Senate Bill S7591C

2015-2016 Legislative Session

Relates to coverage for the purchase of prescription drugs through mail order pharmacies

download bill text pdf

Sponsored By

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

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Actions

Bill Amendments

co-Sponsors

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 - Summary

Provides for reimbursement requirements and coverage for the purchase of prescription drugs through mail order pharmacies.

2015-S7591 - Sponsor Memo

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

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 - Summary

Provides for reimbursement requirements and coverage for the purchase of prescription drugs through mail order pharmacies.

2015-S7591A - Sponsor Memo

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

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 - Summary

Provides for reimbursement requirements and coverage for the purchase of prescription drugs through mail order pharmacies.

2015-S7591B - Sponsor Memo

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

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) - Summary

Provides for reimbursement requirements and coverage for the purchase of prescription drugs through mail order pharmacies.

2015-S7591C (ACTIVE) - Sponsor Memo

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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