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

                                  4536

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 4, 2011
                               ___________

Introduced  by  M.  of  A.  ENGLEBRIGHT -- read once and referred to the
  Committee on Aging

AN ACT to amend the elder law, in relation to  creating  the  pharmaceu-
  tical local choice program

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

  Section 1. Article 2 of the elder law is amended by adding a new title
5 to read as follows:
                                  TITLE 5
                        MISCELLANEOUS PROVISIONS

SECTION 260. PHARMACEUTICAL LOCAL CHOICE PROGRAM.
  S 260. PHARMACEUTICAL LOCAL CHOICE PROGRAM. 1. ANY  PROVISION  OF  ANY
OTHER LAW TO THE CONTRARY NOTWITHSTANDING, EVERY HEALTH INSURANCE POLICY
WHICH  PROVIDES  COVERAGE  TO ANY PERSON SIXTY YEARS OF AGE OR OLDER FOR
PRESCRIBED DRUGS  THAT  INCLUDES  A  REQUIREMENT  THAT  INSUREDS  OBTAIN
PRESCRIPTION  DRUGS  FROM  A  NON-RESIDENT  ESTABLISHMENT, AS DEFINED IN
SECTION SIXTY-EIGHT HUNDRED EIGHT-B OF THE EDUCATION  LAW,  SHALL  ADDI-
TIONALLY  PROVIDE  THAT AN INSURED MAY OBTAIN SUCH PRESCRIPTION DRUGS IN
THE QUANTITY ALLOWED BY LAW AS ORDERED BY A PRESCRIBER  LEGALLY  AUTHOR-
IZED  TO  WRITE  A  PRESCRIPTION, IN ANY THERAPEUTIC CATEGORY OR FOR ANY
MEDICAL CONDITION WITHOUT ANY FINANCIAL DISINCENTIVE OR PENALTY  FROM  A
PHARMACY REGISTERED WITH THE DEPARTMENT OF EDUCATION PURSUANT TO SECTION
SIXTY-EIGHT HUNDRED EIGHT OF THE EDUCATION LAW WHICH, INSOFAR AS REASON-
ABLE,  SHALL  BE  LOCATED  AND  ACCESSIBLE IN THE LOCAL COMMUNITY OF THE
INSURED AND  WHICH  SHALL  BE  A  PHARMACY  UNDER  CONTRACT  TO  PROVIDE
PRESCRIPTION  DRUGS  FOR THE INSURED.  FOR PURPOSES OF THIS SECTION, THE
TERM "HEALTH INSURANCE POLICY" SHALL MEAN  AND  INCLUDE  ANY  POLICY  OF
ACCIDENT  AND  HEALTH INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS
STATE, AS DESCRIBED IN SUBSECTION (I)  OF  SECTION  THREE  THOUSAND  TWO
HUNDRED  SIXTEEN  OF THE INSURANCE LAW, TO ANY PERSON SIXTY YEARS OF AGE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08850-01-1
              

A. 4536                             2

OR OLDER AND ANY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR  DELIV-
ERY  IN  THIS  STATE, AS DESCRIBED IN SECTION THREE THOUSAND TWO HUNDRED
TWENTY-ONE OF THE INSURANCE LAW TO ANY PERSON  SIXTY  YEARS  OF  AGE  OR
OLDER.
  2.  THE  PROVISIONS  OF  SUBDIVISION ONE OF THIS SECTION (A) SHALL NOT
APPLY TO HEALTH INSURANCE POLICIES THE PROVISIONS OF WHICH  ARE  SUBJECT
TO  COLLECTIVE  BARGAINING  AGREEMENTS WHICH ARE IN CONTRADICTION TO THE
REQUIREMENTS OF SUCH SUBDIVISION OR WHICH ARE PREEMPTED BY  ANY  FEDERAL
LAW,  RULE  OR  OTHER  REGULATION;  (B) SHALL ONLY APPLY TO POLICIES AND
CONTRACTS ISSUED, RENEWED, MODIFIED, ALTERED OR AMENDED ON OR AFTER  THE
EFFECTIVE  DATE OF THIS SECTION; AND (C) SHALL NOT IMPOSE OR REQUIRE ANY
OTHER DIFFERENCES IN TREATMENT FOR THE USE OF SUCH LOCAL  PHARMACY  WITH
RESPECT TO CO-PAYMENTS OR QUANTITY LIMITATIONS OR OTHER SIMILAR PAYMENTS
OR LIMITATIONS.
  S 2. This act shall take effect July 1, 2011.