Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jun 07, 2016 |
print number 7591c |
Jun 07, 2016 |
amend and recommit to insurance |
Jun 01, 2016 |
print number 7591b |
Jun 01, 2016 |
amend and recommit to insurance |
May 18, 2016 |
print number 7591a |
May 18, 2016 |
amend and recommit to insurance |
May 10, 2016 |
referred to insurance |
Senate Bill S7591C
2015-2016 Legislative Session
Sponsored By
(R, C, IP) Senate District
Archive: Last Bill Status - In Senate Committee Insurance Committee
- Introduced
-
- In Committee Assembly
- In Committee Senate
-
- On Floor Calendar Assembly
- On Floor Calendar Senate
-
- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
Bill Amendments
co-Sponsors
(D) 15th Senate District
(R, C, IP, RFM) Senate District
(D) 14th Senate District
(D, WF) Senate District
2015-S7591 - Details
- Current Committee:
- Senate Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Amd ยงยง3216, 3221 & 4303, Ins L
- Versions Introduced in 2017-2018 Legislative Session:
-
S1766
2015-S7591 - Sponsor Memo
BILL NUMBER: S7591 TITLE OF BILL : An act to amend the insurance law, in relation to reimbursements to mail order pharmacies PURPOSE OR GENERAL IDEA OF BILL : To clarify and strengthen provisions in current law to ensure that consumers have the option to access every covered medication from a local network participating pharmacy and are not forced to use a mail order pharmacy. SUMMARY OF SPECIFIC PROVISIONS : Section one of this bill amends paragraphs (13-a) and (28) of Insurance Law section 380(i) to provide new terms with corresponding definitions and to remove certain requirements that have become impediments to the Legislature's intent in this area. The new defined terms are "same reimbursement amount," "mail order pharmacy," and "standard terms and conditions." The amendment to these paragraphs also provide that when a prescription for 90-day refills is filled on a monthly basis, the insurance policy may not impose an additional fee, co-pay or other
2015-S7591 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7591 I N S E N A T E May 10, 2016 ___________ Introduced by Sens. GOLDEN, ADDABBO, AKSHAR, COMRIE, FUNKE, HAMILTON, KRUEGER, LANZA, O'MARA, PARKER, RITCHIE, ROBACH, SAVINO -- read twice and ordered printed, and when printed to be committed 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 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 PHARMA- CIES, AND PROVIDED FURTHER THAT ANY SUCH STANDARD TERMS AND CONDITIONS THAT REQUIRE: EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
co-Sponsors
(D) 15th Senate District
(R, C, IP, RFM) Senate District
(R) Senate District
(D) 14th Senate District
2015-S7591A - Details
- Current Committee:
- Senate Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Amd ยงยง3216, 3221 & 4303, Ins L
- Versions Introduced in 2017-2018 Legislative Session:
-
S1766
2015-S7591A - Sponsor Memo
BILL NUMBER: S7591A TITLE OF BILL : An act to amend the insurance law, in relation to reimbursements to mail order pharmacies PURPOSE OR GENERAL IDEA OF BILL : To clarify and strengthen provisions in current law to ensure that consumers have the option to access every covered medication from a local network participating pharmacy and are not forced to use a mail order pharmacy. SUMMARY OF SPECIFIC PROVISIONS : Section one of this bill amends paragraphs (13-a) and (28) of Insurance Law section 380(i) to provide new terms with corresponding definitions and to remove certain requirements that have become impediments to the Legislature's intent in this area. The new defined terms are "same reimbursement amount," "mail order pharmacy," and "standard terms and conditions." The amendment to these paragraphs also provides that when a prescription has been written for and may be filled for more than a 30-day supply, the insurance policy may not impose an additional fee, co-pay or other cost that would exceed the amount that would be paid to a mail order pharmacy for a supply in excess of 30 days.
2015-S7591A - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7591--A I N S E N A T E May 10, 2016 ___________ Introduced by Sens. GOLDEN, ADDABBO, AKSHAR, COMRIE, CROCI, ESPAILLAT, FUNKE, HAMILTON, KRUEGER, LANZA, LARKIN, MARTINS, O'MARA, PANEPINTO, PARKER, RITCHIE, ROBACH, SAVINO, STAVISKY -- read twice and ordered printed, and when printed to be committed to the Committee on Insur- ance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
co-Sponsors
(D) 15th Senate District
(R, C, IP, RFM) Senate District
(R) Senate District
(D) 14th Senate District
2015-S7591B - Details
- Current Committee:
- Senate Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Amd ยงยง3216, 3221 & 4303, Ins L
- Versions Introduced in 2017-2018 Legislative Session:
-
S1766
2015-S7591B - Sponsor Memo
BILL NUMBER: S7591B TITLE OF BILL : An act to amend the insurance law, in relation to reimbursements to mail order pharmacies PURPOSE OR GENERAL IDEA OF BILL : To clarify and strengthen provisions in current law to ensure that consumers have the option to access every covered medication from a local network participating pharmacy and are not forced to use a mail order pharmacy. SUMMARY OF SPECIFIC PROVISIONS : Section one of this bill amends paragraphs (13-a) and (28) of Insurance Law section 380(i) to provide new terms with corresponding definitions and to remove certain requirements that have become impediments to the Legislature's intent in this area. The new defined terms are "same reimbursement amount," "mail order pharmacy," and "standard terms and conditions." The amendment to these paragraphs also provides that when a prescription has been written for and may be filled for more than a 30-day supply, the insurance policy may not impose an additional fee,
2015-S7591B - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7591--B I N S E N A T E May 10, 2016 ___________ Introduced by Sens. GOLDEN, ADDABBO, AKSHAR, BOYLE, COMRIE, CROCI, ESPAILLAT, FUNKE, HAMILTON, KRUEGER, LANZA, LARKIN, MARTINS, O'MARA, PANEPINTO, PARKER, RITCHIE, ROBACH, SAVINO, STAVISKY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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 USE THE SAME SINGULAR BENCHMARK INDEX, WHICH MAY BE SAME AVERAGE WHOLESALE PRICE, MAXIMUM ALLOWABLE COST, FEDERAL UPPER LIMIT, OR ANOTHER SIMILAR BENCHMARK INDEX USED BY THE INSURANCE INDUSTRY, AND NATIONAL PRESCRIPTION DRUG CODES TO REIMBURSE ALL PHARMACIES PARTICIPATING IN THE INSURANCE NETWORK FOR ALL PRESCRIPTIONS REGARDLESS OF WHETHER A PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL RETAIL ORDER PHARMACY, PROVIDED, HOWEVER, THAT WHEN THE SELECTED BENCHMARK INDEX DOES NOT INCLUDE A PARTICULAR PRESCRIPTION DRUG, A HIERARCHY OF BENCHMARK INDICES SHALL BE USED IN THEIR HIERARCHI- CAL ORDER AND SUCH SECONDARY INDEX SHALL BE USED TO PROVIDE PRICING FOR ONLY THOSE DRUGS NOT INCLUDED IN THE MAIN INDEX. IF THE TWO SELECTED BENCHMARKS DO NOT INCLUDE A PARTICULAR PRESCRIPTION DRUG, A THIRD BENCH- MARK INDEX SHALL BE USED TO PROVIDE PRICING ONLY FOR DRUGS NOT INCLUDED IN THE MAIN INDEX OR SECONDARY INDEX. ALL PARTICIPATING NETWORK PHARMA- CIES, NON-MAIL ORDER RETAIL PHARMACIES AND MAIL ORDER PHARMACIES, SHALL RECEIVE A DISCLOSURE OF THE REIMBURSEMENT HIERARCHY, THE CURRENT BENCH- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
co-Sponsors
(D) 15th Senate District
(R, C, IP, RFM) Senate District
(R) Senate District
(D) 14th Senate District
2015-S7591C (ACTIVE) - Details
- Current Committee:
- Senate Insurance
- Law Section:
- Insurance Law
- Laws Affected:
- Amd ยงยง3216, 3221 & 4303, Ins L
- Versions Introduced in 2017-2018 Legislative Session:
-
S1766
2015-S7591C (ACTIVE) - Sponsor Memo
BILL NUMBER: S7591C TITLE OF BILL : An act to amend the insurance law, in relation to reimbursements to mail order pharmacies PURPOSE OR GENERAL IDEA OF BILL : To clarify and strengthen provisions in current law to ensure that consumers have the option to access every covered medication from a local network participating pharmacy and are not forced to use a mail order pharmacy. SUMMARY OF SPECIFIC PROVISIONS : Section one of this bill amends paragraphs (13-a) and (28) of Insurance Law section 380(i) to provide new terms with corresponding definitions and to remove certain requirements that have become impediments to the Legislature's intent in this area. The new defined terms are "same reimbursement amount," "mail order pharmacy," and "standard terms and conditions." The amendment to these paragraphs also provides that when a prescription has been written for and may be filled for more than a 30-day supply, the insurance policy may not impose an additional fee, co-pay or other cost that would exceed the amount that would be paid to a mail order pharmacy for a supply in excess of 30 days.
2015-S7591C (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 7591--C I N S E N A T E May 10, 2016 ___________ Introduced by Sens. GOLDEN, ADDABBO, AKSHAR, BOYLE, COMRIE, CROCI, ESPAILLAT, FUNKE, HAMILTON, KRUEGER, LANZA, LARKIN, MARTINS, O'MARA, PANEPINTO, PARKER, RITCHIE, ROBACH, SAVINO, STAVISKY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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 USE THE SAME SINGULAR BENCHMARK INDEX, WHICH MAY BE AVERAGE WHOLESALE PRICE, MAXIMUM ALLOWABLE COST, FEDERAL UPPER LIMIT, OR ANOTHER SIMILAR BENCHMARK INDEX USED BY THE INSURANCE INDUSTRY, AND NATIONAL PRESCRIPTION DRUG CODES TO REIM- BURSE ALL PHARMACIES PARTICIPATING IN THE INSURANCE NETWORK FOR ALL PRESCRIPTIONS REGARDLESS OF WHETHER A PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL RETAIL ORDER PHARMACY, PROVIDED, HOWEVER, THAT WHEN THE SELECTED BENCHMARK INDEX DOES NOT INCLUDE ONE OR MORE PARTICULAR PRESCRIPTION DRUGS, A HIERARCHY OF BENCHMARK INDICES SHALL BE USED IN THEIR HIERARCHICAL ORDER AND SUCH SECONDARY INDEX SHALL BE USED TO PROVIDE PRICING FOR ONLY THOSE DRUGS NOT INCLUDED IN THE MAIN INDEX. IF THE TWO SELECTED BENCHMARKS DO NOT INCLUDE ONE OR MORE PARTICULAR PRESCRIPTION DRUGS, A THIRD BENCHMARK INDEX SHALL BE USED TO PROVIDE PRICING ONLY FOR THOSE DRUGS NOT INCLUDED IN THE MAIN INDEX OR SECONDARY INDEX. ALL PARTICIPATING NETWORK PHARMACIES, NON-MAIL ORDER RETAIL PHAR- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
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