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

                                  4534

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 4, 2011
                               ___________

Introduced  by  M.  of  A.  DESTITO, GOTTFRIED, PHEFFER, REILLY, CASTRO,
  JAFFEE, GIBSON, GUNTHER, GALEF, ROSENTHAL, PERRY, ORTIZ -- Multi-Spon-
  sored by -- M. of A. BRENNAN, HOOPER, MAYERSOHN, MENG, SCHIMEL,  WEIS-
  ENBERG -- read once and referred to the Committee on Health

AN  ACT  to  direct  the  department of health to evaluate and report on
  Medicaid prescription drug reimbursement to retail pharmacies

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

  Section  1.  The commissioner of health shall establish in the depart-
ment of health a Medicaid pharmacy reimbursement workgroup (referred  to
in this act as the "workgroup") for the purpose of assisting the commis-
sioner of health in studying Medicaid prescription drug reimbursement to
retail  pharmacies.  The  workgroup  shall  consist of 16 members, to be
appointed as follows: 4 members shall be appointed by  the  governor,  3
members  shall  be  appointed  by the speaker of the assembly, 3 members
shall be appointed by the temporary president of the  senate,  1  member
shall  be  appointed  by the minority leader of the senate, and 1 member
shall be appointed by the minority leader of the assembly. The chairs of
the assembly and senate fiscal and health committees, or their designees
shall serve as ex-officio members. The work group shall include:  (a)  3
representatives of organizations of chain and independent retail pharma-
cies, 3 prescription drug manufacturers and wholesalers, 2 advocates for
Medicaid recipients, and other stakeholders; (b) 2 appropriate officials
of  the  department  of health; and (c) 2 academic or other professional
experts on prescription drug reimbursement.
  S 2. 1. The workgroup's study shall include but need not be limited to
an analysis of:
  (a) how the current reimbursement methodology relates  to  pharmacies'
actual  costs  for wholesale purchasing of drugs and dispensing Medicaid
prescriptions, including but not limited to  inventory  acquisition  and
management,  payroll  costs,  employee  benefits, professional liability

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01744-01-1
              

A. 4534                             2

insurance, licenses and other fees, professional services such as  coor-
dination of benefits, patient counseling and prescription verifications,
facility costs including rent, mortgage interest, insurance, real estate
taxes,  utilities,  maintenance, permits and delivery expenses, contain-
ers, labels and supplies, specialized packaging, transaction fees, tele-
phone, data management, computer systems and support, bad debt including
uncollected co-pays, and payment lag times;
  (b) the comparative merits  of  reimbursement  methodologies  used  in
other states or allowed by the Federal government;
  (c)  the effect of New York's current and possible alternative method-
ologies on the financial viability of pharmacies, access to prescription
drugs for Medicaid recipients, controlling wholesale prices,  and  costs
to the Medicaid system;
  (d)  the  actual  cost to New York of the pharmacy benefit considering
the total amount paid to pharmacies after federal  participation,  minus
the  total  amount  collected by New York in rebates from pharmaceutical
manufacturers, and separately identifying product costs  and  dispensing
fees.
  2.  The  department  of  health and other state agencies shall provide
assistance to the workgroup in conducting its work. Members of the work-
group shall receive no compensation for their service as members of  the
workgroup  but may receive reimbursement for their reasonable and neces-
sary expenses incurred in connection with  their  participation  in  the
workgroup.  A  public  official or employee may serve as a member of the
workgroup.
  S 3. The commissioner of health shall report his  or  her  preliminary
findings  and  recommendations  relating  to  Medicaid prescription drug
reimbursement to retail pharmacies to the governor and  the  legislature
no  later  than January first after this act shall have become a law and
may provide further findings and recommendations thereafter.
  S 4. This act shall take effect immediately.