Assembly Bill A2653

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2653
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 20, 2017
                                ___________
 
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05109-02-7
              

 A. 2653                             2
 
 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.
   (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

 A. 2653                             3

 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 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

 A. 2653                             4
 
 pharmacy  which  is  not  also  imposed on insureds electing to purchase
 drugs from a network participating mail order or other non-retail  phar-
 macy.
   (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.
   § 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

 A. 2653                             5
 
 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-
 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

 A. 2653                             6
 
 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 CLAUSE SHALL NOT BE LIMITED
 TO A SPECIFIC NUMBER OF OCCURRENCES DURING A CONTRACT YEAR.
   §  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

 A. 2653                             7
 
 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 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.
   § 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

 A. 2653                             8
 
 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  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.

 A. 2653                             9
 
 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-
 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.
   § 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

 A. 2653                            10
 
 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-
 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.
   § 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.
   § 7. This act shall take effect immediately.