NY State Assembly Bill 2009-A8858

Assembly Bill A8858

2009-2010 Legislative Session

Relates to pharmaceutical reimbursement under the EPIC program and Medicaid for certain small pharmacies

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Archive: Last Bill Status - In Assembly 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 aging
Jun 11, 2009	referred to aging

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multi-Sponsors

2009-A8858 (ACTIVE) - Details

See Senate Version of this Bill:: S2229
Current Committee:: Assembly Aging
Law Section:: Elder Law
Laws Affected:: Amd §250, Eld L; amd §367-a, Soc Serv L
Versions Introduced in 2011-2012 Legislative Session:: A647

2009-A8858 (ACTIVE) - Summary

Relates to pharmaceutical reimbursement under the EPIC program and Medicaid for pharmacies that it is determined dispense on average under two hundred scripts a day.

2009-A8858 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:A8858

TITLE OF BILL:
An act to amend the elder law and the social services law, in relation
to pharmaceutical reimbursement under the EPIC program and Medicaid for
certain pharmacies

PURPOSE:
This legislation sets forth the pharmaceutical reimbursement rate for
Medicaid and the Elderly Pharmaceutical Insurance Coverage program for
smaller pharmacies.

SUMMARY OF PROVISIONS:
Section 1 of the bill amends Section 250(1)(b) (1) of the Elder Law to
set reimbursement rates for brand name drugs under EPIC to pharmacies
which write under 200 prescriptions a day on average at Average
Wholesale Price (AWP) minus 14 percent.

Section 2 of the bill amends Section 367-a(9)(b)(ii) of the Social
Services Law setting the pharmaceutical reimbursement rates for brand
name drugs under the Medicaid program to pharmacies which dispense under
200 prescriptions a day on average at AWP minus 14 percent.

Section 3 sets forth an immediate effective date, provided, however,
that the amendments to subdivision 9 of section 367-a of the social
services law made by section two of this act shall not affect the

expiration of such subdivision and shall be deemed to expire therewith;
and provided, however, that effective immediately, the addition,
amendment and/or repeal of any rule or regulation necessary for the
implementation of this act on its effective date ~s authorized and
directed to be made and completed on or before such effective date.

JUSTIFICATION:
In the 2008-09 Enacted Budget, pharmaceutical reimbursement for EPIC and
Medicaid for brand name drugs was reduced from (AWP) minus 14 percent to
AWP minus 16.25 percent. Larger pharmacies and chain pharmacies are in a
better position to deal with this decrease than smaller pharmacies. The
amount of business these pharmacies do puts them in a better bargaining
position with drug manufacturers when procuring medication, whereas
smaller pharmacies do not have this advantage. This legislation would
place small pharmacies on a level playing field by reinstituting the
prior reimbursement rate.

LEGISLATIVE HISTORY:
06/03/08 S.7929A Finance; 05/27/08 - A11274 Aging

FISCAL IMPLICATIONS:
To be determined.

EFFECTIVE DATE:
Immediately.

2009-A8858 (ACTIVE) - Bill Text download pdf

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

                                  8858

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                              June 11, 2009
                               ___________

Introduced  by  M.  of  A. GUNTHER, SAYWARD, CHRISTENSEN, REILLY, SPANO,
  DUPREY, BURLING, BACALLES, KOLB, SCOZZAFAVA, RAIA,  MOLINARO,  CALHOUN
  --  Multi-Sponsored by -- M.  of A. CROUCH, EDDINGTON, McKEVITT, WEIS-
  ENBERG -- read once and referred to the Committee on Aging

AN ACT to amend the elder law and the social services law,  in  relation
  to  pharmaceutical  reimbursement  under the EPIC program and Medicaid
  for certain pharmacies

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

  Section 1. Subparagraph 1 of paragraph (b) of subdivision 1 of section
250 of the elder law, as amended by section 1 of part A of chapter 58 of
the laws of 2008, is amended and a new subparagraph 1-a is added to read
as follows:
  (1)  Average wholesale price discounted by sixteen and twenty-five one
hundredths percent, plus a dispensing fee as defined in paragraph (c) of
this subdivision, [or]
  (1-A) AVERAGE WHOLESALE PRICE DISCOUNTED BY  FOURTEEN  PERCENT  FOR  A
SMALL  PHARMACY,  PLUS  A  DISPENSING FEE AS DEFINED IN PARAGRAPH (C) OF
THIS SUBDIVISION. FOR THE PURPOSES OF THIS SUBPARAGRAPH, A "SMALL  PHAR-
MACY"  SHALL  MEAN  A  PHARMACY, APPROVED BY THE COMMISSIONER OF HEALTH,
WHICH IS DETERMINED BY THE COMMISSIONER OF HEALTH TO DISPENSE ON AVERAGE
UNDER TWO HUNDRED SCRIPTS A DAY, OR
  S 2. Subparagraph (ii) of paragraph (b) of subdivision  9  of  section
367-a  of  the social services law, as amended by section 4 of part C of
chapter 58 of the laws of 2008, is amended and a new  paragraph  (i)  is
added to read as follows:
  (ii) if the drug dispensed is a multiple source prescription drug or a
brand-name  prescription drug for which no specific upper limit has been
set by such federal agency, the lower of the estimated acquisition  cost
of  such  drug  to  pharmacies,  or  the dispensing pharmacy's usual and
customary price charged to the general public.  For  sole  and  multiple

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00965-03-9

A. 8858                             2

source  brand  name  drugs, estimated acquisition cost means the average
wholesale price of a prescription  drug  based  upon  the  package  size
dispensed  from,  as  reported  by the prescription drug pricing service
used  by  the  department,  less  sixteen and twenty-five one hundredths
percent thereof, and updated monthly by  the  department;  FOR  A  SMALL
PHARMACY,  AS  DEFINED IN PARAGRAPH (I) OF THIS SUBDIVISION, ACQUISITION
COSTS MEANS THE AVERAGE WHOLESALE PRICE OF  A  PRESCRIPTION  DRUG  BASED
UPON  THE  PACKAGE  SIZE DISPENSED FROM, AS REPORTED BY THE PRESCRIPTION
DRUG PRICING SERVICE USED BY THE DEPARTMENT, LESS FOURTEEN PERCENT THER-
EOF, AND UPDATED MONTHLY BY THE DEPARTMENT; or, for  a  specialized  HIV
pharmacy,  as  defined in paragraph (f) of this subdivision, acquisition
cost means the average wholesale price of a prescription drug based upon
the package size dispensed from, as reported by  the  prescription  drug
pricing service used by the department, less twelve percent thereof, and
updated  monthly  by  the department. For multiple source generic drugs,
estimated acquisition cost means the  lower  of  the  average  wholesale
price  of  a prescription drug based on the package size dispensed from,
as reported by the prescription drug pricing service used by the depart-
ment, less twenty-five percent thereof, or the maximum acquisition cost,
if any, established pursuant to paragraph (e) of this  subdivision;  or,
for  a  specialized  HIV  pharmacy,  as defined in paragraph (f) of this
subdivision, acquisition cost means the lower of the  average  wholesale
price  of  a prescription drug based on the package size dispensed from,
as reported by the prescription drug pricing service used by the depart-
ment, less twelve percent thereof, or the maximum acquisition  cost,  if
any, established pursuant to paragraph (e) of this subdivision.
  (I)  FOR PURPOSES OF THIS SECTION, A SMALL PHARMACY SHALL MEAN A PHAR-
MACY WHICH IS INDEPENDENTLY  OWNED,  APPROVED  BY  THE  COMMISSIONER  OF
HEALTH,  AND  WHICH  IS  DETERMINED  BY  THE  COMMISSIONER  OF HEALTH TO
DISPENSE ON AVERAGE UNDER TWO HUNDRED SCRIPTS A DAY.
  S 3. This act shall take effect immediately; provided,  however,  that
the  amendments to subdivision 9 of section 367-a of the social services
law made by section two of this act shall not affect the  expiration  of
such  subdivision  and  shall  be deemed to expire therewith.  Effective
immediately, the addition, amendment and/or repeal of any rule or  regu-
lation  necessary  for  the  implementation of this act on its effective
date is authorized and directed to be made and completed  on  or  before
such effective date.

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Assembly Bill A8858

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Sponsored By

GUNTHER

Archive: Last Bill Status - In Assembly Committee

co-Sponsors

Teresa Sayward

Joan Christensen

Robert Reilly

Mike Spano

multi-Sponsors

Clifford Crouch

Thomas McKevitt

Harvey Weisenberg

2009-A8858 (ACTIVE) - Details

2009-A8858 (ACTIVE) - Summary

2009-A8858 (ACTIVE) - Sponsor Memo

2009-A8858 (ACTIVE) - Bill Text download pdf

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