assembly Bill A5502B

Signed By Governor
2011-2012 Legislative Session

Prohibits health insurers from requiring insureds purchase prescribed drugs from mail order pharmacy

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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

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Dec 12, 2011 approval memo.14
signed chap.597
Nov 30, 2011 delivered to governor
Jun 20, 2011 returned to assembly
passed senate
3rd reading cal.1383
substituted for s3510b
Jun 15, 2011 referred to rules
delivered to senate
passed assembly
May 26, 2011 advanced to third reading cal.462
May 24, 2011 reported
May 17, 2011 print number 5502b
amend and recommit to insurance
Apr 25, 2011 print number 5502a
amend and recommit to insurance
Feb 22, 2011 referred to insurance

Votes

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Bill Amendments

Original
A
B (Active)
Original
A
B (Active)

Co-Sponsors

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A5502 - Bill Details

See Senate Version of this Bill:
S3510B
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2009-2010 Legislative Session:
A1267A, S6007

A5502 - Bill Texts

view summary

Prohibits health insurers from requiring the insured purchase prescribed drugs from a mail order pharmacy or pay a co-payment fee when such purchases are not made from a mail order pharmacy if a similar fee is not charged for drugs from a mail order pharmacy.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  5502

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 22, 2011
                               ___________

Introduced  by  M.  of  A.  HEASTIE,  COLTON, ROSENTHAL -- read once and
  referred to the Committee on Insurance

AN ACT to amend the insurance  law,  in  relation  to  the  purchase  of
  prescription drugs

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

  Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
amended by adding a new paragraph 28 to read as follows:
  (28)  NO  POLICY  WHICH  PROVIDES  COVERAGE FOR PRESCRIBED DRUGS SHALL
MANDATE THAT THE SAME BE PURCHASED BY THE  INSURED  FROM  A  MAIL  ORDER
PHARMACY, NOR MAY SUCH POLICY IMPOSE A CO-PAYMENT FEE OR OTHER CONDITION
ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM OTHER THAN A MAIL ORDER
PHARMACY  WHICH  IS  NOT  ALSO  IMPOSED ON INSUREDS ELECTING TO PURCHASE
DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER, THAT THE
PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A COLLECTIVE
BARGAINING AGREEMENT OR APPLY TO A  POLICY  THAT  IS  THE  RESULT  OF  A
COLLECTIVE  BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOGNIZED OR
CERTIFIED EMPLOYEE ORGANIZATION. NOTHING IN THIS PARAGRAPH  SHALL  ALTER
ANY  PROVISIONS  OF  SECTIONS  THIRTEEN  AND  THIRTEEN-O OF THE WORKERS'
COMPENSATION LAW REGARDING THE PURCHASE OF PRESCRIPTION  DRUGS  AND  THE
USE OF MAIL ORDER PHARMACY.
  S 2. Subsection (1) of section 3221 of the insurance law is amended by
adding a new paragraph 18 to read as follows:
  (18)  NO  INSURER  DELIVERING  A  GROUP OR BLANKET POLICY OR ISSUING A
GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES COVER-
AGE FOR PRESCRIBED DRUGS SHALL MANDATE THAT THE SAME BE PURCHASED BY THE
INSURED FROM A MAIL ORDER PHARMACY, NOR MAY SUCH POLICY IMPOSE A CO-PAY-
MENT FEE OR OTHER CONDITION ON ANY INSURED WHO ELECTS TO PURCHASE  DRUGS
FROM  OTHER  THAN  A  MAIL  ORDER  PHARMACY WHICH IS NOT ALSO IMPOSED ON
INSUREDS ELECTING TO PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMA-
CY; PROVIDED, HOWEVER, THAT THE PROVISIONS OF  THIS  SECTION  SHALL  NOT

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09145-01-1

A. 5502                             2

SUPERSEDE  THE  TERMS OF A COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A
POLICY THAT IS THE RESULT OF A COLLECTIVE BARGAINING  AGREEMENT  BETWEEN
AN EMPLOYER AND A RECOGNIZED OR CERTIFIED EMPLOYEE ORGANIZATION. NOTHING
IN  THIS  PARAGRAPH  SHALL ALTER ANY PROVISIONS OF SECTIONS THIRTEEN AND
THIRTEEN-O OF THE WORKERS' COMPENSATION LAW REGARDING  THE  PURCHASE  OF
PRESCRIPTION DRUGS AND THE USE OF MAIL ORDER PHARMACY.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (hh) to read as follows:
  (HH) NO POLICY ISSUED BY A MEDICAL EXPENSE  INDEMNITY  CORPORATION,  A
HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH SERVICES CORPORATION WHICH
PROVIDES COVERAGE FOR PRESCRIBED DRUGS SHALL MANDATE THAT  THE  SAME  BE
PURCHASED BY THE INSURED FROM A MAIL ORDER PHARMACY, NOR MAY SUCH POLICY
IMPOSE  A CO-PAYMENT FEE OR OTHER CONDITION ON ANY INSURED WHO ELECTS TO
PURCHASE DRUGS FROM OTHER THAN A MAIL ORDER PHARMACY WHICH IS  NOT  ALSO
IMPOSED  ON  INSUREDS  ELECTING TO PURCHASE DRUGS FROM A DESIGNATED MAIL
ORDER PHARMACY; PROVIDED, HOWEVER, THAT THE PROVISIONS OF  THIS  SECTION
SHALL  NOT  SUPERSEDE  THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT OR
APPLY TO A POLICY THAT IS THE RESULT OF A COLLECTIVE  BARGAINING  AGREE-
MENT  BETWEEN  AN EMPLOYER AND A RECOGNIZED OR CERTIFIED EMPLOYEE ORGAN-
IZATION. NOTHING IN  THIS  SUBSECTION  SHALL  ALTER  ANY  PROVISIONS  OF
SECTIONS  THIRTEEN  AND  THIRTEEN-O  OF  THE  WORKERS'  COMPENSATION LAW
REGARDING THE PURCHASE OF PRESCRIPTION DRUGS AND THE USE OF  MAIL  ORDER
PHARMACY.
  S  4.  The  opening  paragraph  of  paragraph  25 of subsection (b) of
section 4322 of the insurance law, as amended by chapter 554 of the laws
of 2002, is amended to read as follows:
  Prescription drugs, including contraceptive drugs or devices  approved
by  the  federal  food  and  drug  administration or generic equivalents
approved as substitutes by such food and drug administration and  nutri-
tional supplements (formulas) for the therapeutic treatment of phenylke-
tonuria,  branched-chain  ketonuria,  galactosemia  and  homocystinuria,
obtained at a participating pharmacy under a prescription written by  an
in-plan  or  out-of-plan  provider. Health maintenance organizations, in
addition to providing coverage for prescription drugs at a participating
pharmacy, may utilize a mail order prescription drug program.   HOWEVER,
NO HEALTH MAINTENANCE ORGANIZATION SHALL MANDATE THAT PRESCRIPTION DRUGS
BE PURCHASED BY THE INSURED FROM A MAIL ORDER PHARMACY; PROVIDED, HOWEV-
ER, THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF
A  COLLECTIVE  BARGAINING  AGREEMENT  OR  APPLY  TO A POLICY THAT IS THE
RESULT OF A COLLECTIVE BARGAINING AGREEMENT BETWEEN AN  EMPLOYER  AND  A
RECOGNIZED OR CERTIFIED EMPLOYEE ORGANIZATION. NOTHING IN THIS PARAGRAPH
SHALL  ALTER  ANY  PROVISIONS OF SECTIONS THIRTEEN AND THIRTEEN-O OF THE
WORKERS' COMPENSATION LAW REGARDING THE PURCHASE OF  PRESCRIPTION  DRUGS
AND THE USE OF MAIL ORDER PHARMACY. Health maintenance organizations may
provide prescription drugs pursuant to a drug formulary; however, health
maintenance  organizations must implement an appeals process so that the
use of non-formulary prescription drugs may be requested by a  physician
or other provider.
  S 5. If any clause, subparagraph, subsection, section or other part of
this  act, or the  application thereof be held to be invalid, such hold-
ing shall not affect, impair or invalidate the remainder of this act, or
the application of such section or part of a section held invalid.
  S 6. This act shall take effect on the thirtieth day  after  it  shall
have  become a law and shall apply to all policies and contracts issued,
renewed, modified, altered or amended on or after such effective date.

Co-Sponsors

view all co-sponsors

A5502A - Bill Details

See Senate Version of this Bill:
S3510B
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2009-2010 Legislative Session:
A1267A, S6007

A5502A - Bill Texts

view summary

Prohibits health insurers from requiring the insured purchase prescribed drugs from a mail order pharmacy or pay a co-payment fee when such purchases are not made from a mail order pharmacy if a similar fee is not charged for drugs from a mail order pharmacy.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5502--A

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 22, 2011
                               ___________

Introduced  by  M. of A. HEASTIE, COLTON, ROSENTHAL, M. MILLER, CYMBROW-
  ITZ, MOYA, O'DONNELL, THIELE,  GALEF,  CASTRO,  DenDEKKER,  BENEDETTO,
  GUNTHER,  SCHROEDER,  MAISEL,  SPANO,  SCHIMEL,  V. LOPEZ, WEISENBERG,
  LAVINE, WEPRIN, PHEFFER, ENGLEBRIGHT, SWEENEY, PAULIN, DINOWITZ, MENG,
  RODRIGUEZ, HOYT, GABRYSZAK -- Multi-Sponsored by -- M. of  A.  ABBATE,
  ABINANTI,  BURLING, CASTELLI, CERETTO, CORWIN, CRESPO, CROUCH, DUPREY,
  GIGLIO, GRAF,  HAYES,  JACOBS,  KATZ,  LATIMER,  P. LOPEZ,  LOSQUADRO,
  MALLIOTAKIS,   J. MILLER,  MONTESANO,  MURRAY,  RA,  RAIA,  P. RIVERA,
  ROBERTS, SALADINO, SAYWARD, SMARDZ -- read once and  referred  to  the
  Committee  on Insurance -- committee discharged, bill amended, ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the insurance  law,  in  relation  to  the  purchase  of
  prescription drugs

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

  Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
amended by adding a new paragraph 28 to read as follows:
  (28)  ANY  POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
PERMIT EACH PARTICIPANT TO FILL ANY MAIL ORDER COVERED PRESCRIPTION,  AT
HIS  OR  HER OPTION, AT ANY MAIL ORDER PHARMACY OR NETWORK PARTICIPATING
NON-MAIL ORDER RETAIL PHARMACY IF  THE  NETWORK  PARTICIPATING  NON-MAIL
ORDER  RETAIL  PHARMACY  OFFERS  TO ACCEPT A PRICE THAT IS COMPARABLE TO
THAT OF THE MAIL ORDER PHARMACY. ANY POLICY WHICH PROVIDES COVERAGE  FOR
PRESCRIPTION  DRUGS SHALL NOT IMPOSE A CO-PAYMENT FEE OR OTHER CONDITION
ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM A NETWORK PARTICIPATING
NON-MAIL ORDER RETAIL PHARMACY WHICH IS NOT  ALSO  IMPOSED  ON  INSUREDS
ELECTING  TO  PURCHASE  DRUGS  FROM  A  DESIGNATED  MAIL ORDER PHARMACY;
PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS SECTION SHALL NOT  SUPER-
SEDE THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY
THAT  IS  THE  RESULT  OF  A  COLLECTIVE BARGAINING AGREEMENT BETWEEN AN
EMPLOYER AND A RECOGNIZED OR CERTIFIED EMPLOYEE ORGANIZATION. NOTHING IN

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09145-04-1

A. 5502--A                          2

THIS PARAGRAPH SHALL ALTER ANY PROVISIONS OF SECTIONS THIRTEEN AND THIR-
TEEN-O OF THE  WORKERS'  COMPENSATION  LAW  REGARDING  THE  PURCHASE  OF
PRESCRIPTION DRUGS AND THE USE OF MAIL ORDER PHARMACY.
  S 2. Subsection (1) of section 3221 of the insurance law is amended by
adding a new paragraph 18 to read as follows:
  (18)  ANY  INSURER  DELIVERING  A GROUP OR BLANKET POLICY OR ISSUING A
GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES COVER-
AGE FOR PRESCRIPTION DRUGS SHALL PERMIT EACH  PARTICIPANT  TO  FILL  ANY
MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT ANY MAIL ORDER
PHARMACY  OR NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY IF THE
NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY OFFERS TO ACCEPT  A
PRICE  THAT IS COMPARABLE TO THAT OF THE MAIL ORDER PHARMACY. ANY POLICY
WHICH PROVIDES COVERAGE  FOR  PRESCRIPTION  DRUGS  SHALL  NOT  IMPOSE  A
CO-PAYMENT  FEE OR OTHER CONDITION ON ANY INSURED WHO ELECTS TO PURCHASE
DRUGS FROM A NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY  WHICH
IS NOT ALSO IMPOSED ON INSUREDS ELECTING TO PURCHASE DRUGS FROM A DESIG-
NATED  MAIL  ORDER  PHARMACY;  PROVIDED, HOWEVER, THAT THE PROVISIONS OF
THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF  A  COLLECTIVE  BARGAINING
AGREEMENT  OR  APPLY  TO  A  POLICY  THAT  IS THE RESULT OF A COLLECTIVE
BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOGNIZED  OR  CERTIFIED
EMPLOYEE  ORGANIZATION.  NOTHING  IN  THIS  PARAGRAPH  SHALL  ALTER  ANY
PROVISIONS OF SECTIONS THIRTEEN AND THIRTEEN-O OF THE  WORKERS'  COMPEN-
SATION  LAW  REGARDING THE PURCHASE OF PRESCRIPTION DRUGS AND THE USE OF
MAIL ORDER PHARMACY.
  S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (hh) to read as follows:
  (HH)  ANY  POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION, A
HOSPITAL SERVICE CORPORATION OR  A  HEALTH  SERVICES  CORPORATION  WHICH
PROVIDES  COVERAGE  FOR PRESCRIPTION DRUGS SHALL PERMIT EACH PARTICIPANT
TO FILL ANY MAIL ORDER COVERED PRESCRIPTION, AT HIS OR  HER  OPTION,  AT
ANY  MAIL  ORDER PHARMACY OR NETWORK PARTICIPATING NON-MAIL ORDER RETAIL
PHARMACY IF THE NETWORK PARTICIPATING  NON-MAIL  ORDER  RETAIL  PHARMACY
OFFERS  TO  ACCEPT  A PRICE THAT IS COMPARABLE TO THAT OF THE MAIL ORDER
PHARMACY. ANY POLICY WHICH  PROVIDES  COVERAGE  FOR  PRESCRIPTION  DRUGS
SHALL  NOT  IMPOSE A COPAYMENT FEE OR OTHER CONDITION ON ANY INSURED WHO
ELECTS TO PURCHASE DRUGS FROM A  NETWORK  PARTICIPATING  NON-MAIL  ORDER
RETAIL  PHARMACY  WHICH  IS  NOT  ALSO  IMPOSED  ON INSUREDS ELECTING TO
PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER,
THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS  OF  A
COLLECTIVE  BARGAINING AGREEMENT OR APPLY TO A POLICY THAT IS THE RESULT
OF A COLLECTIVE BARGAINING AGREEMENT BETWEEN AN EMPLOYER  AND  A  RECOG-
NIZED  OR  CERTIFIED  EMPLOYEE  ORGANIZATION. NOTHING IN THIS SUBSECTION
SHALL ALTER ANY PROVISIONS OF SECTIONS THIRTEEN AND  THIRTEEN-O  OF  THE
WORKERS'  COMPENSATION  LAW REGARDING THE PURCHASE OF PRESCRIPTION DRUGS
AND THE USE OF MAIL ORDER PHARMACY.
  S 4. The opening paragraph  of  paragraph  25  of  subsection  (b)  of
section 4322 of the insurance law, as amended by chapter 554 of the laws
of 2002, is amended to read as follows:
  Prescription  drugs, including contraceptive drugs or devices approved
by the federal food  and  drug  administration  or  generic  equivalents
approved  as substitutes by such food and drug administration and nutri-
tional supplements (formulas) for the therapeutic treatment of phenylke-
tonuria,  branched-chain  ketonuria,  galactosemia  and  homocystinuria,
obtained  at a participating pharmacy under a prescription written by an
in-plan or out-of-plan provider. Health  maintenance  organizations,  in
addition to providing coverage for prescription drugs at a participating

A. 5502--A                          3

pharmacy,  may utilize a mail order prescription drug program.  HOWEVER,
NO HEALTH MAINTENANCE ORGANIZATION SHALL MANDATE THAT PRESCRIPTION DRUGS
BE PURCHASED BY THE INSURED FROM A MAIL  ORDER  PHARMACY  IF  A  NETWORK
PARTICIPATING  NON-MAIL  ORDER  RETAIL PHARMACY OFFERS TO ACCEPT A PRICE
THAT IS COMPARABLE TO THAT OF THE MAIL ORDER PHARMACY.  NO HEALTH  MAIN-
TENANCE ORGANIZATION SHALL IMPOSE A CO-PAYMENT FEE OR OTHER CONDITION ON
ANY  INSURED  WHO  ELECTS TO PURCHASE DRUGS FROM A NETWORK PARTICIPATING
NON-MAIL ORDER RETAIL PHARMACY.  THE PROVISIONS OF  THIS  SECTION  SHALL
NOT SUPERSEDE THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT OR APPLY TO
A POLICY THAT IS THE RESULT OF A COLLECTIVE BARGAINING AGREEMENT BETWEEN
AN EMPLOYER AND A RECOGNIZED OR CERTIFIED EMPLOYEE ORGANIZATION. NOTHING
IN  THIS  PARAGRAPH  SHALL ALTER ANY PROVISIONS OF SECTIONS THIRTEEN AND
THIRTEEN-O OF THE WORKERS' COMPENSATION LAW REGARDING  THE  PURCHASE  OF
PRESCRIPTION  DRUGS  AND  THE USE OF MAIL ORDER PHARMACY. Health mainte-
nance organizations may provide prescription drugs pursuant  to  a  drug
formulary;  however,  health maintenance organizations must implement an
appeals process so that the use of non-formulary prescription drugs  may
be requested by a physician or other provider.
  S 5. If any clause, subparagraph, subsection, section or other part of
this  act, or the  application thereof be held to be invalid, such hold-
ing shall not affect, impair or invalidate the remainder of this act, or
the application of such section or part of a section held invalid.
  S 6. This act shall take effect on the thirtieth day  after  it  shall
have  become a law and shall apply to all policies and contracts issued,
renewed, modified, altered or amended on or after such effective date.

Co-Sponsors

view all co-sponsors

A5502B (ACTIVE) - Bill Details

See Senate Version of this Bill:
S3510B
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2009-2010 Legislative Session:
A1267A, S6007

A5502B (ACTIVE) - Bill Texts

view summary

Prohibits health insurers from requiring the insured purchase prescribed drugs from a mail order pharmacy or pay a co-payment fee when such purchases are not made from a mail order pharmacy if a similar fee is not charged for drugs from a mail order pharmacy.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5502--B

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 22, 2011
                               ___________

Introduced by M. of A. HEASTIE, GOTTFRIED, COLTON, ROSENTHAL, M. MILLER,
  CYMBROWITZ,  MOYA,  O'DONNELL, THIELE, GALEF, CASTRO, DenDEKKER, BENE-
  DETTO, GUNTHER, SCHROEDER, MAISEL, SPANO, SCHIMEL,  V. LOPEZ,  WEISEN-
  BERG,  LAVINE,  WEPRIN,  ENGLEBRIGHT, SWEENEY, PAULIN, DINOWITZ, MENG,
  RODRIGUEZ, HOYT, GABRYSZAK, TITONE -- Multi-Sponsored by -- M.  of  A.
  ABBATE,  ABINANTI,  BOYLE, BURLING, CASTELLI, CERETTO, CORWIN, CRESPO,
  CROUCH, DUPREY, GIGLIO, GRAF, HAYES, JACOBS, KATZ, LATIMER,  P. LOPEZ,
  LOSQUADRO,   MALLIOTAKIS,  J. MILLER,  MONTESANO,  MURRAY,  PALMESANO,
  PEOPLES-STOKES,  RA,  RAIA,  P. RIVERA,  ROBERTS,  SALADINO,  SAYWARD,
  SMARDZ  --  read  once  and  referred to the Committee on Insurance --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted  to  said  committee -- again reported from said committee
  with amendments, ordered reprinted as amended and recommitted to  said
  committee

AN  ACT  to  amend  the  insurance  law,  in relation to the purchase of
  prescription drugs

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

  Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
amended by adding a new paragraph 28 to read as follows:
  (28) ANY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION  DRUGS  SHALL
PERMIT  EACH PARTICIPANT TO FILL ANY MAIL ORDER COVERED PRESCRIPTION, AT
HIS OR HER OPTION, AT ANY MAIL ORDER PHARMACY OR  NETWORK  PARTICIPATING
NON-MAIL  ORDER  RETAIL  PHARMACY  IF THE NETWORK PARTICIPATING NON-MAIL
ORDER RETAIL PHARMACY OFFERS TO ACCEPT A PRICE  THAT  IS  COMPARABLE  TO
THAT  OF THE MAIL ORDER PHARMACY. ANY POLICY WHICH PROVIDES COVERAGE FOR
PRESCRIPTION DRUGS SHALL NOT IMPOSE A CO-PAYMENT FEE OR OTHER  CONDITION
ON ANY INSURED WHO ELECTS TO PURCHASE DRUGS FROM A NETWORK PARTICIPATING
NON-MAIL  ORDER  RETAIL  PHARMACY  WHICH IS NOT ALSO IMPOSED ON INSUREDS
ELECTING TO PURCHASE  DRUGS  FROM  A  DESIGNATED  MAIL  ORDER  PHARMACY;
PROVIDED,  HOWEVER, THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPER-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD09145-06-1

A. 5502--B                          2

SEDE THE TERMS OF A COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY
THAT IS THE RESULT OF  A  COLLECTIVE  BARGAINING  AGREEMENT  BETWEEN  AN
EMPLOYER AND A RECOGNIZED OR CERTIFIED EMPLOYEE ORGANIZATION.
  S 2. Subsection (1) of section 3221 of the insurance law is amended by
adding a new paragraph 18 to read as follows:
  (18)  ANY  INSURER  DELIVERING  A GROUP OR BLANKET POLICY OR ISSUING A
GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES COVER-
AGE FOR PRESCRIPTION DRUGS SHALL PERMIT EACH  PARTICIPANT  TO  FILL  ANY
MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT ANY MAIL ORDER
PHARMACY  OR NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY IF THE
NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY OFFERS TO ACCEPT  A
PRICE  THAT IS COMPARABLE TO THAT OF THE MAIL ORDER PHARMACY. ANY POLICY
WHICH PROVIDES COVERAGE  FOR  PRESCRIPTION  DRUGS  SHALL  NOT  IMPOSE  A
CO-PAYMENT  FEE OR OTHER CONDITION ON ANY INSURED WHO ELECTS TO PURCHASE
DRUGS FROM A NETWORK PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY  WHICH
IS NOT ALSO IMPOSED ON INSUREDS ELECTING TO PURCHASE DRUGS FROM A DESIG-
NATED  MAIL  ORDER  PHARMACY;  PROVIDED, HOWEVER, THAT THE PROVISIONS OF
THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF  A  COLLECTIVE  BARGAINING
AGREEMENT  OR  APPLY  TO  A  POLICY  THAT  IS THE RESULT OF A COLLECTIVE
BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOGNIZED  OR  CERTIFIED
EMPLOYEE ORGANIZATION.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (hh) to read as follows:
  (HH) ANY POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY  CORPORATION,  A
HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH SERVICES CORPORATION WHICH
PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL PERMIT  EACH  PARTICIPANT
TO  FILL  ANY  MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT
ANY MAIL ORDER PHARMACY OR NETWORK PARTICIPATING NON-MAIL  ORDER  RETAIL
PHARMACY  IF  THE  NETWORK  PARTICIPATING NON-MAIL ORDER RETAIL PHARMACY
OFFERS TO ACCEPT A PRICE THAT IS COMPARABLE TO THAT OF  THE  MAIL  ORDER
PHARMACY.  ANY  POLICY  WHICH  PROVIDES  COVERAGE FOR PRESCRIPTION DRUGS
SHALL NOT IMPOSE A COPAYMENT FEE OR OTHER CONDITION ON ANY  INSURED  WHO
ELECTS  TO  PURCHASE  DRUGS  FROM A NETWORK PARTICIPATING NON-MAIL ORDER
RETAIL PHARMACY WHICH IS  NOT  ALSO  IMPOSED  ON  INSUREDS  ELECTING  TO
PURCHASE DRUGS FROM A DESIGNATED MAIL ORDER PHARMACY; PROVIDED, HOWEVER,
THAT  THE  PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A
COLLECTIVE BARGAINING AGREEMENT OR APPLY TO A POLICY THAT IS THE  RESULT
OF  A  COLLECTIVE  BARGAINING AGREEMENT BETWEEN AN EMPLOYER AND A RECOG-
NIZED OR CERTIFIED EMPLOYEE ORGANIZATION.
  S 4.  If any clause, subparagraph, subsection, section or  other  part
of  this  act,  or the   application thereof be held to be invalid, such
holding shall not affect, impair or invalidate  the  remainder  of  this
act, or the application of such section or part of a section held inval-
id.
  S  5.  This  act shall take effect on the thirtieth day after it shall
have become a law and shall apply to all policies and contracts  issued,
renewed, modified, altered or amended on or after such effective date.

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