S T A T E O F N E W Y O R K
________________________________________________________________________
S. 4237 A. 6098
2013-2014 Regular Sessions
S E N A T E - A S S E M B L Y
March 15, 2013
___________
IN SENATE -- Introduced by Sens. LAVALLE, LIBOUS -- read twice and
ordered printed, and when printed to be committed to the Committee on
Insurance
IN ASSEMBLY -- Introduced by M. of A. MORELLE -- read once and referred
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 30 to read as follows:
(30) 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:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09791-01-3
S. 4237 2 A. 6098
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
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
S. 4237 3 A. 6098
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
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-1) of subdivision 2 of section 365-a of the social
services law, as amended by section 23 of part H of chapter 59 of the
laws of 2011, is amended to read as follows:
(g-1) drugs provided on an in-patient basis, those drugs contained on
the list established by regulation of the commissioner of health pursu-
ant 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 avail-
ability 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 quanti-
ties 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; provided further that the commissioner of health is
authorized to require prior authorization of prescriptions of opioid
analgesics in excess of four prescriptions in a thirty-day period in
accordance with section two hundred seventy-three of the public health
law; 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 reim-
bursable amounts to be established by department regulations in accord-
ance 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.