NY State Senate Bill 2015-S7595A

Senate Bill S7595A

2015-2016 Legislative Session

Provides that prescriptions covered by insurance, that would otherwise be required to be filled by mail order, may be filled at a retail pharmacy under certain circumstances

download bill text pdf

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

Please enter your contact information

First Name

Last Name

Email Address

A valid email address is required.

Home address is used to determine the senate district in which you reside. Your support or opposition to this bill is then shared immediately with the senator who represents you.

Optional services from the NY State Senate:

Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Include a custom message for your Senator? (Optional)

Enter a message to your senator. Many New Yorkers use this to share the reasoning behind their support or opposition to the bill. Others might share a personal anecdote about how the bill would affect them or people they care about.

Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 02, 2016	print number 7595a
Jun 02, 2016	amend and recommit to insurance
May 10, 2016	referred to insurance

Bill Amendments

Original

A (Active)

co-Sponsors

2015-S7595 - Details

See Assembly Version of this Bill:: A10290
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2017-2018: A1929
2019-2020: A347
2021-2022: A5787

2015-S7595 - Summary

Provides that prescriptions covered by insurance, that would otherwise be required to be filled by mail order, may be filled at a retail pharmacy under certain circumstances.

2015-S7595 - Sponsor Memo

                                 BILL NUMBER:  S7595

 TITLE OF BILL :  An act to amend the insurance law, in relation to
coverage of prescriptions obtained by mail order or at a non-retail
pharmacy

 PURPOSE :

Ensure patient access to retail pharmacies upon the prescribers
determination that mail order delivery would not be appropriate

 SUMMARY OF PROVISIONS :

Sections one, two and three amend Insurance Law §§ 3216, 3221 and 4303
respectively to provide that a prescriber, after consultation with the
patient's insurer, may determine that mail order delivery of
prescription medication is not appropriate given the patient's
residence, medical condition, storage requirements of the drug,
availability of the insured to receive the prescription or the
patient's ability to understand guidance and support over the
telephone. Provided the retail pharmacy agrees to the same
reimbursement amount and is able to fill the prescription, the
prescribers determination shall be final.

Section four provides that the act take effect immediately.

 JUSTIFICATION :

While recognizing the value of mail order pharmacies and the
convenience they provide for many, not all patients have the same
needs. For many patients, especially those with complex medical
conditions, access to local pharmacies for their medications can be
essential for their health and wellbeing. Patients may have residences
lacking secure deliver locations, be on specific treatment regimens
that may be disrupted if the medications are not promptly received,
take medications that need special handling, or need the in person
counseling of a pharmacists. There are many different reasons why an
individual may benefit from access to a retail pharmacy rather than a
mail order pharmacy. That decision should be made between the patient
and his or her prescriber. The Legislature has already acknowledged
the need to ensure patient access to pharmacy options. This
legislation will expand upon the 2011 provisions to ensure a
prescriber, considering all factors relevant to the patient, can
determine when mail order is not appropriate. The bill also ensures
that cost is not affected, by requiring the retail pharmacy to agree
to the same reimbursement amount.

 LEGISLATIVE HISTORY :

New bill.

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
Immediately.

2015-S7595 - Bill Text download pdf

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

                                  7595

                            I N  S E N A T E

                              May 10, 2016
                               ___________

Introduced  by  Sens.  HANNON, GOLDEN -- 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  coverage  of
  prescriptions obtained by mail order or at a non-retail pharmacy

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

  Section 1. The opening paragraph of paragraph 28 of subsection (i)  of
section  3216  of the insurance law, as added by chapter 597 of the laws
of 2011, is designated subparagraph (A) and a new  subparagraph  (B)  is
added to read as follows:
  (B)  NOTWITHSTANDING ANY OTHER PROVISION OF THIS PARAGRAPH, IF A PRES-
CRIBER, AFTER CONSULTING WITH THE INSURER REGARDING THE  APPROPRIATENESS
OF  MAIL ORDER DELIVERY GIVEN: (I) THE RESIDENCE OR DELIVERY LOCATION OF
THE INSURED; (II) THE MEDICAL CONDITION OF THE INSURED; (III) THE  STOR-
AGE  REQUIREMENTS  OF  THE DRUG; (IV) THE AVAILABILITY OF THE INSURED TO
RECEIVE THE PRESCRIPTION; OR (V) THE  INSURED'S  ABILITY  TO  COMPREHEND
PHARMACEUTICAL  GUIDANCE AND SUPPORT OVER THE TELEPHONE, DETERMINES THAT
A DRUG AS PRESCRIBED ON AN INDIVIDUAL BASIS IS MOST APPROPRIATELY FILLED
AT A RETAIL LOCATION, PROVIDED THAT A RETAIL PHARMACY AGREES IN  ADVANCE
TO  THE  SAME REIMBURSEMENT AMOUNT AND IS ABLE TO FILL THE PRESCRIPTION,
THE PRESCRIBER'S DETERMINATION SHALL BE FINAL.
  S 2. The opening paragraph  of  paragraph  18  of  subsection  (1)  of
section  3221  of the insurance law is designated subparagraph (A) and a
new subparagraph (B) is added to read as follows:
  (B) NOTWITHSTANDING ANY OTHER PROVISION OF THIS PARAGRAPH, IF A  PRES-
CRIBER,  AFTER CONSULTING WITH THE INSURER REGARDING THE APPROPRIATENESS
OF MAIL ORDER DELIVERY GIVEN: (I) THE RESIDENCE OR DELIVERY LOCATION  OF
THE  INSURED; (II) THE MEDICAL CONDITION OF THE INSURED; (III) THE STOR-
AGE REQUIREMENTS OF THE DRUG; (IV) THE AVAILABILITY OF  THE  INSURED  TO
RECEIVE  THE  PRESCRIPTION;  OR  (V) THE INSURED'S ABILITY TO COMPREHEND
PHARMACEUTICAL GUIDANCE AND SUPPORT OVER THE TELEPHONE, DETERMINES  THAT
A DRUG AS PRESCRIBED ON AN INDIVIDUAL BASIS IS MOST APPROPRIATELY FILLED
AT  A RETAIL LOCATION, PROVIDED THAT A RETAIL PHARMACY AGREES IN ADVANCE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15123-03-6

S. 7595                             2

TO THE SAME REIMBURSEMENT AMOUNT AND IS ABLE TO FILL  THE  PRESCRIPTION,
THE PRESCRIBER'S DETERMINATION SHALL BE FINAL.
  S  3.  The opening paragraph of subsection (kk) of section 4303 of the
insurance law is designated paragraph 1 and a new paragraph 2  is  added
to read as follows:
  (2) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SUBSECTION, IF A PRES-
CRIBER,  AFTER CONSULTING WITH THE INSURER REGARDING THE APPROPRIATENESS
OF MAIL ORDER DELIVERY GIVEN: (I) THE RESIDENCE OR DELIVERY LOCATION  OF
THE  COVERED  PERSON;  (II) THE MEDICAL CONDITION OF THE COVERED PERSON;
(III) THE STORAGE REQUIREMENTS OF THE DRUG; (IV) THE AVAILABILITY OF THE
COVERED PERSON TO RECEIVE THE PRESCRIPTION; OR (V) THE COVERED  PERSON'S
ABILITY TO COMPREHEND PHARMACEUTICAL GUIDANCE AND SUPPORT OVER THE TELE-
PHONE,  DETERMINES  THAT  A DRUG AS PRESCRIBED ON AN INDIVIDUAL BASIS IS
MOST APPROPRIATELY FILLED AT A RETAIL LOCATION, PROVIDED THAT  A  RETAIL
PHARMACY  AGREES IN ADVANCE TO THE SAME REIMBURSEMENT AMOUNT AND IS ABLE
TO FILL THE PRESCRIPTION, THE PRESCRIBER'S DETERMINATION SHALL BE FINAL.
  S 4. This act shall take effect immediately.

co-Sponsors

2015-S7595A (ACTIVE) - Details

See Assembly Version of this Bill:: A10290
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2017-2018: A1929
2019-2020: A347
2021-2022: A5787

2015-S7595A (ACTIVE) - Summary

Provides that prescriptions covered by insurance, that would otherwise be required to be filled by mail order, may be filled at a retail pharmacy under certain circumstances.

2015-S7595A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S7595A

 TITLE OF BILL :  An act to amend the insurance law, in relation to
coverage of prescriptions obtained by mail order or at a non-retail
pharmacy

 PURPOSE :

Ensure patient access to retail pharmacies upon the prescribers
determination that mail order delivery would not be appropriate

 SUMMARY OF PROVISIONS :

Sections one, two and three amend Insurance Law §§ 3216, 3221 and 4303
respectively to provide that a prescriber, after consultation with the
patient's insurer, may determine that mail order delivery of
prescription medication is not appropriate given the patient's
residence, medical condition, storage requirements of the drug,
availability of the insured to receive the prescription or the
patient's ability to understand guidance and support over the
telephone. Provided a network pharmacy chosen by the patient agrees to
the same reimbursement amount and is able to fill the prescription,
the prescribers determination shall be final.

Section four provides that the act take effect immediately.

 JUSTIFICATION :

While recognizing the value of mail order pharmacies and the
convenience they provide for many, not all patients have the same
needs. For many patients, especially those with complex medical
conditions, access to local pharmacies for their medications can be
essential for their health and wellbeing. Patients may have residences
lacking secure deliver locations, be on specific treatment regimens
that may be disrupted if the medications are not promptly received,
take medications that need special handling, or need the in person
counseling of a pharmacists. There are many different reasons why an
individual may benefit from access to a retail pharmacy rather than a
mail order pharmacy. That decision should be made between the patient
and his or her prescriber. The Legislature has already acknowledged
the need to ensure patient access to pharmacy options. This
legislation will expand upon the 2011 provisions to ensure a
prescriber, considering all factors relevant to the patient, can
determine when mail order is not appropriate. The bill also ensures
that cost is not affected, by requiring the retail pharmacy to agree
to the same reimbursement amount.

 LEGISLATIVE HISTORY :

New bill.

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
Immediately.

2015-S7595A (ACTIVE) - Bill Text download pdf

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

                                 7595--A

                            I N  S E N A T E

                              May 10, 2016
                               ___________

Introduced  by  Sens. HANNON, GOLDEN, KAMINSKY -- 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  coverage  of
  prescriptions obtained by mail order or at a non-retail pharmacy

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

  Section 1. The opening paragraph of paragraph 28 of subsection (i)  of
section  3216  of the insurance law, as added by chapter 589 of the laws
of 2011, is designated subparagraph (A) and a new  subparagraph  (B)  is
added to read as follows:
  (B)  NOTWITHSTANDING ANY OTHER PROVISION OF THIS PARAGRAPH, IF A PRES-
CRIBER, AFTER CONSULTING WITH THE INSURER REGARDING THE  APPROPRIATENESS
OF  MAIL ORDER DELIVERY GIVEN: (I) THE RESIDENCE OR DELIVERY LOCATION OF
THE INSURED; (II) THE MEDICAL CONDITION OF THE INSURED; (III) THE  STOR-
AGE  REQUIREMENTS  OF  THE DRUG; (IV) THE AVAILABILITY OF THE INSURED TO
RECEIVE THE PRESCRIPTION; OR (V) THE  INSURED'S  ABILITY  TO  COMPREHEND
PHARMACEUTICAL  GUIDANCE AND SUPPORT OVER THE TELEPHONE, DETERMINES THAT
A DRUG AS PRESCRIBED ON AN INDIVIDUAL BASIS IS MOST APPROPRIATELY FILLED
AT A RETAIL LOCATION, PROVIDED THAT AN IN-NETWORK RETAIL PHARMACY OF THE
PATIENT'S CHOOSING AGREES TO THE SAME REIMBURSEMENT AMOUNT AND  IS  ABLE
TO FILL THE PRESCRIPTION, THE PRESCRIBER'S DETERMINATION SHALL BE FINAL.
  S  2.  The  opening  paragraph  of  paragraph  18 of subsection (1) of
section 3221 of the insurance law is designated subparagraph (A)  and  a
new subparagraph (B) is added to read as follows:
  (B)  NOTWITHSTANDING ANY OTHER PROVISION OF THIS PARAGRAPH, IF A PRES-
CRIBER, AFTER CONSULTING WITH THE INSURER REGARDING THE  APPROPRIATENESS
OF  MAIL ORDER DELIVERY GIVEN: (I) THE RESIDENCE OR DELIVERY LOCATION OF
THE INSURED; (II) THE MEDICAL CONDITION OF THE INSURED; (III) THE  STOR-
AGE  REQUIREMENTS  OF  THE DRUG; (IV) THE AVAILABILITY OF THE INSURED TO
RECEIVE THE PRESCRIPTION; OR (V) THE  INSURED'S  ABILITY  TO  COMPREHEND
PHARMACEUTICAL  GUIDANCE AND SUPPORT OVER THE TELEPHONE, DETERMINES THAT
A DRUG AS PRESCRIBED ON AN INDIVIDUAL BASIS IS MOST APPROPRIATELY FILLED

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

                                                           LBD15123-06-6

S. 7595--A                          2

AT A RETAIL LOCATION, PROVIDED THAT AN IN-NETWORK RETAIL PHARMACY OF THE
PATIENT'S CHOOSING AGREES TO THE SAME REIMBURSEMENT AMOUNT AND  IS  ABLE
TO FILL THE PRESCRIPTION, THE PRESCRIBER'S DETERMINATION SHALL BE FINAL.
  S  3.  The opening paragraph of subsection (kk) of section 4303 of the
insurance law is designated paragraph 1 and a new paragraph 2  is  added
to read as follows:
  (2) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SUBSECTION, IF A PRES-
CRIBER,  AFTER CONSULTING WITH THE INSURER REGARDING THE APPROPRIATENESS
OF MAIL ORDER DELIVERY GIVEN: (A) THE RESIDENCE OR DELIVERY LOCATION  OF
THE COVERED PERSON; (B) THE MEDICAL CONDITION OF THE COVERED PERSON; (C)
THE  STORAGE  REQUIREMENTS  OF  THE  DRUG;  (D)  THE AVAILABILITY OF THE
COVERED PERSON TO RECEIVE THE PRESCRIPTION; OR (E) THE COVERED  PERSON'S
ABILITY TO COMPREHEND PHARMACEUTICAL GUIDANCE AND SUPPORT OVER THE TELE-
PHONE,  DETERMINES  THAT  A DRUG AS PRESCRIBED ON AN INDIVIDUAL BASIS IS
MOST APPROPRIATELY FILLED AT A RETAIL LOCATION, PROVIDED THAT AN IN-NET-
WORK RETAIL PHARMACY OF  THE  PATIENT'S  CHOOSING  AGREES  TO  THE  SAME
REIMBURSEMENT   AMOUNT  AND  IS  ABLE  TO  FILL  THE  PRESCRIPTION,  THE
PRESCRIBER'S DETERMINATION SHALL BE FINAL.
  S 4. This act shall take effect immediately.

Comments

Open Legislation is a forum for New York State legislation. All comments are subject to review and community moderation is encouraged.

Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity, hate or toxic speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Attempts to intimidate and silence contributors or deliberately deceive the public, including excessive or extraneous posting/posts, or coordinated activity, are prohibited and may result in the temporary or permanent banning of the user. Comment moderation is generally performed Monday through Friday. By contributing or voting you agree to the Terms of Participation and verify you are over 13.

Create an account. An account allows you to sign petitions with a single click, officially support or oppose key legislation, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Senate Bill S7595A

Share this bill

Sponsored By

Kemp Hannon

Archive: Last Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

Martin J. Golden

Todd Kaminsky

2015-S7595 - Details

2015-S7595 - Summary

2015-S7595 - Sponsor Memo

2015-S7595 - Bill Text download pdf

co-Sponsors

Martin J. Golden

Todd Kaminsky

2015-S7595A (ACTIVE) - Details

2015-S7595A (ACTIVE) - Summary

2015-S7595A (ACTIVE) - Sponsor Memo

2015-S7595A (ACTIVE) - Bill Text download pdf

Comments