Assembly Bill A10293

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

                                  10293

                          I N  A S S E M B L Y

                              May 20, 2016
                               ___________

Introduced by M. of A. JOYNER -- read once and referred to the Committee
  on Insurance

AN ACT to amend the insurance law, in relation to reimbursements to mail
  order pharmacies

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

  Section 1. Paragraphs 13-a and 28 of subsection (i) of section 3216 of
the insurance law, paragraph 13-a as amended by chapter 10 of  the  laws
of  2012, paragraph 28 as amended by chapter 11 of the laws of 2012, are
amended to read as follows:
  (13-a) (A) DEFINITIONS. FOR THE PURPOSES OF THIS PARAGRAPH:
  (1) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
UNDER SUBPARAGRAPH (B) OF THIS PARAGRAPH SHALL PROVIDE THE  SAME  BENCH-
MARK  INDEX,  INCLUDING THE SAME AVERAGE WHOLESALE PRICE, MAXIMUM ALLOW-
ABLE COST AND NATIONAL PRESCRIPTION DRUG CODES TO REIMBURSE ALL  PHARMA-
CIES  PARTICIPATING  IN  THE  INSURANCE  NETWORK REGARDLESS OF WHETHER A
PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
  (2) "MAIL ORDER PHARMACY" SHALL MEAN A PHARMACY WHOSE PRIMARY BUSINESS
IS TO RECEIVE PRESCRIPTIONS  BY  MAIL,  TELEFAX  OR  THROUGH  ELECTRONIC
SUBMISSIONS  AND  TO  DISPENSE MEDICATION TO PATIENTS THROUGH THE USE OF
THE UNITED STATES MAIL OR OTHER COMMON OR CONTRACT CARRIER SERVICES  AND
PROVIDES  ANY  CONSULTATION  WITH  PATIENTS  ELECTRONICALLY  RATHER THAN
FACE-TO-FACE.
  (3) "STANDARD TERMS AND CONDITIONS" SHALL MEAN THE  CONTRACTUAL  TERMS
AND  CONDITIONS  APPLICABLE TO ALL NETWORK PARTICIPATING PHARMACIES THAT
WERE IN EFFECT ON JUNE FIRST, TWO THOUSAND FIFTEEN; PROVIDED THAT IF  AN
INSURER HAS ESTABLISHED DIFFERENT STANDARD TERMS AND CONDITIONS FOR MAIL
ORDER  PHARMACIES AND NON-MAIL ORDER RETAIL PHARMACIES, THE TERM "STAND-
ARD TERMS AND CONDITIONS" SHALL MEAN THE STANDARD TERMS  AND  CONDITIONS
THAT  WERE  IN  EFFECT  ON JUNE FIRST, TWO THOUSAND FIFTEEN FOR NON-MAIL
ORDER RETAIL PHARMACIES, AND PROVIDED FURTHER  THAT  ANY  SUCH  STANDARD
TERMS AND CONDITIONS THAT REQUIRE:
  (I) CONSULTATION WITH A PHARMACIST SHALL NOT REQUIRE SUCH CONSULTATION
BE  AVAILABLE  AT  NON-MAIL  ORDER PHARMACIES OUTSIDE OF SUCH PHARMACY'S

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

                                                           LBD15299-04-6

A. 10293                            2

REGULAR HOURS OF OPERATION AND SHALL REQUIRE MAIL  ORDER  PHARMACIES  TO
PROVIDE SUCH CONSULTATION TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK;
  (II)  SPECIFIC  STORAGE  SIZE FOR PRESCRIPTION DRUGS REQUIRING SPECIAL
HANDLING, SUCH AS REFRIGERATION, SHALL BE BASED ON THE CONTRACTING PHAR-
MACY'S DISPENSING  EXPERIENCE  AND  SHALL  NOT  REQUIRE  A  PHARMACY  TO
INCREASE  ITS  STORAGE  SPACE WHEN IT HAS NOT BEEN ESTABLISHED THAT SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE; AND
  (III) SPECIFIC STORAGE  SPACE  FOR  PRESCRIPTION  DRUGS  THAT  DO  NOT
REQUIRE  SPECIAL  HANDLING  SHALL BE BASED ON THE CONTRACTING PHARMACY'S
PHYSICAL SIZE AND DISPENSING EXPERIENCE AND SHALL NOT REQUIRE A PHARMACY
TO INCREASE ITS STORAGE SPACE WHEN IT HAS NOT BEEN ESTABLISHED THAT SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE.
  (B) 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 AND SHALL NOT
LIMIT THE SUPPLY THAT MAY BE DISPENSED TO A THIRTY-DAY SUPPLY 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,]  AND  STANDARD  TERMS  AND  CONDITIONS that the insurer has
established for [a] network participating [mail order or  other  non-re-
tail  pharmacy]  PHARMACIES.   In such case, the policy shall not impose
any  fee,  co-payment,  co-insurance,  deductible  or  other  condition,
INCLUDING  REQUIRING  MONTHLY REFILLS OF A PRESCRIPTION THAT WAS WRITTEN
FOR AND MAY BE FILLED FOR MORE THAN A THIRTY-DAY SUPPLY, on any  insured
who  elects  to  purchase prescription fertility drugs through a network
participating non-mail order retail pharmacy that it does not impose  on
any insured who purchases prescription fertility drugs through a network
participating mail order or other non-retail pharmacy.
  (C) ANY POLICY THAT PROVIDES COVERAGE FOR PRESCRIPTION FERTILITY DRUGS
SHALL,  IN  ADDITION  TO THE STANDARD TERMS AND CONDITIONS, REQUIRE MAIL
ORDER PHARMACIES TO REPLACE DISPENSED PRESCRIPTION FERTILITY  DRUGS  FOR
WHICH  THE  MAIL  OR CARRIER SERVICE HAS PROOF OF DELIVERY THAT HAVE NOT
BEEN RECEIVED BY THE INSURED, OR ARE SPOILED OR DAMAGED,  PROVIDED  THAT
IN  THE CASE OF A PRESCRIPTION FERTILITY DRUG THAT HAS NOT BEEN RECEIVED
BY THE INSURED, THE POLICY MAY REQUIRE THAT THE INSURED PROVIDE PROOF OF
THEFT IN THE FORM OF A FILED POLICE REPORT REPORTING THE  THEFT  AND  IN
THE CASE OF A DAMAGED OR SPOILED PRESCRIPTION FERTILITY DRUG, THE POLICY
MAY  REQUIRE THAT THE DAMAGED PRESCRIPTION FERTILITY DRUG BE RETURNED TO
THE MAIL ORDER PHARMACY WITH THE COST TO BE BORNE BY SUCH PHARMACY,  AND
PROVIDED  FURTHER  THAT SUCH UNRECEIVED, SPOILED OR DAMAGED PRESCRIPTION
FERTILITY DRUG SHALL BE REPLACED BEFORE RECEIPT OF THE POLICE REPORT  OR
THE  RETURNED,  SPOILED  OR  DAMAGED PRESCRIPTION FERTILITY DRUG, AS THE
CASE MAY BE. IF SUCH REQUIRED POLICE  REPORT  IS  NOT  PROVIDED  OR  THE
DAMAGED  OR  SPOILED  PRESCRIPTION  FERTILITY  DRUG IS NOT RETURNED, THE
POLICY MAY REQUIRE THE INSURED TO REIMBURSE THE POLICY FOR THE  COST  OF
THE  PRESCRIPTION FERTILITY DRUG AND, NOTWITHSTANDING THE FORGOING, WHEN
AN INSURED WHO WAS PREVIOUSLY REQUIRED  TO  REIMBURSE  THE  PLAN  FOR  A
DISPENSED  PRESCRIPTION  FERTILITY  DRUG  THAT  WAS  NOT RECEIVED BY THE
INSURED, OR WAS DAMAGED OR SPOILED, THE POLICY  MAY  REFUSE  TO  REPLACE
SUCH PRESCRIPTION FERTILITY DRUG FOR SUCH INSURED UNTIL SUCH INSURED HAS
PROVIDED  THE  PLAN  WITH  THE  REQUIRED  POLICE  REPORT OR RETURNED THE
SPOILED  OR  DAMAGED  PRESCRIPTION  FERTILITY  DRUG.  REPLACEMENT  OF  A

A. 10293                            3

PRESCRIPTION  FERTILITY  DRUG PURSUANT TO THIS SUBPARAGRAPH SHALL NOT BE
LIMITED TO A SPECIFIC NUMBER OF OCCURRENCES DURING A CONTRACT YEAR.
  (28) (A) DEFINITIONS. FOR THE PURPOSES OF THIS PARAGRAPH:
  (1) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
UNDER  SUBPARAGRAPH  (B) OF THIS PARAGRAPH SHALL PROVIDE THE SAME BENCH-
MARK INDEX, INCLUDING THE SAME AVERAGE WHOLESALE PRICE,  MAXIMUM  ALLOW-
ABLE  COST AND NATIONAL PRESCRIPTION DRUG CODES TO REIMBURSE ALL PHARMA-
CIES PARTICIPATING IN THE INSURANCE  NETWORK  REGARDLESS  OF  WHETHER  A
PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
  (2) "MAIL ORDER PHARMACY" SHALL MEAN A PHARMACY WHOSE PRIMARY BUSINESS
IS  TO  RECEIVE  PRESCRIPTIONS  BY  MAIL,  TELEFAX OR THROUGH ELECTRONIC
SUBMISSIONS AND TO DISPENSE MEDICATION TO PATIENTS THROUGH  THE  USE  OF
THE  UNITED STATES MAIL OR OTHER COMMON OR CONTRACT CARRIER SERVICES AND
PROVIDES ANY  CONSULTATION  WITH  PATIENTS  ELECTRONICALLY  RATHER  THAN
FACE-TO-FACE.
  (3)  "STANDARD  TERMS AND CONDITIONS" SHALL MEAN THE CONTRACTUAL TERMS
AND CONDITIONS APPLICABLE TO ALL NETWORK PARTICIPATING  PHARMACIES  THAT
WERE  IN EFFECT ON JUNE FIRST, TWO THOUSAND FIFTEEN; PROVIDED THAT IF AN
INSURER HAS ESTABLISHED DIFFERENT STANDARD TERMS AND CONDITIONS FOR MAIL
ORDER PHARMACIES AND NON-MAIL ORDER RETAIL PHARMACIES, THE TERM  "STAND-
ARD  TERMS  AND CONDITIONS" SHALL MEAN THE STANDARD TERMS AND CONDITIONS
THAT WERE IN EFFECT ON JUNE FIRST, TWO  THOUSAND  FIFTEEN  FOR  NON-MAIL
ORDER  RETAIL  PHARMACIES,  AND  PROVIDED FURTHER THAT ANY SUCH STANDARD
TERMS AND CONDITIONS THAT REQUIRE:
  (I) CONSULTATION WITH A PHARMACIST SHALL NOT REQUIRE SUCH CONSULTATION
BE AVAILABLE AT NON-MAIL ORDER PHARMACIES  OUTSIDE  OF  SUCH  PHARMACY'S
REGULAR  HOURS  OF  OPERATION AND SHALL REQUIRE MAIL ORDER PHARMACIES TO
PROVIDE SUCH CONSULTATION TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK;
  (II) SPECIFIC STORAGE SIZE FOR PRESCRIPTION  DRUGS  REQUIRING  SPECIAL
HANDLING, SUCH AS REFRIGERATION, SHALL BE BASED ON THE CONTRACTING PHAR-
MACY'S  DISPENSING  EXPERIENCE  AND  SHALL  NOT  REQUIRE  A  PHARMACY TO
INCREASE ITS STORAGE SPACE WHEN IT HAS NOT BEEN  ESTABLISHED  THAT  SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE; AND
  (III)  SPECIFIC  STORAGE  SPACE  FOR  PRESCRIPTION  DRUGS  THAT DO NOT
REQUIRE SPECIAL HANDLING SHALL BASE SUCH REQUIREMENTS ON THE CONTRACTING
PHARMACY'S PHYSICAL SIZE AND DISPENSING EXPERIENCE AND SHALL NOT REQUIRE
A PHARMACY TO INCREASE ITS STORAGE SPACE WHEN IT  HAS  NOT  BEEN  ESTAB-
LISHED  THAT SUCH PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED
STORAGE.
  (B) Any policy that provides coverage  for  prescription  drugs  shall
permit  each  insured  to  fill  any  covered  prescription  that may be
obtained at a network participating mail order or other non-retail phar-
macy, at the insured's option, at 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 agree-
ment,] to the same reimbursement amount[, as well as the same applicable
terms and conditions,] AND STANDARD TERMS AND CONDITIONS that the insur-
er  has  established  for the network participating [mail order or other
non-retail pharmacy] PHARMACIES. In such a case, the  policy  shall  not
impose  a co-payment fee or other condition, INCLUDING REQUIRING MONTHLY
REFILLS OF A PRESCRIPTION THAT WAS WRITTEN FOR AND  MAY  BE  FILLED  FOR
MORE  THAN  A  THIRTY-DAY  SUPPLY, on any insured who elects to purchase
prescription drugs from a network participating  non-mail  order  retail
pharmacy  which  is  not  also  imposed on insureds electing to purchase
drugs from a network participating mail order or other non-retail  phar-
macy.

A. 10293                            4

  (C) ANY POLICY THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL, IN
ADDITION  TO THE STANDARD TERMS AND CONDITIONS, REQUIRE MAIL ORDER PHAR-
MACIES TO REPLACE DISPENSED PRESCRIPTION DRUGS FOR  WHICH  THE  MAIL  OR
CARRIER SERVICE HAS PROOF OF DELIVERY THAT HAVE NOT BEEN RECEIVED BY THE
INSURED,  OR  ARE  SPOILED  OR  DAMAGED,  PROVIDED THAT IN THE CASE OF A
PRESCRIPTION DRUG THAT HAS NOT BEEN RECEIVED BY THE INSURED, THE  POLICY
MAY  REQUIRE  THAT  THE  INSURED PROVIDE PROOF OF THEFT IN THE FORM OF A
FILED POLICE REPORT REPORTING THE THEFT AND IN THE CASE OF A DAMAGED  OR
SPOILED  PRESCRIPTION  DRUG,  THE  POLICY  MAY  REQUIRE THAT THE DAMAGED
PRESCRIPTION DRUG BE RETURNED TO THE MAIL ORDER PHARMACY WITH  THE  COST
TO BE BORNE BY SUCH PHARMACY, AND PROVIDED FURTHER THAT SUCH UNRECEIVED,
SPOILED OR DAMAGED PRESCRIPTION DRUG SHALL BE REPLACED BEFORE RECEIPT OF
THE  POLICE  REPORT  OR THE SPOILED OR DAMAGED PRESCRIPTION DRUG, AS THE
CASE MAY BE.  IF SUCH REQUIRED POLICE REPORT  IS  NOT  PROVIDED  OR  THE
DAMAGED  OR  SPOILED  PRESCRIPTION  DRUG IS NOT RETURNED, THE POLICY MAY
REQUIRE THE INSURED  TO  REIMBURSE  THE  POLICY  FOR  THE  COST  OF  THE
PRESCRIPTION DRUG AND, NOTWITHSTANDING THE FORGOING, WHEN AN INSURED WHO
WAS   PREVIOUSLY   REQUIRED  TO  REIMBURSE  THE  PLAN  FOR  A  DISPENSED
PRESCRIPTION DRUG THAT WAS NOT RECEIVED BY THE INSURED, OR  WAS  DAMAGED
OR  SPOILED, THE POLICY MAY REFUSE TO REPLACE SUCH PRESCRIPTION DRUG FOR
SUCH INSURED UNTIL SUCH INSURED HAS PROVIDED THE PLAN WITH THE  REQUIRED
POLICE  REPORT  OR  RETUNED  THE  SPOILED  OR DAMAGED PRESCRIPTION DRUG.
REPLACEMENT OF A PRESCRIPTION DRUG PURSUANT TO THIS  SUBPARAGRAPH  SHALL
NOT  BE  LIMITED  TO  A SPECIFIC NUMBER OF OCCURRENCES DURING A CONTRACT
YEAR.
  S 2. Subparagraph (D) of paragraph 6 of subsection (k) of section 3221
of the insurance law, as amended by chapter 10 of the laws of  2012,  is
amended to read as follows:
  (D) (I) DEFINITIONS. FOR THE PURPOSE OF THIS PARAGRAPH:
  (1) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
UNDER  ITEM  (II)  OF THIS SUBPARAGRAPH SHALL PROVIDE THE SAME BENCHMARK
INDEX, INCLUDING THE SAME AVERAGE  WHOLESALE  PRICE,  MAXIMUM  ALLOWABLE
COST  AND  NATIONAL  PRESCRIPTION DRUG CODES TO REIMBURSE ALL PHARMACIES
PARTICIPATING IN THE INSURANCE NETWORK REGARDLESS OF WHETHER A  PHARMACY
IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
  (2) "MAIL ORDER PHARMACY" SHALL MEAN A PHARMACY WHOSE PRIMARY BUSINESS
IS  TO  RECEIVE  PRESCRIPTIONS  BY  MAIL,  TELEFAX OR THROUGH ELECTRONIC
SUBMISSIONS AND TO DISPENSE MEDICATION TO PATIENTS THROUGH  THE  USE  OF
THE  UNITED STATES MAIL OR OTHER COMMON OR CONTRACT CARRIER SERVICES AND
PROVIDES ANY  CONSULTATION  WITH  PATIENTS  ELECTRONICALLY  RATHER  THAN
FACE-TO-FACE.
  (3)  "STANDARD  TERMS AND CONDITIONS" SHALL MEAN THE CONTRACTUAL TERMS
AND CONDITIONS APPLICABLE TO ALL NETWORK PARTICIPATING  PHARMACIES  THAT
WERE  IN EFFECT ON JUNE FIRST, TWO THOUSAND FIFTEEN; PROVIDED THAT IF AN
INSURER HAS ESTABLISHED DIFFERENT STANDARD TERMS AND CONDITIONS FOR MAIL
ORDER PHARMACIES AND NON-MAIL ORDER RETAIL PHARMACIES, THE TERM STANDARD
TERMS AND CONDITIONS SHALL MEAN THE STANDARD TERMS AND  CONDITIONS  THAT
WERE  IN  EFFECT  ON JUNE FIRST, TWO THOUSAND FIFTEEN FOR NON-MAIL ORDER
RETAIL PHARMACIES, AND PROVIDED FURTHER THAT ANY SUCH STANDARD TERMS AND
CONDITIONS THAT REQUIRE:
  A. CONSULTATION WITH A PHARMACIST SHALL NOT REQUIRE SUCH  CONSULTATION
BE  AVAILABLE  AT  NON-MAIL  ORDER PHARMACIES OUTSIDE OF SUCH PHARMACY'S
REGULAR HOURS OF OPERATION AND SHALL REQUIRE MAIL  ORDER  PHARMACIES  TO
PROVIDE SUCH CONSULTATION TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK;
  B.  SPECIFIC  STORAGE  SIZE  FOR  PRESCRIPTION DRUGS REQUIRING SPECIAL
HANDLING, SUCH AS REFRIGERATION, SHALL BE BASED ON THE CONTRACTING PHAR-

A. 10293                            5

MACY'S DISPENSING  EXPERIENCE  AND  SHALL  NOT  REQUIRE  A  PHARMACY  TO
INCREASE  ITS  STORAGE  SPACE WHEN IT HAS NOT BEEN ESTABLISHED THAT SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE; AND
  C.  SPECIFIC  STORAGE SPACE FOR PRESCRIPTION DRUGS THAT DO NOT REQUIRE
SPECIAL HANDLING SHALL BE BASED ON THE CONTRACTING  PHARMACY'S  PHYSICAL
SIZE  AND  DISPENSING  EXPERIENCE  AND  SHALL  NOT REQUIRE A PHARMACY TO
INCREASE ITS STORAGE SPACE WHEN IT HAS NOT BEEN  ESTABLISHED  THAT  SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE.
  (II)  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 AND SHALL NOT
LIMIT  THE SUPPLY THAT MAY BE DISPENSED TO A THIRTY-DAY SUPPLY 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,] AND STANDARD TERMS AND  CONDITIONS  that  the  insurer  has
established  for  [a] network participating [mail order or other non-re-
tail pharmacy] PHARMACIES. In such case, the policy shall not impose any
fee, co-payment, co-insurance, deductible or other condition,  INCLUDING
REQUIRING MONTHLY REFILLS OF A PRESCRIPTION THAT WAS WRITTEN FOR AND MAY
BE  FILLED  FOR MORE THAN A THIRTY-DAY SUPPLY, on any covered person who
elects to  purchase  prescription  fertility  drugs  through  a  network
participating  non-mail order retail pharmacy that it does not impose on
any covered person who purchases prescription fertility drugs through  a
network participating mail order or other non-retail pharmacy; provided,
however,  that  the  provisions  of this section shall not supersede the
terms of a collective bargaining agreement or apply to a policy that  is
the  result of a collective bargaining agreement between an employer and
a recognized or certified employee organization.
  (III) ANY POLICY THAT PROVIDES  COVERAGE  FOR  PRESCRIPTION  FERTILITY
DRUGS  SHALL,  IN ADDITION TO THE STANDARD TERMS AND CONDITIONS, REQUIRE
MAIL ORDER PHARMACIES TO REPLACE DISPENSED PRESCRIPTION FERTILITY  DRUGS
FOR  WHICH  THE  MAIL OR CARRIER SERVICE HAS PROOF OF DELIVERY THAT HAVE
NOT BEEN RECEIVED BY THE INSURED, OR ARE SPOILED  OR  DAMAGED,  PROVIDED
THAT  IN  THE  CASE  OF  A PRESCRIPTION FERTILITY DRUG THAT HAS NOT BEEN
RECEIVED BY THE INSURED, THE POLICY MAY REQUIRE THAT THE INSURED PROVIDE
PROOF OF THEFT IN THE FORM OF A FILED POLICE REPORT REPORTING THE  THEFT
AND IN THE CASE OF A DAMAGED OR SPOILED PRESCRIPTION FERTILITY DRUG, THE
POLICY  MAY  REQUIRE  THAT  THE  DAMAGED  PRESCRIPTION FERTILITY DRUG BE
RETURNED TO THE MAIL ORDER PHARMACY WITH THE COST TO BE  BORNE  BY  SUCH
PHARMACY,  AND PROVIDED FURTHER THAT SUCH UNRECEIVED, SPOILED OR DAMAGED
PRESCRIPTION FERTILITY DRUG SHALL BE  REPLACED  BEFORE  RECEIPT  OF  THE
POLICE  REPORT OR THE RETURNED SPOILED OR DAMAGED PRESCRIPTION FERTILITY
DRUG, AS THE CASE MAY BE. IF SUCH REQUIRED POLICE REPORT IS NOT PROVIDED
OR THE DAMAGED OR SPOILED PRESCRIPTION FERTILITY DRUG IS  NOT  RETURNED,
THE  POLICY MAY REQUIRE THE INSURED TO REIMBURSE THE POLICY FOR THE COST
OF THE PRESCRIPTION FERTILITY DRUG AND,  NOTWITHSTANDING  THE  FORGOING,
WHEN  AN INSURED WHO WAS PREVIOUSLY REQUIRED TO REIMBURSE THE PLAN FOR A
DISPENSED PRESCRIPTION FERTILITY DRUG  THAT  WAS  NOT  RECEIVED  BY  THE
INSURED,  OR  WAS  DAMAGED  OR SPOILED, THE POLICY MAY REFUSE TO REPLACE
SUCH PRESCRIPTION FERTILITY DRUG FOR SUCH INSURED UNTIL SUCH INSURED HAS
PROVIDED THE PLAN WITH  THE  REQUIRED  POLICE  REPORT  OR  RETURNED  THE
SPOILED  OR  DAMAGED  PRESCRIPTION  FERTILITY  DRUG.    REPLACEMENT OF A

A. 10293                            6

PRESCRIPTION FERTILITY DRUG PURSUANT TO THIS CLAUSE SHALL NOT BE LIMITED
TO A SPECIFIC NUMBER OF OCCURRENCES DURING A CONTRACT YEAR.
  S  3.  Paragraph 18 of subsection (l) of section 3221 of the insurance
law, as amended by chapter 11 of the laws of 2012, is amended to read as
follows:
  (18) (A) DEFINITIONS. FOR THE PURPOSE OF THIS PARAGRAPH:
  (1) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
UNDER SUBPARAGRAPH (B) OF THIS PARAGRAPH SHALL PROVIDE THE  SAME  BENCH-
MARK  INDEX,  INCLUDING THE SAME AVERAGE WHOLESALE PRICE, MAXIMUM ALLOW-
ABLE COST AND NATIONAL PRESCRIPTION DRUG CODES TO REIMBURSE ALL  PHARMA-
CIES  PARTICIPATING  IN  THE  INSURANCE  NETWORK REGARDLESS OF WHETHER A
PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
  (2) "MAIL ORDER PHARMACY" SHALL MEAN A PHARMACY WHOSE PRIMARY BUSINESS
IS TO RECEIVE PRESCRIPTIONS  BY  MAIL,  TELEFAX  OR  THROUGH  ELECTRONIC
SUBMISSIONS  AND  TO  DISPENSE MEDICATION TO PATIENTS THROUGH THE USE OF
THE UNITED STATES MAIL OR OTHER COMMON OR CONTRACT CARRIER SERVICES  AND
PROVIDES  ANY  CONSULTATION  WITH  PATIENTS  ELECTRONICALLY  RATHER THAN
FACE-TO-FACE.
  (3) "STANDARD TERMS AND CONDITIONS" SHALL MEAN THE  CONTRACTUAL  TERMS
AND  CONDITIONS  APPLICABLE TO ALL NETWORK PARTICIPATING PHARMACIES THAT
WERE IN EFFECT ON JUNE FIRST, TWO THOUSAND FIFTEEN; PROVIDED THAT IF  AN
INSURER HAS ESTABLISHED DIFFERENT STANDARD TERMS AND CONDITIONS FOR MAIL
ORDER PHARMACIES AND NON-MAIL ORDER RETAIL PHARMACIES, THE TERM STANDARD
TERMS  AND  CONDITIONS SHALL MEAN THE STANDARD TERMS AND CONDITIONS THAT
WERE IN EFFECT ON JUNE FIRST, TWO THOUSAND FIFTEEN  FOR  NON-MAIL  ORDER
RETAIL PHARMACIES, AND PROVIDED FURTHER THAT ANY SUCH STANDARD TERMS AND
CONDITIONS THAT REQUIRE:
  (I) CONSULTATION WITH A PHARMACIST SHALL NOT REQUIRE SUCH CONSULTATION
BE  AVAILABLE  AT  NON-MAIL  ORDER PHARMACIES OUTSIDE OF SUCH PHARMACY'S
REGULAR HOURS OF OPERATION AND SHALL REQUIRE MAIL  ORDER  PHARMACIES  TO
PROVIDE SUCH CONSULTATION TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK;
  (II)  SPECIFIC  STORAGE  SIZE FOR PRESCRIPTION DRUGS REQUIRING SPECIAL
HANDLING, SUCH AS REFRIGERATION, SHALL BE BASED ON THE CONTRACTING PHAR-
MACY'S DISPENSING  EXPERIENCE  AND  SHALL  NOT  REQUIRE  A  PHARMACY  TO
INCREASE  ITS  STORAGE  SPACE WHEN IT HAS NOT BEEN ESTABLISHED THAT SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE; AND
  (III) SPECIFIC STORAGE  SPACE  FOR  PRESCRIPTION  DRUGS  THAT  DO  NOT
REQUIRE SPECIAL HANDLING SHALL BASE SUCH REQUIREMENTS ON THE CONTRACTING
PHARMACY'S PHYSICAL SIZE AND DISPENSING EXPERIENCE AND SHALL NOT REQUIRE
A  PHARMACY  TO  INCREASE  ITS STORAGE SPACE WHEN IT HAS NOT BEEN ESTAB-
LISHED THAT SUCH PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH  INCREASED
STORAGE.
  (B)  Any  insurer  delivering  a  group or blanket policy or issuing a
group or blanket policy for delivery in this state that provides  cover-
age for prescription drugs shall permit each insured to fill any covered
prescription  that may be obtained at a network participating mail order
or other non-retail pharmacy, at the  insured's  option,  at  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,] AND STANDARD TERMS
AND CONDITIONS that the insurer has established for the network  partic-
ipating [mail order or other non-retail pharmacy] PHARMACIES.  In such a
case,  the  policy shall not impose a co-payment fee or other condition,
INCLUDING REQUIRING MONTHLY REFILLS OF A PRESCRIPTION THAT  WAS  WRITTEN
FOR  AND MAY BE FILLED FOR MORE THAN A THIRTY-DAY SUPPLY, on any insured

A. 10293                            7

who elects to purchase drugs from a network participating non-mail order
retail pharmacy which is  not  also  imposed  on  insureds  electing  to
purchase  drugs from a network participating mail order or other non-re-
tail  pharmacy;  provided,  however, that the provisions of this section
shall not supersede the terms of a collective  bargaining  agreement  or
apply  to  a policy that is the result of a collective bargaining agree-
ment between an employer and a recognized or certified  employee  organ-
ization.
  (C) ANY POLICY THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL, IN
ADDITION  TO THE STANDARD TERMS AND CONDITIONS, REQUIRE MAIL ORDER PHAR-
MACIES TO REPLACE DISPENSED PRESCRIPTION DRUGS FOR  WHICH  THE  MAIL  OR
CARRIER SERVICE HAS PROOF OF DELIVERY THAT HAVE NOT BEEN RECEIVED BY THE
INSURED,  OR  ARE  SPOILED  OR  DAMAGED,  PROVIDED THAT IN THE CASE OF A
PRESCRIPTION DRUG THAT HAS NOT BEEN RECEIVED BY THE INSURED, THE  POLICY
MAY  REQUIRE  THAT  THE  INSURED PROVIDE PROOF OF THEFT IN THE FORM OF A
FILED POLICE REPORT REPORTING THE THEFT AND IN THE CASE OF A DAMAGED  OR
SPOILED  PRESCRIPTION  DRUG,  THE  POLICY  MAY  REQUIRE THAT THE DAMAGED
PRESCRIPTION DRUG BE RETURNED TO THE MAIL ORDER PHARMACY WITH  THE  COST
TO BE BORNE BY SUCH PHARMACY, AND PROVIDED FURTHER THAT SUCH UNRECEIVED,
SPOILED OR DAMAGED PRESCRIPTION DRUG SHALL BE REPLACED BEFORE RECEIPT OF
THE  POLICE  REPORT  OR THE SPOILED OR DAMAGED PRESCRIPTION DRUG, AS THE
CASE MAY BE. IF SUCH REQUIRED POLICE  REPORT  IS  NOT  PROVIDED  OR  THE
DAMAGED  OR  SPOILED  PRESCRIPTION  DRUG IS NOT RETURNED, THE POLICY MAY
REQUIRE THE INSURED  TO  REIMBURSE  THE  POLICY  FOR  THE  COST  OF  THE
PRESCRIPTION DRUG AND, NOTWITHSTANDING THE FORGOING, WHEN AN INSURED WHO
WAS   PREVIOUSLY   REQUIRED  TO  REIMBURSE  THE  PLAN  FOR  A  DISPENSED
PRESCRIPTION DRUG THAT WAS NOT RECEIVED BY THE INSURED, OR  WAS  DAMAGED
OR  SPOILED, THE POLICY MAY REFUSE TO REPLACE SUCH PRESCRIPTION DRUG FOR
SUCH INSURED UNTIL SUCH INSURED HAS PROVIDED THE PLAN WITH THE  REQUIRED
POLICE  REPORT  OR  RETURNED  THE  SPOILED OR DAMAGED PRESCRIPTION DRUG.
REPLACEMENT OF A PRESCRIPTION DRUG PURSUANT TO THIS  SUBPARAGRAPH  SHALL
NOT  BE  LIMITED  TO  A SPECIFIC NUMBER OF OCCURRENCES DURING A CONTRACT
YEAR.
  S 4.  Paragraph 4 of subsection (s) of section 4303 of  the  insurance
law, as amended by chapter 10 of the laws of 2012, is amended to read as
follows:
  (4) (A) DEFINITION. FOR THE PURPOSE OF THIS PARAGRAPH:
  (I) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
UNDER  SUBPARAGRAPH (B) OF THIS SUBSECTION SHALL PROVIDE THE SAME BENCH-
MARK INDEX, INCLUDING THE SAME AVERAGE WHOLESALE PRICE,  MAXIMUM  ALLOW-
ABLE  COST AND NATIONAL PRESCRIPTION DRUG CODES TO REIMBURSE ALL PHARMA-
CIES PARTICIPATING IN THE INSURANCE  NETWORK  REGARDLESS  OF  WHETHER  A
PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
  (II)  "MAIL  ORDER PHARMACY" SHALL MEAN A PHARMACY WHOSE PRIMARY BUSI-
NESS IS TO RECEIVE PRESCRIPTIONS BY MAIL, TELEFAX OR THROUGH  ELECTRONIC
SUBMISSIONS  AND  TO  DISPENSE MEDICATION TO PATIENTS THROUGH THE USE OF
THE UNITED STATES MAIL OR OTHER COMMON OR CONTRACT CARRIER SERVICES  AND
PROVIDES  ANY  CONSULTATION  WITH  PATIENTS  ELECTRONICALLY  RATHER THAN
FACE-TO-FACE.
  (III) "STANDARD TERMS AND CONDITIONS" SHALL MEAN THE CONTRACTUAL TERMS
AND CONDITIONS APPLICABLE TO ALL NETWORK PARTICIPATING  PHARMACIES  THAT
WERE  IN EFFECT ON JUNE FIRST, TWO THOUSAND FIFTEEN; PROVIDED THAT IF AN
INSURER HAD ESTABLISHED DIFFERENT STANDARD TERMS AND CONDITIONS FOR MAIL
ORDER PHARMACIES AND NON-MAIL ORDER RETAIL PHARMACIES, THE TERM STANDARD
TERMS AND CONDITIONS SHALL MEAN THE STANDARD TERMS AND  CONDITIONS  THAT
WERE  IN  EFFECT  ON JUNE FIRST, TWO THOUSAND FIFTEEN FOR NON-MAIL ORDER

A. 10293                            8

RETAIL PHARMACIES, AND PROVIDED FURTHER THAT ANY SUCH STANDARD TERMS AND
CONDITIONS THAT REQUIRE:
  (I) CONSULTATION WITH A PHARMACIST SHALL NOT REQUIRE SUCH CONSULTATION
BE  AVAILABLE  AT  NON-MAIL  ORDER PHARMACIES OUTSIDE OF SUCH PHARMACY'S
REGULAR HOURS OF OPERATION AND SHALL REQUIRE MAIL  ORDER  PHARMACIES  TO
PROVIDE SUCH CONSULTATION TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK;
  (II)  SPECIFIC  STORAGE  SPACE  FOR PRESCRIPTION DRUGS REQUIRE SPECIAL
HANDLING, SUCH AS REFRIGERATION, SHALL BE BASED ON THE CONTRACTING PHAR-
MACY'S DISPENSING  EXPERIENCE  AND  SHALL  NOT  REQUIRE  A  PHARMACY  TO
INCREASE  ITS  STORAGE  SPACE WHEN IT HAS NOT BEEN ESTABLISHED THAT SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE; AND
  (III) SPECIFIC STORAGE  SPACE  FOR  PRESCRIPTION  DRUGS  THAT  DO  NOT
REQUIRE SPECIAL HANDLING SHALL BE BASED ON ON THE CONTRACTING PHARMACY'S
PHYSICAL SIZE AND DISPENSING EXPERIENCE AND SHALL NOT REQUIRE A PHARMACY
TO INCREASE ITS STORAGE SPACE WHEN IT HAS NOT BEEN ESTABLISHED THAT SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE.
  (B)  Every contract issued by a medical expense indemnity corporation,
a hospital service corporation or a  health  services  corporation  that
provides  coverage  for  prescription  fertility  drugs  and requires or
permits prescription drugs to be purchased through a network participat-
ing mail order or other  non-retail  pharmacy  shall  provide  the  same
coverage for prescription fertility drugs AND SHALL NOT LIMIT THE SUPPLY
THAT  MAY  BE  DISPENSED  TO  A  THIRTY-DAY  SUPPLY  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,] AND STANDARD TERMS AND CONDITIONS that the corporation  has
established  for  the network participating [mail order or other non-re-
tail pharmacy] PHARMACIES.  In such case, the contract shall not  impose
any  fee,  co-payment,  co-insurance,  deductible  or  other  condition,
INCLUDING REQUIRING MONTHLY REFILLS OF A PRESCRIPTION THAT  WAS  WRITTEN
FOR  AND MAY BE FILLED FOR MORE THAN A THIRTY-DAY SUPPLY, on any covered
person who does not  elect  to  purchase  prescription  fertility  drugs
through a network participating mail order or other non-retail pharmacy;
provided,  however, that the provisions of this section shall not super-
sede the terms of a  collective  bargaining  agreement  or  apply  to  a
contract that is the result of a collective bargaining agreement between
an employer and a recognized or certified employee organization.
  (3) ANY POLICY THAT PROVIDES COVERAGE FOR PRESCRIPTION FERTILITY DRUGS
SHALL,  IN  ADDITION  TO THE STANDARD TERMS AND CONDITIONS, REQUIRE MAIL
ORDER PHARMACIES TO REPLACE DISPENSED PRESCRIPTION FERTILITY  DRUGS  FOR
WHICH  THE  MAIL OR CARRIER SERVICE HAS PROOF OF DELIVERY THAT HAVE BEEN
NOT RECEIVED BY THE INSURED, OR ARE SPOILED OR DAMAGED, PROVIDED THAT IN
THE CASE OF A PRESCRIPTION FERTILITY DRUG THAT HAS NOT BEEN RECEIVED  BY
THE  INSURED,  THE  POLICY MAY REQUIRE THAT THE INSURED PROVIDE PROOF OF
THEFT IN THE FORM OF A FILED POLICE REPORT REPORTING THE  THEFT  AND  IN
THE CASE OF A DAMAGED OR SPOILED PRESCRIPTION FERTILITY DRUG, THE POLICY
MAY  REQUIRE THAT THE DAMAGED PRESCRIPTION FERTILITY DRUG BE RETURNED TO
THE MAIL ORDER PHARMACY WITH THE COST TO BE BORNE BY SUCH PHARMACY,  AND
PROVIDED  FURTHER  THAT SUCH UNRECEIVED, SPOILED OR DAMAGED PRESCRIPTION
FERTILITY DRUG SHALL BE REPLACED BEFORE RECEIPT OF THE POLICE REPORT  OR
THE  SPOILED OR DAMAGED PRESCRIPTION FERTILITY DRUG, AS THE CASE MAY BE.
IF SUCH REQUIRED POLICE REPORT IS NOT PROVIDED OR THE DAMAGED OR SPOILED
PRESCRIPTION FERTILITY DRUG IS NOT RETURNED, THE POLICY MAY REQUIRE  THE
INSURED TO REIMBURSE THE POLICY FOR THE COST OF THE PRESCRIPTION FERTIL-

A. 10293                            9

ITY  DRUG  AND,  NOTWITHSTANDING  THE  FORGOING, WHEN AN INSURED WHO WAS
PREVIOUSLY REQUIRED TO REIMBURSE THE PLAN FOR A  DISPENSED  PRESCRIPTION
FERTILITY  DRUG  THAT WAS NOT RECEIVED BY THE INSURED, OR WAS DAMAGED OR
SPOILED,  THE  POLICY  MAY REFUSE TO REPLACE SUCH PRESCRIPTION FERTILITY
DRUG FOR SUCH INSURED UNTIL SUCH INSURED HAS PROVIDED THE PLAN WITH  THE
REQUIRED  POLICE  REPORT OR RETURNED THE SPOILED OR DAMAGED PRESCRIPTION
FERTILITY DRUG. REPLACEMENT OF A PRESCRIPTION FERTILITY DRUG PURSUANT TO
THIS PARAGRAPH SHALL NOT BE LIMITED TO A SPECIFIC NUMBER OF  OCCURRENCES
DURING A CONTRACT YEAR.
  S  5. Subsection (kk) of section 4303 of the insurance law, as amended
by chapter 11 of the laws of 2012 and as relettered  by  section  55  of
part D of chapter 56 of the laws of 2013, is amended to read as follows:
  (kk) (1) DEFINITIONS. FOR THE PURPOSE OF THIS SUBSECTION:
  (A) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
UNDER  PARAGRAPH TWO OF THIS SUBSECTION SHALL PROVIDE THE SAME BENCHMARK
INDEX, INCLUDING THE SAME AVERAGE  WHOLESALE  PRICE,  MAXIMUM  ALLOWABLE
COST  AND  NATIONAL  PRESCRIPTION DRUG CODES TO REIMBURSE ALL PHARMACIES
PARTICIPATING IN THE INSURANCE NETWORK REGARDLESS OF WHETHER A  PHARMACY
IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
  (B) "MAIL ORDER PHARMACY" SHALL MEAN A PHARMACY WHOSE PRIMARY BUSINESS
IS  TO  RECEIVE  PRESCRIPTIONS  BY  MAIL,  TELEFAX OR THROUGH ELECTRONIC
SUBMISSIONS AND TO DISPENSE MEDICATION TO PATIENTS THROUGH  THE  USE  OF
THE  UNITED STATES MAIL OR OTHER COMMON OR CONTRACT CARRIER SERVICES AND
PROVIDES ANY  CONSULTATION  WITH  PATIENTS  ELECTRONICALLY  RATHER  THAN
FACE-TO-FACE.
  (C)  "STANDARD  TERMS AND CONDITIONS" SHALL MEAN THE CONTRACTUAL TERMS
AND CONDITIONS APPLICABLE TO ALL NETWORK PARTICIPATING  PHARMACIES  THAT
WERE  IN EFFECT ON JUNE FIRST, TWO THOUSAND FIFTEEN; PROVIDED THAT IF AN
INSURER HAS ESTABLISHED DIFFERENT STANDARD TERMS AND CONDITIONS FOR MAIL
ORDER PHARMACIES AND NON-MAIL ORDER RETAIL PHARMACIES, THE TERM STANDARD
TERMS AND CONDITIONS SHALL MEAN THE STANDARD TERMS AND  CONDITIONS  THAT
WERE  IN  EFFECT  ON JUNE FIRST, TWO THOUSAND FIFTEEN FOR NON-MAIL ORDER
RETAIL PHARMACIES, AND PROVIDED FURTHER THAT ANY SUCH STANDARD TERMS AND
CONDITIONS THAT REQUIRE:
  (I) CONSULTATION WITH A PHARMACIST SHALL NOT REQUIRE SUCH CONSULTATION
BE AVAILABLE AT NON-MAIL ORDER PHARMACIES  OUTSIDE  OF  SUCH  PHARMACY'S
REGULAR  HOURS  OF  OPERATION AND SHALL REQUIRE MAIL ORDER PHARMACIES TO
PROVIDE SUCH CONSULTATION TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK;
  (II) SPECIFIC STORAGE SIZE FOR PRESCRIPTION  DRUGS  REQUIRING  SPECIAL
HANDLING, SUCH AS REFRIGERATION, SHALL BE BASED ON THE CONTRACTING PHAR-
MACY'S  DISPENSING  EXPERIENCE  AND  SHALL  NOT  REQUIRE  A  PHARMACY TO
INCREASE ITS STORAGE SPACE WHEN IT HAS NOT BEEN  ESTABLISHED  THAT  SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE; AND
  (III)  SPECIFIC  STORAGE  SPACE  FOR  PRESCRIPTION  DRUGS  THAT DO NOT
REQUIRE SPECIAL HANDLING SHALL BE BASED ON  THE  CONTRACTING  PHARMACY'S
PHYSICAL SIZE AND DISPENSING EXPERIENCE AND SHALL NOT REQUIRE A PHARMACY
TO INCREASE ITS STORAGE SPACE WHEN IT HAS NOT BEEN ESTABLISHED THAT SUCH
PHARMACY'S PRESCRIPTION VOLUME REQUIRES SUCH INCREASED STORAGE.
  (2)  Any contract issued by a medical expense indemnity corporation, a
hospital service corporation  or  a  health  services  corporation  that
provides  coverage  for  prescription  drugs  shall  permit each covered
person to fill any covered  prescription  that  may  be  obtained  at  a
network  participating  mail  order or other non-retail pharmacy, at the
covered person's option,  at  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 agree-

A. 10293                           10

ment,] to the same reimbursement amount[, as well as the same applicable
terms and conditions,] AND STANDARD TERMS AND CONDITIONS that the corpo-
ration has established for the  network  participating  [mail  order  or
other  non-retail  pharmacy]  PHARMACIES.  In  such a case, the contract
shall not impose a copayment fee or other condition, INCLUDING REQUIRING
MONTHLY REFILLS OF A PRESCRIPTION THAT WAS WRITTEN FOR AND MAY BE FILLED
FOR MORE THAN A THIRTY-DAY SUPPLY, on any covered person who  elects  to
purchase  drugs from a network participating non-mail order retail phar-
macy which is not also imposed on covered persons electing  to  purchase
drugs  from a network participating mail order or other non-retail phar-
macy; provided, however, that the provisions of this section  shall  not
supersede  the  terms of a collective bargaining agreement or apply to a
contract that is the result of a collective bargaining agreement between
an employer and a recognized or certified employee organization.
  (3) ANY POLICY THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL, IN
ADDITION TO THE STANDARD TERMS AND CONDITIONS, REQUIRE MAIL ORDER  PHAR-
MACIES  TO  REPLACE  DISPENSED  PRESCRIPTION DRUGS FOR WHICH THE MAIL OR
CARRIER SERVICE HAS PROOF OF DELIVERY THAT HAVE NOT BEEN RECEIVED BY THE
INSURED, OR ARE SPOILED OR DAMAGED, PROVIDED  THAT  IN  THE  CASE  OF  A
PRESCRIPTION  DRUG THAT HAS NOT BEEN RECEIVED BY THE INSURED, THE POLICY
MAY REQUIRE THAT THE INSURED PROVIDE PROOF OF THEFT IN  THE  FORM  OF  A
FILED  POLICE  REPORT  REPORTING  THEFT  AND IN THE CASE OF A DAMAGED OR
SPOILED PRESCRIPTION DRUG, THE  POLICY  MAY  REQUIRE  THAT  THE  DAMAGED
PRESCRIPTION  DRUG  BE RETURNED TO THE MAIL ORDER PHARMACY WITH THE COST
TO BE BORNE BY SUCH PHARMACY, AND PROVIDED FURTHER THAT SUCH UNRECEIVED,
SPOILED OR DAMAGED PRESCRIPTION DRUG SHALL BE REPLACED BEFORE RECEIPT OF
THE POLICE REPORT OR THE SPOILED OR DAMAGED PRESCRIPTION  DRUG,  AS  THE
CASE  MAY  BE.  IF  SUCH  REQUIRED  POLICE REPORT IS NOT PROVIDED OR THE
DAMAGED OR SPOILED PRESCRIPTION DRUG IS NOT RETURNED, THE  POLICY    MAY
REQUIRE  THE  INSURED  TO  REIMBURSE  THE  POLICY  FOR  THE  COST OF THE
PRESCRIPTION DRUG AND, NOTWITHSTANDING THE FORGOING, WHEN AN INSURED WHO
WAS  PREVIOUSLY  REQUIRED  TO  REIMBURSE  THE  PLAN  FOR   A   DISPENSED
PRESCRIPTION  DRUG  THAT WAS NOT RECEIVED BY THE INSURED, OR WAS DAMAGED
OR SPOILED, THE POLICY MAY REFUSE TO REPLACE SUCH PRESCRIPTION DRUG  FOR
SUCH  INSURED UNTIL SUCH INSURED HAS PROVIDED THE PLAN WITH THE REQUIRED
POLICE REPORT OR RETURNED THE  SPOILED  OR  DAMAGED  PRESCRIPTION  DRUG.
REPLACEMENT  OF A PRESCRIPTION DRUG PURSUANT TO THIS PARAGRAPH SHALL NOT
BE LIMITED TO A SPECIFIC NUMBER OF OCCURRENCES DURING A CONTRACT YEAR.
  S 6. Severability. If any clause, sentence, paragraph, section or part
of this act shall be adjudged by any court of competent jurisdiction  to
be  invalid,  the  judgement shall not affect, impair, or invalidate the
remainder thereof, but shall be confined in its operation to the clause,
sentence, paragraph, section or part thereof directly  involved  in  the
controversy in which the judgement shall have been rendered.
  S 7. This act shall take effect immediately.