senate Bill S5000B

Signed By Governor
2009-2010 Legislative Session

Relates to eliminating cost-sharing, deductibles and co-payments for certain prescription drugs

download bill text pdf

Sponsored By

Archive: Last Bill Status - Signed by Governor


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed by Governor

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Actions

view actions (24)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Oct 08, 2010 approval memo.29
Oct 01, 2010 signed chap.536
Sep 20, 2010 delivered to governor
Jun 23, 2010 returned to senate
passed assembly
ordered to third reading rules cal.291
substituted for a8278b
Jun 03, 2010 referred to insurance
delivered to assembly
passed senate
May 17, 2010 amended on third reading 5000b
Apr 26, 2010 advanced to third reading
Apr 21, 2010 2nd report cal.
Apr 20, 2010 1st report cal.418
Jan 20, 2010 reported and committed to codes
Jan 13, 2010 print number 5000a
Jan 13, 2010 amend and recommit to health
Jan 06, 2010 referred to health
Jul 16, 2009 committed to rules
Jun 04, 2009 advanced to third reading
Jun 03, 2009 2nd report cal.
Jun 02, 2009 1st report cal.576
May 19, 2009 reported and committed to codes
Apr 27, 2009 referred to health

Votes

view votes

Apr 20, 2010 - Codes committee Vote

S5000A
11
1
committee
11
Aye
1
Nay
4
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show committee vote details

Jan 20, 2010 - Health committee Vote

S5000A
12
0
committee
12
Aye
0
Nay
5
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show committee vote details

Jun 2, 2009 - Codes committee Vote

S5000
10
1
committee
10
Aye
1
Nay
5
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show committee vote details

Co-Sponsors

S5000 - Details

See Assembly Version of this Bill:
A8278
Law Section:
Public Health Law
Laws Affected:
Amd §4406-c, Pub Health L; amd §§3216, 3221 & 4303, Ins L; amd §296, Exec L

S5000 - Summary

Provides that no health care plan or health insurance policy which provides coverage for prescription drugs and for which cost-sharing, deductibles or co-insurance obligations are determined by category of prescription drugs including, but not limited to, generic drugs, preferred brand drugs and non-preferred brand drugs, shall impose cost-sharing, deductibles or co-insurance obligations for any prescription drug that exceeds the dollar amount of cost-sharing, deductibles or co-insurance obligations for any other prescription drug provided under such coverage in the category of non-preferred brand drugs or their equivalents.

S5000 - Sponsor Memo

S5000 - Bill Text download pdf

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

                                  5000

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 27, 2009
                               ___________

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

AN ACT to amend the public health law and the insurance law, in relation
  to cost-sharing, deductible or co-insurance for tier  IV  prescription
  drugs; and to amend the executive law, in relation to unlawful discri-
  minatory practice in relation to tier IV prescription drugs

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

  Section 1. Legislative findings.  The  cost-sharing,  deductibles  and
co-insurance  obligations for certain drugs have become cost prohibitive
for persons trying to overcome serious diseases such as cancer, multiple
sclerosis, rheumatoid arthritis,  hepatitis  C,  and  hemophilia.  These
drugs are typically new, produced in lesser quantities than other drugs,
and  not  available as less expensive brand name or generic prescription
drugs. Some health insurance plans and policies have established  unique
categories  or specialty tiers for these drugs, sometimes referred to as
Tier IV or Tier V. Patients under these plans  are  required  to  pay  a
percentage  of  the  cost  of  these  high-priced drugs, rather than the
traditional co-payment amounts for generic, preferred  brand,  and  non-
preferred  brand  prescription  drugs, often covered by Tier I, Tier II,
and Tier III plans and policies, respectively.  As  a  result,  patients
covered  under Tier IV or Tier V plans or policies must pay thousands of
dollars in out-of-pocket costs for drugs critical for their treatment.
  It is in the public interest to  help  patients  to  afford  necessary
prescription drugs by prohibiting cost-sharing, deductibles and co-insu-
rance  obligations  by  patients  that exceed payments for non-preferred
brand prescription drugs or the equivalent thereof. It is not the intent
of this legislation to preclude  plans  or  policies  from  categorizing
drugs  used  in  the  treatment  of  these common diseases as brand name
prescription drugs or generic prescription drug equivalents.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11409-01-9

Co-Sponsors

view additional co-sponsors

S5000A - Details

See Assembly Version of this Bill:
A8278
Law Section:
Public Health Law
Laws Affected:
Amd §4406-c, Pub Health L; amd §§3216, 3221 & 4303, Ins L; amd §296, Exec L

S5000A - Summary

Provides that no health care plan or health insurance policy which provides coverage for prescription drugs and for which cost-sharing, deductibles or co-insurance obligations are determined by category of prescription drugs including, but not limited to, generic drugs, preferred brand drugs and non-preferred brand drugs, shall impose cost-sharing, deductibles or co-insurance obligations for any prescription drug that exceeds the dollar amount of cost-sharing, deductibles or co-insurance obligations for any other prescription drug provided under such coverage in the category of non-preferred brand drugs or their equivalents.

S5000A - Sponsor Memo

S5000A - Bill Text download pdf

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

                                 5000--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 27, 2009
                               ___________

Introduced  by  Sens.  DUANE,  ESPADA,  KRUEGER, MONSERRATE, MONTGOMERY,
  VALESKY -- read twice and ordered printed,  and  when  printed  to  be
  committed  to  the Committee on Health -- recommitted to the Committee
  on Health 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 public health law and the insurance law, in relation
  to  cost-sharing,  deductible or co-insurance for tier IV prescription
  drugs; and to amend the executive law, in relation to unlawful discri-
  minatory practice in relation to tier IV prescription drugs

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

  Section  1.  Legislative  findings.  The cost-sharing, deductibles and
co-insurance obligations for certain drugs have become cost  prohibitive
for persons trying to overcome serious diseases such as cancer, multiple
sclerosis,  rheumatoid  arthritis,  hepatitis  C,  and hemophilia. These
drugs are typically new, produced in lesser quantities than other drugs,
and not available as less expensive brand name or  generic  prescription
drugs.  Some health insurance plans and policies have established unique
categories or specialty tiers for these drugs, sometimes referred to  as
Tier  IV  or  Tier  V.  Patients under these plans are required to pay a
percentage of the cost of  these  high-priced  drugs,  rather  than  the
traditional  co-payment  amounts  for generic, preferred brand, and non-
preferred brand prescription drugs, often covered by Tier  I,  Tier  II,
and  Tier  III  plans  and policies, respectively. As a result, patients
covered under Tier IV or Tier V plans or policies must pay thousands  of
dollars in out-of-pocket costs for drugs critical for their treatment.
  It  is  in  the  public  interest to help patients to afford necessary
prescription drugs by prohibiting cost-sharing, deductibles and co-insu-
rance obligations by patients that  exceed  payments  for  non-preferred
brand prescription drugs or the equivalent thereof. It is not the intent

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11409-02-0

Co-Sponsors

view additional co-sponsors

S5000B (ACTIVE) - Details

See Assembly Version of this Bill:
A8278
Law Section:
Public Health Law
Laws Affected:
Amd §4406-c, Pub Health L; amd §§3216, 3221 & 4303, Ins L; amd §296, Exec L

S5000B (ACTIVE) - Summary

Provides that no health care plan or health insurance policy which provides coverage for prescription drugs and for which cost-sharing, deductibles or co-insurance obligations are determined by category of prescription drugs including, but not limited to, generic drugs, preferred brand drugs and non-preferred brand drugs, shall impose cost-sharing, deductibles or co-insurance obligations for any prescription drug that exceeds the dollar amount of cost-sharing, deductibles or co-insurance obligations for any other prescription drug provided under such coverage in the category of non-preferred brand drugs or their equivalents.

S5000B (ACTIVE) - Sponsor Memo

S5000B (ACTIVE) - Bill Text download pdf

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

                                 5000--B
    Cal. No. 418

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 27, 2009
                               ___________

Introduced  by Sens. DUANE, DILAN, ESPADA, KRUEGER, MONTGOMERY, PERKINS,
  THOMPSON, VALESKY -- read twice and ordered printed, and when  printed
  to  be  committed  to  the  Committee  on Health -- recommitted to the
  Committee on Health in accordance  with  Senate  Rule  6,  sec.  8  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee -- reported favorably from said  commit-
  tee and committed to the Committee on Codes -- reported favorably from
  said committee, ordered to first and second report, ordered to a third
  reading,  amended  and  ordered  reprinted, retaining its place in the
  order of third reading

AN ACT to amend the public health law and the insurance law, in relation
  to cost-sharing, deductible or co-insurance for tier  IV  prescription
  drugs; and to amend the executive law, in relation to unlawful discri-
  minatory practice in relation to tier IV prescription drugs

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

  Section 1. Legislative findings.  The  cost-sharing,  deductibles  and
co-insurance obligations for certain drugs are becoming cost prohibitive
for  persons  trying  to  overcome  serious  and  often life-threatening
diseases and conditions such as cancer, multiple  sclerosis,  rheumatoid
arthritis, hepatitis C, hemophilia and psoriasis.  These drugs are typi-
cally  new,  produced  in  lesser  quantities  than other drugs, and not
available as less expensive brand name or  generic  prescription  drugs.
Some health insurance plans and policies in other states as well as some
self-insured  plans  in  New  York have established unique categories or
specialty tiers for these drugs, sometimes referred to  as  Tier  IV  or
Tier  V.  Patients under these plans are required to pay a percentage of
the cost of these high-priced drugs, rather than the traditional co-pay-
ment amounts for  generic,  preferred  brand,  and  non-preferred  brand
prescription drugs, often covered by Tier I, Tier II, and Tier III plans
and  policies,  respectively.  As a result, patients covered under plans

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

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