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Senate Bill S5043A

2011-2012 Legislative Session

Establishes a Medicaid drug rebate remittance demonstration program to validate existing Medicaid drug rebate claims

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Archive: Last Bill Status - In Senate Committee Health Committee

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Bill Amendments

2011-S5043 - Details

Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Add §276-b, Pub Health L

2011-S5043 - Summary

Establishes a Medicaid drug rebate remittance demonstration program to authorize the department of health to work collaboratively with third party vendors to validate existing Medicaid drug rebate claims and the data contains duplicate claims or claims on which rebates may have already been paid all or in part to Medicare Part D plans or some other third parties in order to rectify disputed claims.

2011-S5043 - Sponsor Memo

2011-S5043 - Bill Text download pdf

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

                                  5043

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               May 3, 2011
                               ___________

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

AN ACT to amend the public health law, in  relation  to  establishing  a
  medicaid drug rebate remittance demonstration program

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

  Section 1. The public health law is amended by adding  a  new  section
276-b to read as follows:
  S  276-B.  MEDICAID  DRUG REBATE REMITTANCE DEMONSTRATION PROGRAM.  1.
THE DEPARTMENT SHALL ESTABLISH A MEDICAID DRUG REBATE REMITTANCE  DEMON-
STRATION  PROGRAM  FOR THE PURPOSE OF WORKING COLLABORATIVELY WITH THIRD
PARTY VENDORS TO VALIDATE THE EXISTING MEDICAID DRUG REBATE  CLAIMS  AND
DETERMINE  WHETHER THE DATA CONTAINS DUPLICATE CLAIMS OR CLAIMS ON WHICH
REBATES MAY ALREADY HAVE BEEN PAID ALL OR IN PART  TO  MEDICARE  PART  D
PLANS OR SOME OTHER THIRD PARTIES IN ORDER TO RECTIFY DISPUTED CLAIMS.
  2.  FOR  THE  PURPOSES  OF  THIS DEMONSTRATION PROGRAM, THE DEPARTMENT
SHALL PROVIDE UTILIZATION INFORMATION TYING TO INVOICES SENT TO  PHARMA-
CEUTICAL  MANUFACTURERS, WHICH HAVE ENTERED INTO A REBATE AGREEMENT WITH
THE DEPARTMENT OR  WITH  THE  FEDERAL  SECRETARY  OF  HEALTH  AND  HUMAN
SERVICES  ON  BEHALF OF THE DEPARTMENT UNDER SECTION 1927 OF THE FEDERAL
SOCIAL SECURITY ACT, AND TO THIRD PARTY DATA VENDORS, FOR THE PURPOSE OF
VALIDATING CLAIMS SUBMITTED  UNDER  SUCH  REBATE  AGREEMENT  OR  PROGRAM
INCLUDING  BUT  NOT  LIMITED  TO, THE PROGRAM FOR ELDERLY PHARMACEUTICAL
INSURANCE COVERAGE, AND THE MEDICAID DRUG REBATE PROGRAM IN GENERAL  FOR
THE PERIOD FROM JANUARY FIRST, TWO THOUSAND NINE THROUGH JUNE THIRTIETH,
TWO THOUSAND TWELVE. SUCH UTILIZATION INFORMATION SHALL INCLUDE, BUT NOT
BE  LIMITED  TO:  PRESCRIPTION  NUMBERS,  NATIONAL DRUG CODES, NUMBER OF
UNITS DISPENSED, CLAIMS PAID DATE, DATE OF SERVICE,  PRESCRIBING  PHYSI-
CIAN  STATE  IDENTIFICATION NUMBER, AMOUNT BILLED FOR EACH PRESCRIPTION,
AMOUNT OF REIMBURSEMENT RECEIVED FOR EACH  PRESCRIPTION  (INCLUDING  ANY
ADJUSTMENT  CODES),  DISPENSING  PHARMACY'S STATE IDENTIFICATION NUMBER,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11186-01-1
              

2011-S5043A (ACTIVE) - Details

Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Add §276-b, Pub Health L

2011-S5043A (ACTIVE) - Summary

Establishes a Medicaid drug rebate remittance demonstration program to authorize the department of health to work collaboratively with third party vendors to validate existing Medicaid drug rebate claims and the data contains duplicate claims or claims on which rebates may have already been paid all or in part to Medicare Part D plans or some other third parties in order to rectify disputed claims.

2011-S5043A (ACTIVE) - Sponsor Memo

2011-S5043A (ACTIVE) - Bill Text download pdf

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

                                 5043--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               May 3, 2011
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed  to  the  Committee  on  Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN  ACT  to  amend  the public health law, in relation to establishing a
  medicaid drug rebate remittance demonstration program

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

  Section  1.  The  public health law is amended by adding a new section
276-b to read as follows:
  S 276-B. MEDICAID DRUG REBATE REMITTANCE DEMONSTRATION  PROGRAM.    1.
THE  DEPARTMENT SHALL ESTABLISH A MEDICAID DRUG REBATE REMITTANCE DEMON-
STRATION PROGRAM FOR THE PURPOSE OF WORKING COLLABORATIVELY  WITH  THIRD
PARTY  VENDORS  TO VALIDATE THE EXISTING MEDICAID DRUG REBATE CLAIMS AND
DETERMINE WHETHER THE DATA CONTAINS DUPLICATE CLAIMS OR CLAIMS ON  WHICH
REBATES  MAY  ALREADY  HAVE  BEEN PAID ALL OR IN PART TO MEDICARE PART D
PLANS OR SOME OTHER THIRD PARTIES IN ORDER TO RECTIFY DISPUTED CLAIMS.
  2. FOR THE PURPOSES OF  THIS  DEMONSTRATION  PROGRAM,  THE  DEPARTMENT
SHALL  PROVIDE UTILIZATION INFORMATION TYING TO INVOICES SENT TO PHARMA-
CEUTICAL MANUFACTURERS, WHICH HAVE ENTERED INTO A REBATE AGREEMENT  WITH
THE  DEPARTMENT  OR  WITH  THE  FEDERAL  SECRETARY  OF  HEALTH AND HUMAN
SERVICES ON BEHALF OF THE DEPARTMENT UNDER SECTION 1927 OF  THE  FEDERAL
SOCIAL SECURITY ACT, AND TO THIRD PARTY DATA VENDORS, FOR THE PURPOSE OF
VALIDATING  CLAIMS  SUBMITTED  UNDER  SUCH  REBATE  AGREEMENT OR PROGRAM
INCLUDING BUT NOT LIMITED TO, THE  PROGRAM  FOR  ELDERLY  PHARMACEUTICAL
INSURANCE  COVERAGE, AND THE MEDICAID DRUG REBATE PROGRAM IN GENERAL FOR
THE PERIOD FROM JANUARY FIRST, TWO THOUSAND NINE THROUGH JUNE THIRTIETH,
TWO THOUSAND TWELVE. SUCH UTILIZATION INFORMATION SHALL INCLUDE, BUT NOT
BE LIMITED TO: PRESCRIPTION NUMBERS,  NATIONAL  DRUG  CODES,  NUMBER  OF
UNITS  DISPENSED,  CLAIMS PAID DATE, DATE OF SERVICE, PRESCRIBING PHYSI-
CIAN STATE IDENTIFICATION NUMBER, AMOUNT BILLED FOR  EACH  PRESCRIPTION,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11186-02-1
              

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