|Assembly Actions - Lowercase
Senate Actions - UPPERCASE
|Jun 17, 2014||referred to rules|
senate Bill S7894
Archive: Last Bill Status - In Senate Committee
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
S7894 - Details
- See Assembly Version of this Bill:
- Law Section:
- Social Services Law
- Laws Affected:
- Add §365-i, rpld §364-j subs 25 & 25-a, §369-ee sub 2-b, amd §369-ee, Soc Serv L; amd §§2511, 270 & 272, Pub Health L
S7894 - Sponsor Memo
BILL NUMBER:S7894 TITLE OF BILL: An act to amend the social services law and the public health law, in relation to prescription drugs in Medicaid managed care programs; and to repeal certain provisions of the social services law, relating to payments for prescription drugs PURPOSE: To restore the "prescriber prevails" principle for all drugs, and other basic consumer protections, to prescription drug coverage under Medicaid managed care and add it to Family Health Plus and Child Health Plus. SUMMARY OF PROVISIONS: This bill requires Medicaid managed care, Family Health Plus, and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program, including "prescriber prevails," for all drugs. If a Medi- caid managed care plan chooses not to do so, prescription drugs will be carved out of that plan and covered on a fee-for-service basis. Plans may also contract with the Department of Health to use the Department's PDP to carry out these functions. JUSTIFICATION: In 2005, when Medicaid prescription drug coverage was administered
S7894 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7894 I N S E N A T E June 17, 2014 ___________ Introduced by Sen. CARLUCCI -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the social services law and the public health law, in relation to prescription drugs in Medicaid managed care programs; and to repeal certain provisions of the social services law, relating to payments for prescription drugs THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The social services law is amended by adding a new section 365-i to read as follows: S 365-I. PRESCRIPTION DRUGS IN MEDICAID MANAGED CARE PROGRAMS. 1. DEFINITIONS. AS USED IN THIS SECTION, UNLESS THE CONTEXT CLEARLY REQUIRES OTHERWISE: (A) "ARTICLE" MEANS TITLE ELEVEN OF ARTICLE FIVE OF THIS CHAPTER WITH RESPECT TO THE MEDICAL ASSISTANCE PROGRAM, TITLE ELEVEN-D OF ARTICLE FIVE OF THIS CHAPTER WITH RESPECT TO THE FAMILY HEALTH PLUS PROGRAM, AND TITLE ONE-A OF ARTICLE TWENTY-FIVE OF THE PUBLIC HEALTH LAW WITH RESPECT TO THE CHILD HEALTH INSURANCE PROGRAM. (B) "CLINICAL DRUG REVIEW PROGRAM" MEANS THE CLINICAL DRUG REVIEW PROGRAM UNDER SECTION TWO HUNDRED SEVENTY-FOUR OF THE PUBLIC HEALTH LAW. (C) "EMERGENCY CONDITION" MEANS A MEDICAL OR BEHAVIORAL CONDITION AS DETERMINED BY THE PRESCRIBER OR PHARMACIST, THE ONSET OF WHICH IS SUDDEN, THAT MANIFESTS ITSELF BY SYMPTOMS OF SUFFICIENT SEVERITY, INCLUDING SEVERE PAIN, AND FOR WHICH DELAY IN BEGINNING TREATMENT PRESCRIBED BY THE PATIENT'S HEALTH CARE PRACTITIONER WOULD RESULT IN: (I) PLACING THE HEALTH OR SAFETY OF THE PERSON AFFLICTED WITH SUCH CONDITION OR OTHER PERSON OR PERSONS IN SERIOUS JEOPARDY; (II) SERIOUS IMPAIRMENT TO SUCH PERSON'S BODILY FUNCTIONS; (III) SERIOUS DYSFUNCTION OF ANY BODILY ORGAN OR PART OF SUCH PERSON; (IV) SERIOUS DISFIGUREMENT OF SUCH PERSON; OR (V) SEVERE DISCOMFORT. (D) "MANAGED CARE PROVIDER" MEANS A MANAGED CARE PROVIDER UNDER SECTION THREE HUNDRED SIXTY-FOUR-J OF THIS TITLE, A MANAGED LONG TERM CARE PLAN OR OTHER CARE COORDINATION MODEL UNDER SECTION FORTY-FOUR EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
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