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Senate Bill S4786

Signed By Governor

2009-2010 Legislative Session

Relates to co-payments for prescription drugs

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Archive: Last Bill Status Via A5653 - Signed by Governor

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Bill Amendments

co-Sponsors

2009-S4786 - Details

Law Section:
Insurance Law
Laws Affected:
Amd §4325, Ins L; amd §4406-c, Pub Health L; add §6826-a, Ed L

2009-S4786 - Summary

Prohibits insurers, HMO's and health plans from charging a copayment for a prescription drug which is higher than the usual and customary cost of such drug.

2009-S4786 - Sponsor Memo

2009-S4786 - Bill Text download pdf 

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

                                  4786

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 27, 2009
                               ___________

Introduced  by  Sen. KRUEGER -- read twice and ordered printed, and when
  printed to be committed to the Committee on Insurance

AN ACT to amend the insurance law, the public health law and the  educa-
  tion law, in relation to copayments for prescription drugs

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

  Section 1. Subsection (g) of section 4325 of  the  insurance  law,  as
relettered  by chapter 586 of the laws of 1998, is relettered subsection
(i) and a new subsection (g) is added to read as follows:
  (G) NO CORPORATION OR INSURER ORGANIZED OR LICENSED UNDER THIS CHAPTER
WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL REQUIRE,  OR  ENTER
INTO  A  CONTRACT WHICH PERMITS, A COPAYMENT WHICH EXCEEDS THE USUAL AND
CUSTOMARY COST OF SUCH PRESCRIBED DRUG.
  S 2. Subdivision 6 of section 4406-c  of  the  public  health  law  is
renumbered  subdivision  7  and  a new subdivision 6 is added to read as
follows:
  6. NO HEALTH CARE PLAN WHICH PROVIDES COVERAGE FOR PRESCRIPTION  DRUGS
SHALL REQUIRE, OR ENTER INTO A CONTRACT WHICH PERMITS, A COPAYMENT WHICH
EXCEEDS THE USUAL AND CUSTOMARY COST OF SUCH PRESCRIBED DRUG.
  S  3.  The  education law is amended by adding a new section 6826-a to
read as follows:
  S 6826-A. REDUCING CERTAIN COPAYMENTS. 1. WHERE AN INSURED'S COPAYMENT
FOR A DRUG EXCEEDS THE CORRESPONDING RETAIL PRICE FOR THE SAME  DRUG  ON
THE  PHARMACY'S  DRUG RETAIL PRICE LIST, THE PHARMACIST SHALL NOTIFY THE
INSURED OF THIS OCCURRENCE AND CHARGE NO  GREATER  THAN  THE  PHARMACY'S
CORRESPONDING RETAIL PRICE.
  2.  WHERE  THE  DRUG  BEING  PURCHASED IS NOT ON THE DRUG RETAIL PRICE
LIST, AND THE COPAYMENT FOR THE DRUG EXCEEDS THE  PHARMACY'S  USUAL  AND
CUSTOMARY  PRICE  FOR THAT DRUG, THE PHARMACIST SHALL NOTIFY THE INSURED
OF THIS OCCURRENCE AND CHARGE THE LESSER OF THE INSURED'S COPAYMENT  AND
THE PHARMACY'S USUAL AND CUSTOMARY PRICE FOR THAT DRUG.
  S  4.  This  act shall take effect on the ninetieth day after it shall
have become a law.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

co-Sponsors

2009-S4786A (ACTIVE) - Details

Law Section:
Insurance Law
Laws Affected:
Amd §4325, Ins L; amd §4406-c, Pub Health L; add §6826-a, Ed L

2009-S4786A (ACTIVE) - Summary

Prohibits insurers, HMO's and health plans from charging a copayment for a prescription drug which is higher than the usual and customary cost of such drug.

2009-S4786A (ACTIVE) - Sponsor Memo

2009-S4786A (ACTIVE) - Bill Text download pdf 

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

                                 4786--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 27, 2009
                               ___________

Introduced  by Sens. KRUEGER, ADDABBO -- read twice and ordered printed,
  and when printed to be committed to  the  Committee  on  Insurance  --
  recommitted  to  the  Committee on Insurance in accordance with Senate
  Rule  6,  sec.  8  --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

AN  ACT to amend the insurance law, the public health law and the educa-
  tion law, in relation to copayments for prescription drugs

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

  Section  1.  Subsections  (h) and (i) of section 4325 of the insurance
law, as relettered by chapter 237 of the laws of  2009,  are  relettered
subsections  (i)  and  (j)  and a new subsection (h) is added to read as
follows:
  (H) NO CORPORATION OR INSURER ORGANIZED OR LICENSED UNDER THIS CHAPTER
WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL REQUIRE,  OR  ENTER
INTO  A  CONTRACT WHICH PERMITS, A COPAYMENT WHICH EXCEEDS THE USUAL AND
CUSTOMARY COST OF SUCH PRESCRIBED DRUG.
  S 2. Subdivision 6 of section 4406-c  of  the  public  health  law  is
renumbered  subdivision  7  and  a new subdivision 6 is added to read as
follows:
  6. NO HEALTH CARE PLAN WHICH PROVIDES COVERAGE FOR PRESCRIPTION  DRUGS
SHALL REQUIRE, OR ENTER INTO A CONTRACT WHICH PERMITS, A COPAYMENT WHICH
EXCEEDS THE USUAL AND CUSTOMARY COST OF SUCH PRESCRIBED DRUG.
  S  3.  The  education law is amended by adding a new section 6826-a to
read as follows:
  S 6826-A. REDUCING CERTAIN COPAYMENTS. 1. WHERE AN INSURED'S COPAYMENT
FOR A DRUG EXCEEDS THE CORRESPONDING RETAIL PRICE FOR THE SAME  DRUG  ON
THE  PHARMACY'S  DRUG RETAIL PRICE LIST, THE PHARMACIST SHALL NOTIFY THE
INSURED OF THIS OCCURRENCE AND CHARGE NO  GREATER  THAN  THE  PHARMACY'S
CORRESPONDING RETAIL PRICE.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06117-05-0

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