|Assembly Actions - Lowercase
Senate Actions - UPPERCASE
|Jan 08, 2014||referred to insurance|
|Jun 18, 2013||referred to rules|
senate Bill S5851
Archive: Last Bill Status -
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
S5851 - Details
- See Assembly Version of this Bill:
- Law Section:
- Insurance Law
- Laws Affected:
- Amd §§3216, 3221 & 4303, Ins L
S5851 - Sponsor Memo
BILL NUMBER:S5851 TITLE OF BILL: An act to amend the insurance law, in relation to the purchase of fertility drugs through mail order pharmacies PURPOSE: To clarify the terms and conditions expected of non-mail order retail pharmacies in relation to reimbursement for fertility drugs. SUMMARY OF PROVISIONS: Section one amends section 3216 of the Insurance Law providing that the terms and conditions of an agreement between an insurer and a non-mail order retail pharmacy shall not be inconsistent with the terms and conditions of agreements with network participating mail order pharma- cies in 2009. The provisions include exceptions for new products enter- ing the market place; updated manufacturer guidelines; or as required by state and federal law. Section two amends section 3221 of the Insurance Law providing that the terms and conditions of an agreement between an insurer and a non-mail order retail pharmacy shall not be inconsistent with the terms and conditions of agreements with network participating mail order pharma- cies in 2009. The provisions include exceptions for new products enter- ing the market place; updated manufacturer guidelines; or as required by state and federal law.
S5851 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5851 2013-2014 Regular Sessions I N S E N A T E June 18, 2013 ___________ Introduced by Sen. SKELOS -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the insurance law, in relation to the purchase of fertility drugs through mail order pharmacies THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 13-a of subsection (i) of section 3216 of the insurance law, as amended by chapter 10 of the laws of 2012, is amended to read as follows: (13-a) Every policy that provides coverage for prescription fertility drugs and requires or permits prescription drugs to be purchased through a network participating mail order or other non-retail pharmacy shall provide the same coverage for prescription fertility drugs when such drugs are purchased from a network participating non-mail order retail pharmacy provided that the network participating non-mail order retail pharmacy agrees in advance through a contractual network agreement, to the same reimbursement amount, [as well as the same applicable terms and conditions,] that the insurer has established for a network participat- ing mail order or other non-retail pharmacy. PROVIDED, HOWEVER, THAT THE TERMS AND CONDITIONS OF SUCH AGREEMENT SHALL NOT BE INCONSISTENT WITH THE TERMS AND CONDITIONS OF AGREEMENTS MADE BY THE INSURER WITH NETWORK PARTICIPATING MAIL ORDER OR OTHER NON-RETAIL PHARMACY PROVIDERS FOR THE FIVE YEAR PERIOD PRIOR TO THE EFFECTIVE DATE OF THE CHAPTER OF THE LAWS OF TWO THOUSAND THIRTEEN WHICH AMENDED THIS PARAGRAPH. THIS PARAGRAPH SHALL NOT BE CONSTRUED AS PROHIBITING THE UPDATING OF POLICIES AND PROCEDURES (A) AS THEY RELATE TO NEW PRODUCTS ENTERING THE MARKET THAT ARE DISTRIBUTED BY THE MAIL ORDER, OTHER NON-RETAIL, AND NON-MAIL ORDER RETAIL PHARMACIES, (B) AS NECESSARY TO COMPLY WITH UPDATED MANUFACTURER GUIDELINES, OR UPDATED MEDICAL GUIDELINES, OR (C) AS REQUIRED BY STATE OR FEDERAL LAW. In such case, the policy shall not impose any fee, co-payment, co-insurance, deductible or other condition EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11574-02-3
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