PRICES THAT IS REGISTERED AS A PARTICIPAT-
ING RETAILER IN THE PROGRAM.
  7. "PROGRAM" MEANS THE PRESCRIPTION DRUG DISCOUNT PROGRAM  ESTABLISHED
BY THIS TITLE.
  8.  "REBATE AGREEMENT" MEANS AN AGREEMENT EXECUTED WITH A MANUFACTURER
OR OTHER ENTITY TO PROVIDE REBATES  TO  THE  PROGRAM  PURSUANT  TO  THIS
TITLE.
  S  280-A. PRESCRIPTION DRUG DISCOUNT PROGRAM. 1. THE PRESCRIPTION DRUG
DISCOUNT PROGRAM IS HEREBY ESTABLISHED IN THE  DEPARTMENT.  ITS  PURPOSE
SHALL  BE  TO  PROVIDE  ACCESS  TO PRESCRIPTION DRUGS TO PARTICIPANTS AT
DISCOUNTED COST, AND TO OBTAIN APPROPRIATE REBATES  FROM  MANUFACTURERS,
AS  AUTHORIZED  IN  THIS  TITLE. FOR THE PURPOSES OF MARKETING AND OTHER
PURPOSES, THE COMMISSIONER MAY CHOOSE  ANOTHER  NAME  FOR  THE  PROGRAM;
PROVIDED,  HOWEVER,  THAT  ANY  SUCH CHANGE OF NAME SHALL NOT AFFECT THE
LEGAL DESCRIPTION OR INTENT  OF THE PROGRAM, OR ITS EXEMPTION,  IF  ANY,
FROM  THE  "BEST PRICE" RULE OF TITLE XIX OF THE FEDERAL SOCIAL SECURITY
ACT. THE PROGRAM SHALL  BE  ADMINISTERED  IN  A  MANNER  THAT  MAXIMIZES
SAVINGS FOR THE PARTICIPANTS CONSISTENT WITH THIS TITLE WHILE MINIMIZING

S. 121                              3

ANY  COST  TO  THE  STATE,  INCLUDING COORDINATING OR COMBINING ADMINIS-
TRATION OF ANY ASPECT OF THE PROGRAM WITH MEDICAID OR EPIC TO THE EXTENT
CONSISTENT WITH THE INTERESTS OF THOSE PROGRAMS AND THEIR PARTICIPANTS.
  2.  THE COMMISSIONER MAY REQUIRE EVERY MANUFACTURER PARTICIPATING IN A
REBATE AGREEMENT, EVERY PARTICIPANT AND EVERY PARTICIPATING RETAILER  TO
PROVIDE ANY INFORMATION, AND MAY CONDUCT SUCH AUDITS AND INVESTIGATIONS,
AS REASONABLY NECESSARY FOR EFFECTIVE ADMINISTRATION OF THE PROGRAM. ALL
INDIVIDUAL  IDENTIFYING  INFORMATION RELATING TO ANY PATIENT OR CONSUMER
ACQUIRED BY THE PROGRAM SHALL BE KEPT CONFIDENTIAL BY  THE  COMMISSIONER
AND  SHALL  BE USED SOLELY FOR THE PURPOSE OF ADMINISTERING THE PROGRAM.
ANY MATTER RELATING TO TRADE OR COMPETITIVE SECRETS OF MANUFACTURERS AND
PARTICIPATING RETAILERS, AND ANY MATTER CONCERNING PRICING  AND  PROFIT,
WHICH  IS  OBTAINED  PURSUANT  TO  THIS  SUBDIVISION, OR PURSUANT TO ANY
INVESTIGATION OR AUDIT AUTHORIZED PURSUANT TO THIS  TITLE,  OR  OBTAINED
INDIRECTLY  BY  ANY OTHER AUDITS OR INVESTIGATIONS, SHALL BE KEPT CONFI-
DENTIAL.
  3. IF THE IMPLEMENTATION OF THE PROGRAM REQUIRES ANY FEDERAL  APPROVAL
OR WAIVER, THE COMMISSIONER SHALL EXPEDITIOUSLY APPLY FOR AND USE HIS OR
HER BEST EFFORTS TO OBTAIN SUCH APPROVAL OR WAIVER, CONSISTENT WITH THIS
TITLE AND ANY STATE LAW APPLICABLE TO MEDICAID OR EPIC.
  4.  THE  COMMISSIONER  MAY  MAKE  REGULATIONS  AND ESTABLISH TERMS AND
CONDITIONS CONSISTENT WITH THIS TITLE  AND  OTHER  APPLICABLE  LAW,  FOR
IMPLEMENTATION OF THE PROGRAM.
  S 280-B. CONTRACTS. 1. THE COMMISSIONER MAY CONTRACT WITH, OR AMEND AN
EXISTING  CONTRACT  WITH, ONE OR MORE PUBLIC, PRIVATE, OR NOT-FOR-PROFIT
ENTITIES TO ADMINISTER ANY AND ALL  COMPONENTS  OF  THE  PROGRAM  OR  TO
PROVIDE TECHNICAL OR CLINICAL SUPPORT FOR THE PROGRAM.
  2.  (A)  EVERY CONTRACTOR SHALL HAVE A FIDUCIARY RELATIONSHIP WITH AND
OBLIGATION TO THE COMMISSIONER AND THE PROGRAM.
  (B) ALL FUNDS RECEIVED BY ANY CONTRACTOR IN RELATION  TO  THE  PROGRAM
SHALL  BE RECEIVED BY THE CONTRACTOR SOLELY ON BEHALF OF THE PROGRAM FOR
USE OR DISTRIBUTION ONLY PURSUANT TO THIS TITLE, INCLUDING THE  CONTRAC-
TOR'S  CONTRACT  WITH THE COMMISSIONER; EXCEPT FOR ANY PAYMENT EXPRESSLY
PROVIDED FOR IN THE  CONTRACT  TO  COMPENSATE  THE  CONTRACTOR  FOR  ITS
SERVICES. THE CONTRACTOR SHALL ACCOUNT TO THE COMMISSIONER FOR ALL FUNDS
RECEIVED AND PROCESSED BY THE CONTRACTOR IN RELATION TO THE PROGRAM. THE
COMMISSIONER  AND  THE  COMPTROLLER  SHALL  HAVE ACCESS TO ALL BOOKS AND
RECORDS OF THE CONTRACTOR IN RELATION TO THE PROGRAM.
  (C) THE CONTRACTOR SHALL DISCLOSE TO THE COMMISSIONER  AND  THE  COMP-
TROLLER  THE TERMS AND CONDITIONS OF ANY CONTRACT OR ARRANGEMENT BETWEEN
THE CONTRACTOR AND ANY PARTY RELATING TO THE PROGRAM.
  S 280-C. REBATES. 1. THE COMMISSIONER SHALL ENTER INTO AGREEMENTS WITH
MANUFACTURERS TO ACHIEVE  REBATES  FROM  MANUFACTURERS  FOR  THEIR  DRUG
PRODUCTS PURCHASED BY PARTICIPANTS THROUGH THE PROGRAM.
  2.  THE  COMMISSIONER  SHALL USE BEST EFFORTS TO MAXIMIZE THE LEVEL OF
REBATES OBTAINED FROM MANUFACTURERS TO THE EXTENT ALLOWABLE  BY  LAW  OR
REGULATION.  THE  COMMISSIONER  MAY  SEEK ANY FEDERAL APPROVAL NEEDED TO
ENSURE REBATES RECEIVED UNDER THIS PROGRAM ARE EXCLUDED FROM  THE  DEFI-
NITION  OF  "BEST  PRICE" UNDER SECTION NINETEEN HUNDRED TWENTY-SEVEN OF
THE FEDERAL SOCIAL SECURITY ACT.
  3. TO ADVANCE THE PURPOSES OF THE PROGRAM, THE COMMISSIONER MAY  COOR-
DINATE  NEGOTIATIONS UNDER THE PROGRAM WITH GOVERNMENTAL AND NON-GOVERN-
MENTAL ENTITIES, IN THIS STATE OR ELSEWHERE.
  4. THE COMMISSIONER SHALL DESIGNATE DRUGS TO BE SUBJECT TO PURCHASE BY
PARTICIPANTS UNDER THE PROGRAM. THE COMMISSIONER MAY  LIMIT  DESIGNATION
UNDER THE PROGRAM TO DRUGS COVERED BY A REBATE AGREEMENT.

S. 121                              4

  5.  THE  COMMISSIONER MAY SEEK SUPPLEMENTAL REBATES FROM MANUFACTURERS
CONSISTENT WITH THOSE REBATES PROVIDED TO THE MEDICAID PROGRAM FOR DRUGS
ON THE PREFERRED DRUG LIST PURSUANT TO TITLE ONE  OF  THIS  ARTICLE.  IN
EXCHANGE  FOR THE PROVISION OF SUCH REBATES, THE COMMISSIONER MAY DESIG-
NATE  SUCH DRUGS AS PREFERRED DRUGS IN PROGRAM MARKETING AND EDUCATIONAL
ACTIVITIES AND  MATERIALS.  THE  COMMISSIONER  IS  AUTHORIZED  TO  LIMIT
PROGRAM  COVERAGE  OF  DRUGS  IN  THERAPEUTIC  CLASSES  INCLUDED  IN THE
PREFERRED DRUG PROGRAM TO THOSE ON THE PREFERRED DRUG LIST.
  S 280-D. RETAIL DISCOUNT PRICES. 1. A PERSON OR ENTITY  MAY  BECOME  A
PARTICIPATING  RETAILER  BY  AGREEING  TO  THE  TERMS  AND CONDITIONS OF
PROGRAM PARTICIPATION, AND MEETING QUALIFICATIONS, AS ESTABLISHED BY THE
COMMISSIONER. THE COMMISSIONER MAY REQUIRE PERIODIC RE-REGISTRATION.
  2. A PARTICIPATING RETAILER MAY NOT CHARGE A PARTICIPANT A PRICE FOR A
COVERED DRUG WHICH IS HIGHER  THAN  THE  AMOUNT  PAID  BY  THE  MEDICAID
PROGRAM  PURSUANT  TO  SECTION THREE HUNDRED SIXTY-SEVEN-A OF THE SOCIAL
SERVICES LAW, LESS THE APPLICABLE REBATE AMOUNT ADVANCED BY THE  PROGRAM
IN ACCORDANCE WITH SECTION TWO HUNDRED EIGHTY-E OF THIS TITLE.
  S  280-E.  DISTRIBUTION OF REBATE FUNDS. 1. THE APPROPRIATE CONTRACTOR
SHALL EXPEDITIOUSLY MAKE PAYMENTS TO  PARTICIPATING  RETAILERS  FOR  THE
ESTIMATED REBATE AMOUNTS, RELATING TO COVERED DRUGS DISPENSED BY PARTIC-
IPATING  RETAILERS TO PROGRAM PARTICIPANTS, SUBJECT TO SUBSEQUENT RECON-
CILIATION AGAINST ACTUAL REBATES COLLECTED FROM MANUFACTURERS. RECONCIL-
IATION SHALL NOT REQUIRE RECOUPMENT FROM OR PAYMENTS TO PARTICIPANTS  OR
PARTICIPATING  RETAILERS  FOR  PREVIOUS PURCHASES UNDER THE PROGRAM, BUT
MAY INCLUDE, AS APPROPRIATE, PROVISION FOR ADJUSTMENT AGAINST  ESTIMATED
REBATE AMOUNTS FACTORED INTO FUTURE PRICES TO BE PAID BY PARTICIPANTS.
  2.  THE COMMISSIONER MAY MAKE ARRANGEMENTS WITH MANUFACTURERS CONCERN-
ING THE TIMING OR STRUCTURE OF THE REBATE PAYMENTS  AS  IN  HIS  OR  HER
DETERMINATION SHALL BEST FACILITATE LOWER PRICES FOR PARTICIPANTS, EXPE-
DITIOUS PAYMENT OF REBATES AND EFFICIENT ADMINISTRATION OF THE PROGRAM.
  S  280-F.  REGISTRATION  OF  PARTICIPANTS.  1.  TO BE ELIGIBLE TO BE A
PARTICIPANT, A PERSON SHALL BE A RESIDENT OF  NEW  YORK,  REGARDLESS  OF
AGE, WHO HAS A HOUSEHOLD INCOME EQUAL TO OR LESS THAN THE GREATER OF (A)
THREE HUNDRED FIFTY PERCENT OF THE FEDERAL POVERTY LEVEL FOR A HOUSEHOLD
OF  THAT SIZE (AS DEFINED AND UPDATED BY THE UNITED STATES DEPARTMENT OF
HEALTH AND HUMAN SERVICES); OR (B) THE INCOME ELIGIBILITY LEVELS  ESTAB-
LISHED  UNDER SUBDIVISION ONE OR TWO OF SECTION TWO HUNDRED FORTY-TWO OF
THE ELDER LAW, IS NOT IN RECEIPT  OF  MEDICAID,  AND  MEETS  SUCH  OTHER
REQUIREMENTS  AS  THE  COMMISSIONER  MAY  ESTABLISH CONSISTENT WITH THIS
TITLE. ANY PERSON ENROLLED IN THE  PRESCRIPTION  DRUG  DISCOUNT  PROGRAM
UNDER  SECTION TWO HUNDRED EIGHTY-H OF THIS ARTICLE SHALL BE ELIGIBLE TO
BE A PARTICIPANT UNDER THIS PROGRAM.
  2. ANY PERSON ELIGIBLE TO BE A PARTICIPANT MAY BECOME A PARTICIPANT IN
THE PROGRAM BY REGISTERING WITH THE PROGRAM.  ANY PERSON ENROLLED IN THE
PRESCRIPTION DRUG DISCOUNT PROGRAM UNDER SECTION TWO HUNDRED EIGHTY-H OF
THIS ARTICLE SHALL AUTOMATICALLY BE REGISTERED BY  THE  COMMISSIONER  IN
THIS PROGRAM.
  3.  THE COMMISSIONER SHALL ADVISE EACH APPLICANT THAT THE PROGRAM DOES
NOT APPLY TO ANY PRESCRIPTION DRUG PURCHASE FOR WHICH REIMBURSEMENT  (IN
WHOLE OR IN PART) IS PROVIDED BY ANY THIRD-PARTY PAYER. THE COMMISSIONER
MAY  REQUIRE PERIODIC RE-REGISTRATION AND MAY REQUIRE THE PARTICIPANT TO
INFORM THE PROGRAM OF  ANY  CHANGE  IN  THE  INFORMATION  PROVIDED.  THE
COMMISSIONER  SHALL MAKE THE APPLICATION PROCESS AS SIMPLE AS REASONABLY
POSSIBLE TO MAXIMIZE PARTICIPATION IN THE PROGRAM CONSISTENT WITH PROPER
ADMINISTRATION OF THIS TITLE.

S. 121                              5

  4. THE COMMISSIONER SHALL REVIEW ALL APPLICATIONS TO DETERMINE IF  THE
APPLICANT  APPEARS  TO  MEET THE ELIGIBILITY REQUIREMENTS FOR THE FAMILY
HEALTH PLUS PROGRAM UNDER SECTION THREE  HUNDRED  SIXTY-NINE-EE  OF  THE
SOCIAL  SERVICES  LAW,  THE CHILD HEALTH INSURANCE PROGRAM UNDER SECTION
TWENTY-FIVE  HUNDRED TEN AND TWENTY-FIVE HUNDRED ELEVEN OF THIS CHAPTER,
OR MEDICAL ASSISTANCE UNDER ARTICLE FIVE OF THE SOCIAL SERVICES LAW.  IF
THE  APPLICANT  DOES  APPEAR TO MEET ELIGIBILITY REQUIREMENTS FOR ANY OF
THOSE PROGRAMS, THE COMMISSIONER SHALL, IN ADDITION TO ANY OTHER ACTIONS
TAKEN UNDER THIS TITLE,  PROVIDE  THE  APPLICANT  WITH  INFORMATION  AND
ENROLLMENT  MATERIAL ABOUT SUCH OTHER PROGRAM. HOWEVER, THE COMMISSIONER
SHALL REGISTER THE APPLICANT UNDER THIS  SECTION  IF  THE  APPLICANT  IS
OTHERWISE ELIGIBLE.
  S 280-G. EDUCATION AND OUTREACH. THE COMMISSIONER SHALL CONDUCT EDUCA-
TION  AND  OUTREACH  TO  PROMOTE  THE  PROGRAM AND TO ENCOURAGE ELIGIBLE
PERSONS AND ENTITIES TO BECOME PARTICIPANTS AND PARTICIPATING RETAILERS.
  S 4. Section 280 of the public health law, as added by section  75  of
part  C  of chapter 58 of the laws of 2008, is renumbered section 280-h,
and amended to read as follows:
  S 280-h. Prescription drug discount program.  1. The prescription drug
discount program is hereby established in  the  department.    The  drug
discount  card  shall  be  available to any resident between the ages of
fifty and sixty-four, and any resident of any age who  has  been  deter-
mined  to  meet  the  disability  criteria in 20 C.F.R. S 404.1505, who:
meets the income eligibility levels established under subdivision one or
two of section two hundred forty-two of the elder law; is not in receipt
of medical assistance under title eleven of article five of  the  social
services  law.  The  drug  discount  card  shall offer discounts on drug
purchases which are not covered by other public or private  third  party
payment  sources.    Provided, however, that participation by a provider
pharmacy and drug manufacturers shall be voluntary and reimbursement  to
the  provider  pharmacy  under  the  drug discount card program shall be
adjudicated and paid within two business days for any rebates,  dispens-
ing  fees  and  drug  costs  not  paid by the resident eligible for such
program at the point of sale.
  2. THE COMMISSIONER SHALL, AS EXPEDITIOUSLY AS POSSIBLE, INTEGRATE THE
OPERATION OF THE PRESCRIPTION DRUG DISCOUNT PROGRAM UNDER  THIS  SECTION
WITH  THE  PRESCRIPTION  DRUG DISCOUNT PROGRAM UNDER SECTION TWO HUNDRED
EIGHTY-A OF THIS  ARTICLE.  WHEN  THE  COMMISSIONER  BEGINS  REGISTERING
PARTICIPANTS  UNDER  SECTION TWO HUNDRED EIGHTY-A OF THIS ARTICLE, HE OR
SHE SHALL CEASE ENROLLING PARTICIPANTS UNDER THIS SECTION.   ANY  PERSON
ENROLLED IN THE PROGRAM UNDER THIS SECTION SHALL BE AUTOMATICALLY REGIS-
TERED  BY  THE  COMMISSIONER  IN  THE  PROGRAM UNDER SECTION TWO HUNDRED
EIGHTY-A OF THIS ARTICLE.
  S 5. Section 280-h of the public health law,  as  amended  by  section
four of this act, is REPEALED.
  S 6. Severability. If any clause, sentence, paragraph, section or part
of  title  II of article 2-A of the public health law as enacted by this
act or any application thereof shall be adjudged by any court of  compe-
tent  jurisdiction  to  be  invalid, or ruled by any appropriate federal
agency to violate or be inconsistent with any applicable federal law  or
regulation,  the  judgment or ruling shall not affect, impair or invali-
date the remainder thereof, but shall be confined in  its  operation  to
the clause, sentence, paragraph, section or part of that title or appli-
cation  thereof  directly involved in the controversy or matter in which
the judgment or ruling shall have been rendered.
  S 7. This act shall take effect immediately; provided, however that:

S. 121                              6

  (a) the amendments to article 2-A of the public  health  law  made  by
sections  two  and  four of this act shall not affect the repeal of such
article and shall be deemed repealed therewith;
  (b)  section  280-a  of the public health law as added by secion three
and section five of this act shall take effect on the one hundred eight-
ieth day after this act shall have become a law;
  (c) any  rebate  payment  due  from  any  drug  manufacturer  and  any
reimbursement  due under section 280-h of the public health law shall be
paid notwithstanding the repeal of section 280-h made by section five of
this act; and
  (d) the amendments to article 2-A of the public  health  law  made  by
section  three  of  this  act shall survive the expiration and repeal of
such article as provided in section 79 of part C of chapter  58  of  the
laws of 2005, as amended.

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2009-S121A (ACTIVE) - Details

Current Committee:: Senate Health

2009-S121A (ACTIVE) - Summary

2009-S121A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S121A

 TITLE OF BILL :
An act to amend the public health law, in relation to creating the
prescription drug discount program and to repeal certain provisions of
the public health law relating thereto


 PURPOSE OR GENERAL IDEA OF BILL :
This bill aims to improve the health of New York residents by making
prescription drugs more accessible and affordable.

 SUMMARY OF SPECIFIC PROVISIONS :
Section 1 sets forth legislative findings and purpose. It further
declares that the legislature intends to lower enrollment in public
health insurance programs by providing more affordable prescription
drugs and thus be exempt from the "best price" rule of title XIX of
the federal social security act. If further declares that the program
shall help reduce the cost of prescription drugs to those lacking
prescription drug coverage and those facing gaps in coverage.

Section 2 designates sections 270-277 of the article 2-A of the public
health law as Title I and amends it to add a title heading.

Section 3 amends article 2-A of the public health law to add a new
Title II that creates the Prescription Drug Discount Card.

Section 280 of the title defines "Contractor," "Covered Drug,"
"Fiduciary relationship," "Manufacturer," "Participant,"
"Participating retailer," "Program," and "Rebate agreement."

Section 280-a of the title establishes the program in the department
of health for the purpose of providing access to prescription drugs at
reduced cost, by deriving state revenue from rebates and applying that
revenue to reducing costs for participants. It also directs the
commissioner to apply for any necessary waivers to implement the title
and allows the commissioner to create regulations if necessary.

Section 280-b describes the procedure through which the board shall
contract with administrators to manage the program.

Section 280-c requires the commissioner to negotiate agreements with
suppliers in which the suppliers pay rebates to the fiscal
administrator of the program for prescription drugs purchased by
participants in t.he program. It provides that the commissioner may
limit access to drugs covered under the program to those which are
extended a rebate by manufacturers.

Section 280-d sets forth the formula used to set the discounted retail
prices participants in the program pay for prescription drugs.

Section 280-e outlines the distribution of the rebate funds to the
retailers or individual participants, as appropriate.

Section 280-f describes the procedure for participants to register for
the program. It directs the commissioner to advise every participant
that the program does not apply to any drugs where payment is provided
in whole or in part by a third-party payor.  Section 280-g requires
the department of health to promote the program through education and
outreach.

Section 4 of the bill redesignates section 280 of the public health
law, as created by section 75 of Part C of a chapter of the laws of
2008, as section 280-h of the public health law. It also creates a new
subdivision two in section 280-h that directs the commissioner to
enroll anyone who enrolled in the prescription drug discount card
under section 280-h of the public health law into the program created
by Title II of the public health law and cease enrolling people under
section 280-h.

Section 5 provides for the repeal of section 280-h of the public
health law.

Section 6 is a severability clause.

Section 7 of the bill establishes effective dates.

 JUSTIFICATION :
For many people, prescription drugs are necessary for health and life.
Increasing prescription drug costs limit their accessibility,
especially for seniors, who tend to need them most. These costs also
place a burden on health insurance plans and publicly funded medical
assistance programs. This bill intends to alleviate those burdens and
improve access to necessary medication by organizing the collective
market power of New York's prescription drug consumers to negotiate
rebates with suppliers.

 PRIOR LEGISLATIVE HISTORY :
2006: A.6336-B - passed the Assembly 2007: A.3848 - passed Assembly
Committee on Health S.8393 Referred to Health

 FISCAL IMPLICATIONS :
This bill will have no fiscal impact.

 EFFECTIVE DATE :
This act shall take effect immediately; except that section 4 of the
act shall be deemed to have taken effect on the same day as section 75
of Part C of chapter 58 of the laws of 2008.  Section 5 shall take
effect 180 days after the act shall become a law.

2009-S121A (ACTIVE) - Bill Text download pdf

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

                                 121--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 7, 2009
                               ___________

Introduced  by  Sens.  SAMPSON,  DIAZ, KRUEGER -- 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 Commit-
  tee  on  Codes -- 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  public  health law, in relation to creating the
  prescription drug discount program and to repeal certain provisions of
  the public health law relating thereto

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

  Section  1.  Legislative  findings  and declaration.   The legislature
hereby finds and declares that the high and rising cost of  prescription
drugs  limits  access to those of limited means. It makes it more likely
that they will become eligible for Medicaid, imposing increased costs on
Medicaid.
  The legislature therefore declares that it is  an  appropriate  public
purpose  and  in the public interest for New York to exercise the powers
of the state to provide its residents with means and methods of reducing
the high cost of prescription drugs and avoid  increased  costs  to  the
Medicaid  program,  and  that  the  prescription drug assistance program
created by this act is consistent with these public purposes.
  The legislature further declares that the purpose of this  act  is  to
help  reduce  the  cost  of and improve access to prescription drugs, by
providing a means to organize and thus maximize  the  market  purchasing
power  of  consumers  to earn revenue from supplier rebates and use that
revenue to make prescription drugs more affordable.
  The legislature further declares its intent that  the  program,  as  a
state  prescription  drug  assistance  program  and as a program to help
avoid increased costs to the Medicaid program, shall be able to  negoti-

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

                                                           LBD00356-06-9

S. 121--A                           2

ate  rebates  that are exempt from the "best price" rule of title XIX of
the federal social security act.
  S  2. Sections 270 through 277 of article 2-A of the public health law
are designated title I and a new title  heading  is  added  to  read  as
follows:
            PREFERRED DRUG AND CLINICAL DRUG REVIEW PROGRAMS
  S  3.  Article 2-A of the public health law is amended by adding a new
title II to read as follows:
                                 TITLE II
                     PRESCRIPTION DRUG DISCOUNT CARD
SECTION 280.   DEFINITIONS.
        280-A. PRESCRIPTION DRUG DISCOUNT PROGRAM.
        280-B. CONTRACTS.
        280-C. REBATES.
        280-D. RETAIL DISCOUNT PRICES.
        280-E. DISTRIBUTION OF REBATE FUNDS.
        280-F. REGISTRATION OF PARTICIPANTS.
        280-G. EDUCATION AND OUTREACH.
  S 280. DEFINITIONS. FOR PURPOSES OF THIS TITLE,  THE  FOLLOWING  TERMS
SHALL  HAVE  THE  FOLLOWING MEANINGS, UNLESS THE CONTEXT REQUIRES OTHER-
WISE:
  1. "CONTRACTOR" IS ANY PUBLIC, PRIVATE, OR NOT-FOR-PROFIT ENTITY  WITH
WHICH  THE  COMMISSIONER  CONTRACTS FOR THE PURPOSE OF ADMINISTERING ANY
ELEMENT OF THE PROGRAM OR PROVIDING TECHNICAL OR  CLINICAL  SUPPORT  FOR
THE PROGRAM. THERE MAY BE ONE OR MORE CONTRACTORS.
  2.  "COVERED DRUG" MEANS A PRESCRIPTION DRUG THAT IS DESIGNATED BY THE
COMMISSIONER TO BE SUBJECT  TO  PURCHASE  BY  A  PARTICIPANT  UNDER  THE
PROGRAM UNDER SECTION TWO HUNDRED EIGHTY-C OF THIS TITLE.
  3.  "FIDUCIARY  RELATIONSHIP" MEANS A RELATIONSHIP IN WHICH ONE PERSON
OR ENTITY IS UNDER A DUTY TO ACT FOR THE BENEFIT OF THE OTHER PERSON  OR
ENTITY  IN THE RELATIONSHIP ON MATTERS WITHIN THE SCOPE OF THE RELATION-
SHIP, AND OWES A DUTY OF GOOD FAITH, TRUST, CONFIDENCE,  AND  CANDOR  TO
THE OTHER PERSON OR ENTITY.
  4.  "MANUFACTURER"  HAS  THE  SAME  MEANING  ASCRIBED  TO SUCH TERM IN
SECTION NINETEEN HUNDRED TWENTY-SEVEN OF  THE  FEDERAL  SOCIAL  SECURITY
ACT.
  5.  "PARTICIPANT"  MEANS  A  NATURAL  PERSON WHO MEETS THE ELIGIBILITY
GUIDELINES ESTABLISHED IN SECTION TWO HUNDRED EIGHTY-F OF THIS TITLE AND
REGISTERS TO PARTICIPATE IN THE PROGRAM.
  6.  "PARTICIPATING  RETAILER"  MEANS  ANY  PERSON  OR  ENTITY  SELLING
PRESCRIPTION  DRUGS AT RETAIL PRICES THAT IS REGISTERED AS A PARTICIPAT-
ING RETAILER IN THE PROGRAM.
  7. "PROGRAM" MEANS THE PRESCRIPTION DRUG DISCOUNT PROGRAM  ESTABLISHED
BY THIS TITLE.
  8.  "REBATE AGREEMENT" MEANS AN AGREEMENT EXECUTED WITH A MANUFACTURER
OR OTHER ENTITY TO PROVIDE REBATES  TO  THE  PROGRAM  PURSUANT  TO  THIS
TITLE.
  S  280-A. PRESCRIPTION DRUG DISCOUNT PROGRAM. 1. THE PRESCRIPTION DRUG
DISCOUNT PROGRAM IS HEREBY ESTABLISHED IN THE  DEPARTMENT.  ITS  PURPOSE
SHALL  BE  TO  PROVIDE  ACCESS  TO PRESCRIPTION DRUGS TO PARTICIPANTS AT
DISCOUNTED COST, AND TO OBTAIN APPROPRIATE REBATES  FROM  MANUFACTURERS,
AS  AUTHORIZED  IN  THIS  TITLE. FOR THE PURPOSES OF MARKETING AND OTHER
PURPOSES, THE COMMISSIONER MAY CHOOSE  ANOTHER  NAME  FOR  THE  PROGRAM;
PROVIDED,  HOWEVER,  THAT  ANY  SUCH CHANGE OF NAME SHALL NOT AFFECT THE
LEGAL DESCRIPTION OR INTENT  OF THE PROGRAM, OR ITS EXEMPTION,  IF  ANY,
FROM  THE  "BEST PRICE" RULE OF TITLE XIX OF THE FEDERAL SOCIAL SECURITY

S. 121--A                           3

ACT. THE PROGRAM SHALL  BE  ADMINISTERED  IN  A  MANNER  THAT  MAXIMIZES
SAVINGS FOR THE PARTICIPANTS CONSISTENT WITH THIS TITLE WHILE MINIMIZING
ANY  COST  TO  THE  STATE,  INCLUDING COORDINATING OR COMBINING ADMINIS-
TRATION OF ANY ASPECT OF THE PROGRAM WITH MEDICAID OR EPIC TO THE EXTENT
CONSISTENT WITH THE INTERESTS OF THOSE PROGRAMS AND THEIR PARTICIPANTS.
  2.  THE COMMISSIONER MAY REQUIRE EVERY MANUFACTURER PARTICIPATING IN A
REBATE AGREEMENT, EVERY PARTICIPANT AND EVERY PARTICIPATING RETAILER  TO
PROVIDE ANY INFORMATION, AND MAY CONDUCT SUCH AUDITS AND INVESTIGATIONS,
AS REASONABLY NECESSARY FOR EFFECTIVE ADMINISTRATION OF THE PROGRAM. ALL
INDIVIDUAL  IDENTIFYING  INFORMATION RELATING TO ANY PATIENT OR CONSUMER
ACQUIRED BY THE PROGRAM SHALL BE KEPT CONFIDENTIAL BY  THE  COMMISSIONER
AND  SHALL  BE USED SOLELY FOR THE PURPOSE OF ADMINISTERING THE PROGRAM.
ANY MATTER RELATING TO TRADE OR COMPETITIVE SECRETS OF MANUFACTURERS AND
PARTICIPATING RETAILERS, AND ANY MATTER CONCERNING PRICING  AND  PROFIT,
WHICH  IS  OBTAINED  PURSUANT  TO  THIS  SUBDIVISION, OR PURSUANT TO ANY
INVESTIGATION OR AUDIT AUTHORIZED PURSUANT TO THIS  TITLE,  OR  OBTAINED
INDIRECTLY  BY  ANY OTHER AUDITS OR INVESTIGATIONS, SHALL BE KEPT CONFI-
DENTIAL.
  3. IF THE IMPLEMENTATION OF THE PROGRAM REQUIRES ANY FEDERAL  APPROVAL
OR WAIVER, THE COMMISSIONER SHALL EXPEDITIOUSLY APPLY FOR AND USE HIS OR
HER BEST EFFORTS TO OBTAIN SUCH APPROVAL OR WAIVER, CONSISTENT WITH THIS
TITLE AND ANY STATE LAW APPLICABLE TO MEDICAID OR EPIC.
  4.  THE  COMMISSIONER  MAY  MAKE  REGULATIONS  AND ESTABLISH TERMS AND
CONDITIONS CONSISTENT WITH THIS TITLE  AND  OTHER  APPLICABLE  LAW,  FOR
IMPLEMENTATION OF THE PROGRAM.
  S 280-B. CONTRACTS. 1. THE COMMISSIONER MAY CONTRACT WITH, OR AMEND AN
EXISTING  CONTRACT  WITH, ONE OR MORE PUBLIC, PRIVATE, OR NOT-FOR-PROFIT
ENTITIES TO ADMINISTER ANY AND ALL  COMPONENTS  OF  THE  PROGRAM  OR  TO
PROVIDE TECHNICAL OR CLINICAL SUPPORT FOR THE PROGRAM.
  2.  (A)  EVERY CONTRACTOR SHALL HAVE A FIDUCIARY RELATIONSHIP WITH AND
OBLIGATION TO THE COMMISSIONER AND THE PROGRAM.
  (B) ALL FUNDS RECEIVED BY ANY CONTRACTOR IN RELATION  TO  THE  PROGRAM
SHALL  BE RECEIVED BY THE CONTRACTOR SOLELY ON BEHALF OF THE PROGRAM FOR
USE OR DISTRIBUTION ONLY PURSUANT TO THIS TITLE, INCLUDING THE  CONTRAC-
TOR'S  CONTRACT  WITH THE COMMISSIONER; EXCEPT FOR ANY PAYMENT EXPRESSLY
PROVIDED FOR IN THE  CONTRACT  TO  COMPENSATE  THE  CONTRACTOR  FOR  ITS
SERVICES. THE CONTRACTOR SHALL ACCOUNT TO THE COMMISSIONER FOR ALL FUNDS
RECEIVED AND PROCESSED BY THE CONTRACTOR IN RELATION TO THE PROGRAM. THE
COMMISSIONER  AND  THE  COMPTROLLER  SHALL  HAVE ACCESS TO ALL BOOKS AND
RECORDS OF THE CONTRACTOR IN RELATION TO THE PROGRAM.
  (C) THE CONTRACTOR SHALL DISCLOSE TO THE COMMISSIONER  AND  THE  COMP-
TROLLER  THE TERMS AND CONDITIONS OF ANY CONTRACT OR ARRANGEMENT BETWEEN
THE CONTRACTOR AND ANY PARTY RELATING TO THE PROGRAM.
  S 280-C. REBATES. 1. THE COMMISSIONER SHALL ENTER INTO AGREEMENTS WITH
MANUFACTURERS TO ACHIEVE  REBATES  FROM  MANUFACTURERS  FOR  THEIR  DRUG
PRODUCTS PURCHASED BY PARTICIPANTS THROUGH THE PROGRAM.
  2.  THE  COMMISSIONER  SHALL USE BEST EFFORTS TO MAXIMIZE THE LEVEL OF
REBATES OBTAINED FROM MANUFACTURERS TO THE EXTENT ALLOWABLE  BY  LAW  OR
REGULATION.  THE  COMMISSIONER  MAY  SEEK ANY FEDERAL APPROVAL NEEDED TO
ENSURE REBATES RECEIVED UNDER THIS PROGRAM ARE EXCLUDED FROM  THE  DEFI-
NITION  OF  "BEST  PRICE" UNDER SECTION NINETEEN HUNDRED TWENTY-SEVEN OF
THE FEDERAL SOCIAL SECURITY ACT.
  3. TO ADVANCE THE PURPOSES OF THE PROGRAM, THE COMMISSIONER MAY  COOR-
DINATE  NEGOTIATIONS UNDER THE PROGRAM WITH GOVERNMENTAL AND NON-GOVERN-
MENTAL ENTITIES, IN THIS STATE OR ELSEWHERE.

S. 121--A                           4

  4. THE COMMISSIONER SHALL DESIGNATE DRUGS TO BE SUBJECT TO PURCHASE BY
PARTICIPANTS UNDER THE PROGRAM. THE COMMISSIONER MAY  LIMIT  DESIGNATION
UNDER THE PROGRAM TO DRUGS COVERED BY A REBATE AGREEMENT.
  5.  THE  COMMISSIONER MAY SEEK SUPPLEMENTAL REBATES FROM MANUFACTURERS
CONSISTENT WITH THOSE REBATES PROVIDED TO THE MEDICAID PROGRAM FOR DRUGS
ON THE PREFERRED DRUG LIST PURSUANT TO TITLE ONE  OF  THIS  ARTICLE.  IN
EXCHANGE  FOR THE PROVISION OF SUCH REBATES, THE COMMISSIONER MAY DESIG-
NATE SUCH DRUGS AS PREFERRED DRUGS IN PROGRAM MARKETING AND  EDUCATIONAL
ACTIVITIES  AND  MATERIALS.  THE  COMMISSIONER  IS  AUTHORIZED  TO LIMIT
PROGRAM COVERAGE  OF  DRUGS  IN  THERAPEUTIC  CLASSES  INCLUDED  IN  THE
PREFERRED DRUG PROGRAM TO THOSE ON THE PREFERRED DRUG LIST.
  S  280-D.  RETAIL  DISCOUNT PRICES. 1. A PERSON OR ENTITY MAY BECOME A
PARTICIPATING RETAILER BY  AGREEING  TO  THE  TERMS  AND  CONDITIONS  OF
PROGRAM PARTICIPATION, AND MEETING QUALIFICATIONS, AS ESTABLISHED BY THE
COMMISSIONER. THE COMMISSIONER MAY REQUIRE PERIODIC RE-REGISTRATION.
  2. A PARTICIPATING RETAILER MAY NOT CHARGE A PARTICIPANT A PRICE FOR A
COVERED  DRUG  WHICH  IS  HIGHER  THAN  THE  AMOUNT PAID BY THE MEDICAID
PROGRAM PURSUANT TO SECTION THREE HUNDRED SIXTY-SEVEN-A  OF  THE  SOCIAL
SERVICES  LAW, LESS THE APPLICABLE REBATE AMOUNT ADVANCED BY THE PROGRAM
IN ACCORDANCE WITH SECTION TWO HUNDRED EIGHTY-E OF THIS TITLE.
  S 280-E. DISTRIBUTION OF REBATE FUNDS. 1. THE  APPROPRIATE  CONTRACTOR
SHALL  EXPEDITIOUSLY  MAKE  PAYMENTS  TO PARTICIPATING RETAILERS FOR THE
ESTIMATED REBATE AMOUNTS, RELATING TO COVERED DRUGS DISPENSED BY PARTIC-
IPATING RETAILERS TO PROGRAM PARTICIPANTS, SUBJECT TO SUBSEQUENT  RECON-
CILIATION AGAINST ACTUAL REBATES COLLECTED FROM MANUFACTURERS. RECONCIL-
IATION  SHALL NOT REQUIRE RECOUPMENT FROM OR PAYMENTS TO PARTICIPANTS OR
PARTICIPATING RETAILERS FOR PREVIOUS PURCHASES UNDER  THE  PROGRAM,  BUT
MAY  INCLUDE, AS APPROPRIATE, PROVISION FOR ADJUSTMENT AGAINST ESTIMATED
REBATE AMOUNTS FACTORED INTO FUTURE PRICES TO BE PAID BY PARTICIPANTS.
  2. THE COMMISSIONER MAY MAKE ARRANGEMENTS WITH MANUFACTURERS  CONCERN-
ING  THE  TIMING  OR  STRUCTURE  OF THE REBATE PAYMENTS AS IN HIS OR HER
DETERMINATION SHALL BEST FACILITATE LOWER PRICES FOR PARTICIPANTS, EXPE-
DITIOUS PAYMENT OF REBATES AND EFFICIENT ADMINISTRATION OF THE PROGRAM.
  S 280-F. REGISTRATION OF PARTICIPANTS. 1.  TO  BE  ELIGIBLE  TO  BE  A
PARTICIPANT,  A  PERSON  SHALL  BE A RESIDENT OF NEW YORK, REGARDLESS OF
AGE, WHO HAS A HOUSEHOLD INCOME EQUAL TO OR LESS THAN THE GREATER OF (A)
THREE HUNDRED FIFTY PERCENT OF THE FEDERAL POVERTY LEVEL FOR A HOUSEHOLD
OF THAT SIZE (AS DEFINED AND UPDATED BY THE UNITED STATES DEPARTMENT  OF
HEALTH  AND HUMAN SERVICES); OR (B) THE INCOME ELIGIBILITY LEVELS ESTAB-
LISHED UNDER SUBDIVISION ONE OR TWO OF SECTION TWO HUNDRED FORTY-TWO  OF
THE  ELDER  LAW,  IS  NOT  IN  RECEIPT OF MEDICAID, AND MEETS SUCH OTHER
REQUIREMENTS AS THE COMMISSIONER  MAY  ESTABLISH  CONSISTENT  WITH  THIS
TITLE.  ANY  PERSON  ENROLLED  IN THE PRESCRIPTION DRUG DISCOUNT PROGRAM
UNDER SECTION TWO HUNDRED EIGHTY-H OF THIS TITLE SHALL BE ELIGIBLE TO BE
A PARTICIPANT UNDER THIS PROGRAM.
  2. ANY PERSON ELIGIBLE TO BE A PARTICIPANT MAY BECOME A PARTICIPANT IN
THE PROGRAM BY REGISTERING WITH THE PROGRAM.  ANY PERSON ENROLLED IN THE
PRESCRIPTION DRUG DISCOUNT PROGRAM UNDER SECTION TWO HUNDRED EIGHTY-H OF
THIS TITLE SHALL AUTOMATICALLY BE REGISTERED BY THE COMMISSIONER IN THIS
PROGRAM.
  3. THE COMMISSIONER SHALL ADVISE EACH APPLICANT THAT THE PROGRAM  DOES
NOT  APPLY TO ANY PRESCRIPTION DRUG PURCHASE FOR WHICH REIMBURSEMENT (IN
WHOLE OR IN PART) IS PROVIDED BY ANY THIRD-PARTY PAYER. THE COMMISSIONER
MAY REQUIRE PERIODIC RE-REGISTRATION AND MAY REQUIRE THE PARTICIPANT  TO
INFORM  THE  PROGRAM  OF  ANY  CHANGE  IN  THE INFORMATION PROVIDED. THE
COMMISSIONER SHALL MAKE THE APPLICATION PROCESS AS SIMPLE AS  REASONABLY

S. 121--A                           5

POSSIBLE TO MAXIMIZE PARTICIPATION IN THE PROGRAM CONSISTENT WITH PROPER
ADMINISTRATION OF THIS TITLE.
  4.  THE COMMISSIONER SHALL REVIEW ALL APPLICATIONS TO DETERMINE IF THE
APPLICANT APPEARS TO MEET THE ELIGIBILITY REQUIREMENTS  FOR  THE  FAMILY
HEALTH  PLUS  PROGRAM  UNDER  SECTION THREE HUNDRED SIXTY-NINE-EE OF THE
SOCIAL SERVICES LAW, THE CHILD HEALTH INSURANCE  PROGRAM  UNDER  SECTION
TWENTY-FIVE  HUNDRED TEN AND TWENTY-FIVE HUNDRED ELEVEN OF THIS CHAPTER,
OR MEDICAL ASSISTANCE UNDER ARTICLE FIVE OF THE SOCIAL SERVICES LAW.  IF
THE  APPLICANT  DOES  APPEAR TO MEET ELIGIBILITY REQUIREMENTS FOR ANY OF
THOSE PROGRAMS, THE COMMISSIONER SHALL, IN ADDITION TO ANY OTHER ACTIONS
TAKEN UNDER THIS TITLE,  PROVIDE  THE  APPLICANT  WITH  INFORMATION  AND
ENROLLMENT  MATERIAL ABOUT SUCH OTHER PROGRAM. HOWEVER, THE COMMISSIONER
SHALL REGISTER THE APPLICANT UNDER THIS  SECTION  IF  THE  APPLICANT  IS
OTHERWISE ELIGIBLE.
  S 280-G. EDUCATION AND OUTREACH. THE COMMISSIONER SHALL CONDUCT EDUCA-
TION  AND  OUTREACH  TO  PROMOTE  THE  PROGRAM AND TO ENCOURAGE ELIGIBLE
PERSONS AND ENTITIES TO BECOME PARTICIPANTS AND PARTICIPATING RETAILERS.
  S 4. Section 280 of the public health law, as added by section  75  of
part  C  of chapter 58 of the laws of 2008, is renumbered section 280-h,
and amended to read as follows:
  S 280-h. Prescription drug discount program.  1. The prescription drug
discount program is hereby established in  the  department.    The  drug
discount  card  shall  be  available to any resident between the ages of
fifty and sixty-four, and any resident of any age who  has  been  deter-
mined  to  meet  the  disability  criteria in 20 C.F.R. S 404.1505, who:
meets the income eligibility levels established under subdivision one or
two of section two hundred forty-two of the elder law; is not in receipt
of medical assistance under title eleven of article five of  the  social
services  law.  The  drug  discount  card  shall offer discounts on drug
purchases which are not covered by other public or private  third  party
payment  sources.    Provided, however, that participation by a provider
pharmacy and drug manufacturers shall be voluntary and reimbursement  to
the  provider  pharmacy  under  the  drug discount card program shall be
adjudicated and paid within two business days for any rebates,  dispens-
ing  fees  and  drug  costs  not  paid by the resident eligible for such
program at the point of sale.
  2. THE COMMISSIONER SHALL, AS EXPEDITIOUSLY AS POSSIBLE, INTEGRATE THE
OPERATION OF THE PRESCRIPTION DRUG DISCOUNT PROGRAM UNDER  THIS  SECTION
WITH  THE  PRESCRIPTION  DRUG DISCOUNT PROGRAM UNDER SECTION TWO HUNDRED
EIGHTY-A OF THIS TITLE. WHEN THE COMMISSIONER BEGINS REGISTERING PARTIC-
IPANTS UNDER SECTION TWO HUNDRED EIGHTY-A OF THIS TITLE, HE OR SHE SHALL
CEASE ENROLLING PARTICIPANTS UNDER THIS SECTION.  ANY PERSON ENROLLED IN
THE PROGRAM UNDER THIS SECTION SHALL BE AUTOMATICALLY REGISTERED BY  THE
COMMISSIONER  IN  THE PROGRAM UNDER SECTION TWO HUNDRED EIGHTY-A OF THIS
TITLE.
  S 5. Section 280-h of the public health law,  as  amended  by  section
four of this act, is REPEALED.
  S  6. Severability.   If any provision of this act, or any application
of any provision of this act, is held to be invalid,  or  ruled  by  any
federal agency to violate or be inconsistent with any applicable federal
law  or  regulation, that shall not affect the validity or effectiveness
of any other provision of this act, or of any other application  of  any
provision of this act.
  S 7. This act shall take effect immediately; provided, however that:

S. 121--A                           6

  (a)  the  amendments  to  article 2-A of the public health law made by
sections two and four of this act shall not affect the  repeal  of  such
article and shall be deemed repealed therewith;
  (b)  section  five  of  this  act shall take effect on the one hundred
eightieth day after this act shall have become a law;
  (c) any  rebate  payment  due  from  any  drug  manufacturer  and  any
reimbursement  due under section 280-h of the public health law shall be
paid notwithstanding the repeal of section 280-h made by section five of
this act; and
  (d) the amendments to article 2-A of the public  health  law  made  by
section  three  of  this  act shall survive the expiration and repeal of
such article as provided in section 79 of part C of chapter  58  of  the
laws of 2005, as amended.

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Senate Bill S121

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2009-S121 - Details

2009-S121 - Summary

2009-S121 - Sponsor Memo

2009-S121 - Bill Text download pdf

co-Sponsors

2009-S121A (ACTIVE) - Details

2009-S121A (ACTIVE) - Summary

2009-S121A (ACTIVE) - Sponsor Memo

2009-S121A (ACTIVE) - Bill Text download pdf

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Senate Bill S121

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Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2009-S121 - Details

2009-S121 - Summary

2009-S121 - Sponsor Memo

2009-S121 - Bill Text download pdf

co-Sponsors

2009-S121A (ACTIVE) - Details

2009-S121A (ACTIVE) - Summary

2009-S121A (ACTIVE) - Sponsor Memo

2009-S121A (ACTIVE) - Bill Text download pdf

Comments