Senate Bill S3909

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

                                  3909

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                              March 9, 2011
                               ___________

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

AN  ACT  to  amend  the  insurance  law,  in   relation   to   requiring
  prescriptions  for  drugs  to be filled in the amount indicated by the
  prescription; and to amend  the  public  health  law  and  the  social
  services law, in relation to increasing the number of days for which a
  prescription may be filled

  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) EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
PROVIDE THAT ANY PRESCRIPTION WRITTEN BY AN AUTHORIZED PROVIDER SHALL BE
FILLED  IN  SUCH  EXACT QUANTITY AS INDICATED BY THE PRESCRIPTION WITHIN
AMOUNTS AUTHORIZED BY LAW, PROVIDED THAT NO SUCH QUANTITY SHALL EXCEED A
NINETY DAY SUPPLY. NO POLICY  SHALL  LIMIT  THE  QUANTITY  OF  ANY  DRUG
PRESCRIBED NOR SHALL ANY SUCH POLICY PROVIDE FOR A HIGHER CO-PAYMENT FOR
PRESCRIPTIONS  WRITTEN  AND  DISPENSED IN QUANTITIES ABOVE A SET AMOUNT.
WHERE A PHARMACY IS UNABLE TO PROVIDE THE  FULL  QUANTITY  OF  ANY  DRUG
PRESCRIBED, SUCH PRESCRIPTION SHALL BE FILLED TO THE EXTENT POSSIBLE AND
THE  BALANCE  OF  ANY  UNFILLED  PRESCRIPTION  SHALL  BE PROVIDED TO THE
INSURED  WHEN  IT  BECOMES  AVAILABLE  WITH  NO  ADDITIONAL   CO-PAYMENT
REQUIRED.
  S  2.  Subdivision  3  of  section  3332  of the public health law, as
amended by chapter 178 of the laws  of  2010,  is  amended  to  read  as
follows:
  3.  No  such  prescription  shall be made for a quantity of controlled
substances which would exceed  a  [thirty]  NINETY  day  supply  if  the
controlled substance were used in accordance with the directions for use
specified  on  the  prescription.  [A practitioner may, however, issue a
prescription for up to a three month supply of  a  controlled  substance

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05381-01-1
              

S. 3909                             2

provided  that the controlled substance has been prescribed to treat one
of the conditions that have been enumerated by the commissioner pursuant
to regulations as warranting the prescribing of greater  than  a  thirty
day supply of a controlled substance and that the practitioner specifies
the   condition   on  the  face  of  the  prescription.]  No  additional
prescriptions for a controlled substance may be issued by a practitioner
to an ultimate user within [thirty] NINETY  days  of  the  date  of  any
prescription  previously  issued  unless and until the ultimate user has
exhausted all but  a  seven  day  supply  of  the  controlled  substance
provided  by  any  previously  issued  prescription. A practitioner may,
however, issue a prescription for up  to  a  six  month  supply  of  any
substance  listed  in  subdivision (h) of Schedule II of section thirty-
three hundred six of this article provided that such substance has  been
prescribed  to  treat one of the conditions that have been enumerated by
the commissioner pursuant to regulations as warranting  the  prescribing
of  a six month supply and that the practitioner specifies the condition
on the prescription or on the electronic prescription.
  S 3. Subdivision 1 of section  3333  of  the  public  health  law,  as
amended  by  chapter  178  of  the  laws  of 2010, is amended to read as
follows:
  1. A licensed pharmacist may, in good faith and in the course  of  his
or  her  professional  practice,  sell  and dispense to an ultimate user
controlled substances only upon the delivery of  an  official  New  York
state  prescription or the receipt of an electronic prescription to such
pharmacist, within thirty days of the date such prescription was  signed
by  an  authorized  practitioner;  provided,  however,  a pharmacist may
dispense a part or portion of such prescription in accordance with regu-
lations of the commissioner in consultation  with  the  commissioner  of
education. No pharmacy or pharmacist may sell or dispense greater than a
[thirty] NINETY day supply of a controlled substance to an ultimate user
unless  and  until  the  ultimate user has exhausted all but a seven day
supply of the controlled substance provided pursuant to  any  previously
issued  prescription,  except  that a pharmacy or pharmacist may sell or
dispense up to a three month supply of a controlled substance  if  there
appears,  on  the  official  New  York  state prescription or electronic
prescription,  a  statement  that  the  controlled  substance  has  been
prescribed  to  treat one of the conditions that have been enumerated by
the regulations of the commissioner as  warranting  the  prescribing  of
greater  than  a [thirty] NINETY day supply of a controlled substance. A
pharmacy or pharmacist may sell or dispense up to a six month supply  of
any  substance listed in subdivision (h) of Schedule II of section thir-
ty-three hundred six of this article if there appears, on  the  official
New  York  state prescription or on an electronic prescription, a state-
ment that the substance has been prescribed to treat one of  the  condi-
tions  that  have been enumerated by the regulations of the commissioner
as warranting the prescribing of a specified greater supply.
  S 4. Subdivision 2 of section  3339  of  the  public  health  law,  as
amended  by  section  13 of part A of chapter 58 of the laws of 2004, is
amended to read as follows:
  2. A prescription, except for a schedule II  controlled  substance  or
those  schedule  III  or  schedule  IV  controlled  substances which the
commissioner may require by regulation may be refilled not more than the
number of times specifically  authorized  by  the  prescriber  upon  the
prescription,  provided however no such authorization shall be effective
for a period greater than six months from the date the  prescription  is
signed.  In the event that the prescription authorizes the dispensing of

S. 3909                             3

more than a [thirty] NINETY day supply of schedule III, schedule  IV  or
schedule  V  substances  pursuant  to  regulations  of  the commissioner
enumerating  conditions  warranting  specified  greater  supplies,   the
prescription may be refilled only once.
  S  5.  Paragraph  (g)  of subdivision 2 of section 365-a of the social
services law, as amended by section 1 of part F of chapter  497  of  the
laws of 2008, is amended to read as follows:
  (g)  sickroom  supplies,  eyeglasses, prosthetic appliances and dental
prosthetic appliances furnished in accordance with  the  regulations  of
the  department,  provided that the commissioner of health is authorized
to implement a preferred diabetic supply program wherein the  department
of  health will receive enhanced rebates from preferred manufacturers of
glucometers and test strips, and may subject  non-preferred  manufactur-
ers'  glucometers  and  test strips to prior authorization under section
two hundred seventy-three of the public health law; drugs provided on an
in-patient basis, those drugs contained on the list established by regu-
lation of the commissioner of health pursuant  to  subdivision  four  of
this  section,  and  those  drugs  which  may not be dispensed without a
prescription as required by  section  sixty-eight  hundred  ten  of  the
education law and which the commissioner of health shall determine to be
reimbursable  based  upon such factors as the availability of such drugs
or alternatives at low cost if purchased by a medicaid recipient, or the
essential nature of such drugs as  described  by  such  commissioner  in
regulations,  provided, however, that such drugs, exclusive of long-term
maintenance drugs, shall be dispensed in quantities no  greater  than  a
[thirty]  NINETY  day supply or one hundred doses, whichever is greater;
provided further that  the  commissioner  of  health  is  authorized  to
require  prior  authorization for any refill of a prescription when less
than seventy-five percent of the previously dispensed  amount  per  fill
should  have  been  used  were  the  product used as normally indicated;
medical assistance shall not include any drug provided on other than  an
in-patient  basis for which a recipient is charged or a claim is made in
the case of a prescription drug, in excess of the  maximum  reimbursable
amounts  to  be established by department regulations in accordance with
standards established by the secretary of the United  States  department
of  health and human services, or, in the case of a drug not requiring a
prescription, in excess of the maximum reimbursable  amount  established
by  the  commissioner of health pursuant to paragraph (a) of subdivision
four of this section;
  S 6. This act shall take effect immediately and section  one  of  this
act  shall  apply  to  policies  issued,  reissued, renewed, modified or
amended on and after such date.