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Assembly Bill A5502

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

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2011-A5502 - Details

Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221, 4303 & 4322, Ins L
Versions Introduced in 2009-2010 Legislative Session:
A1267

2011-A5502 - 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.

2011-A5502 - Bill 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

co-Sponsors

multi-Sponsors

2011-A5502A - Details

Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221, 4303 & 4322, Ins L
Versions Introduced in 2009-2010 Legislative Session:
A1267

2011-A5502A - 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.

2011-A5502A - Bill 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

co-Sponsors

multi-Sponsors

2011-A5502B (ACTIVE) - Details

Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221, 4303 & 4322, Ins L
Versions Introduced in 2009-2010 Legislative Session:
A1267

2011-A5502B (ACTIVE) - 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.

2011-A5502B (ACTIVE) - Bill 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

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