S T A T E O F N E W Y O R K
________________________________________________________________________
7835
2017-2018 Regular Sessions
I N A S S E M B L Y
May 16, 2017
___________
Introduced by M. of A. BICHOTTE -- read once and referred to the Commit-
tee on Health
AN ACT to amend the social services law, in relation to requiring
managed care providers that provide coverage for prescription drugs to
provide coverage for home delivery of any covered prescription drug by
any non-mail-order retail pharmacy in the managed care provider
network
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph (u) of subdivision 4 of section 364-j of the
social services law, as amended by section 12 of part A of chapter 56 of
the laws of 2013, is amended to read as follows:
(u) A managed care provider that provides coverage for prescription
drugs shall permit each participant to fill any mail order covered
prescription, at his or her option, at any mail order pharmacy or non-
mail-order retail pharmacy in the managed care provider network. A
MANAGED CARE PROVIDER THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS
SHALL ALSO PROVIDE COVERAGE FOR HOME DELIVERY OF ANY COVERED
PRESCRIPTION DRUG BY ANY NON-MAIL-ORDER RETAIL PHARMACY IN THE MANAGED
CARE PROVIDER NETWORK. If the managed care provider has designated one
or more pharmacies for filling prescriptions for a particular drug or
drugs, then such prescriptions may be filled, at the participant's
option, at any other pharmacy in the network, if the network pharmacy
chosen by the participant offers to accept a price that is comparable to
that of the pharmacy designated by the managed care provider. For the
purposes of this section, "mail order pharmacy" means 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. Every non-mail-order retail pharmacy in the
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11260-01-7
A. 7835 2
managed care provider's network with respect to any prescription drug
shall be deemed to be in the managed care provider's network for every
covered prescription drug.
§ 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law, and shall apply to all contracts, agreements
and leases entered into on or after such date; provided that the amend-
ments to section 364-j of the social services law made by section one of
this act shall not affect the repeal of such section and shall be deemed
repealed therewith.