NY State Senate Bill 2009-S423

Senate Bill S423

2009-2010 Legislative Session

Prohibits contracts that include any incentive plan that includes specific payment to a health care provider as an inducement to change a prescription

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance 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

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2010	referred to insurance
Jan 07, 2009	referred to insurance

2009-S423 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §3217-b, Ins L

2009-S423 (ACTIVE) - Summary

Prohibits contracts that include any incentive plan that includes specific payment to a health care provider as an inducement to change a prescription for a drug or medical product issued to a covered person from one specific drug or medical product to another.

2009-S423 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S423

 TITLE OF BILL :
An act to amend the insurance law, in relation to prohibiting drug
switching payments


 PURPOSE :
Prohibits contracts that include any incentive plan that includes
specific payment to a health care provider as an inducement to change
a prescription

 SUMMARY OF PROVISIONS :
Section 1 amends 3217-b of the insurance law by adding a new
subsection (i).

Section 2 states that this act shall take effect on the ninetieth day
after it shall have become law.

 JUSTIFICATION :
Many employers and health plans have adopted incentive-based
formularies in an attempt to control prescription drug costs. For
several years, doctors have been accepting these bonuses or
performance incentives from health plans for boosting their patients'
use of generic drugs. Although increasing the use of generics can save
health plans a great deal of money, this practice may compromise the

patient's health. Offering physicians incentives to switch their
patients' prescription is unethical as it may influence their judgment
on what should purely be a medical decision.  Under no circumstances
should an HMO ask a physician to place their own financial interests
above the welfare of their patients.

The incentive program that has drawn the most scrutiny is one
initiated last year by Blue Care Network. Under the three-month
program, primary care physicians were asked to consider switching
patients from a brand-name drug and received $100 for each plan member
who filled a generic cholesterol-lowering statin prescription.  In an
effort to assist doctors, the HMO mailed them a list of members who
were taking brand-name statins. Blue Care Network spent $2 million in
payments to doctors in compliance. In response to this program, the
American Medical Association posted a document on its website
challenging the use of such programs, while states such as Michigan
and Massachusetts conducted hearings and introduced legislation to
regulate such programs.

 LEGISLATIVE HISTORY :
2007/2008 - S.7938 Remained in the Senate Committee on Insurance

 FISCAL IMPLICATIONS :
None.

 EFFECTIVE DATE :
This act shall take effect on the ninetieth day after it shall have
become a law.

2009-S423 (ACTIVE) - Bill Text download pdf

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

                                   423

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 7, 2009
                               ___________

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

AN ACT to amend the insurance  law,  in  relation  to  prohibiting  drug
  switching payments

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

  Section 1. Section 3217-b of the insurance law is amended by adding  a
new subsection (i) to read as follows:
  (I)  NO CONTRACT OR AGREEMENT BETWEEN AN INSURER SUBJECT TO THIS ARTI-
CLE AND A HEALTH CARE PROVIDER SHALL INCLUDE  ANY  INCENTIVE  PLAN  THAT
INCLUDES A SPECIFIC PAYMENT TO THE HEALTH CARE PROVIDER AS AN INDUCEMENT
TO  CHANGE  A  PRESCRIPTION  FOR  A  DRUG OR MEDICAL PRODUCT ISSUED TO A
COVERED PERSON FROM ONE SPECIFIC DRUG OR  MEDICAL  PRODUCT  TO  ANOTHER.
NOTHING  IN  THIS  SUBSECTION SHALL PROHIBIT INCENTIVE PLANS THAT DO NOT
MAKE REFERENCE TO ANY SPECIFIC PRESCRIPTION DRUG OR MEDICAL PRODUCT.  IN
THE  EVENT  OF  A  VIOLATION  OF  THIS SUBSECTION, THE SUPERINTENDENT IS
AUTHORIZED TO IMPOSE A FINE ON SUCH INSURER IN AN AMOUNT OF TEN THOUSAND
DOLLARS PER VIOLATION.
  S 2. 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
                      [ ] is old law to be omitted.
                                                           LBD03615-01-9

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