S T A T E O F N E W Y O R K
________________________________________________________________________
4852
2019-2020 Regular Sessions
I N A S S E M B L Y
February 5, 2019
___________
Introduced by M. of A. ENGLEBRIGHT, CAHILL, JAFFEE, L. ROSENTHAL, DINOW-
ITZ, BENEDETTO, PERRY, GUNTHER, COLTON, GALEF -- Multi-Sponsored by --
M. of A. ABBATE, COOK, PEOPLES-STOKES -- read once and referred to the
Committee on Health
AN ACT to amend the elder law and the social services law, in relation
to payments for multiple source prescription drugs
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subparagraph 2 of paragraph (a) of subdivision 1 of
section 250 of the elder law, as amended by section 18 of part T of
chapter 56 of the laws of 2012, is amended to read as follows:
(2) The upper limit, if any, set by the centers for medicare and medi-
caid services for such multiple source drug AND THE DEPARTMENT OF HEALTH
TOGETHER WITH THE PHARMACY ADVISORY COMMITTEE SHALL DETERMINE THE IMPACT
OF SUCH UPPER LIMIT PAYMENTS FOR DRUGS IMPLEMENTED UNDER THE DEFICIT
REDUCTION ACT OF 2005 AND SHALL REPORT TO THE DIRECTOR OF THE DIVISION
OF THE BUDGET, SECRETARY OF THE SENATE FINANCE COMMITTEE AND SECRETARY
OF THE ASSEMBLY WAYS AND MEANS COMMITTEE ON SUCH IMPACT AND SHALL ADJUST
PHARMACY DISPENSING FEES FOR MULTIPLE SOURCE PRESCRIPTION DRUGS TO
COMPENSATE FOR ANY REDUCTION AS A RESULT OF THE UPPER LIMITS IMPLEMENTED
UNDER THE DEFICIT REDUCTION ACT OF 2005 AT SUCH TIME THAT THE NEW UPPER
LIMITS ARE IMPLEMENTED, or
§ 2. Subparagraph (i) of paragraph (b) of subdivision 9 of section
367-a of the social services law, as amended by section 7 of part D of
chapter 57 of the laws of 2017, is amended to read as follows:
(i) (A) if the drug dispensed is a generic prescription drug, the
lower of: (1) an amount equal to the national average drug acquisition
cost set by the federal centers for medicare and medicaid services for
the drug, if any, or if such amount if not available, the wholesale
acquisition cost of the drug based on the package size dispensed from,
as reported by the prescription drug pricing service used by the depart-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09045-01-9
A. 4852 2
ment, less seventeen and one-half percent thereof; (2) the federal upper
limit, if any, established by the federal centers for medicare and medi-
caid services; (3) the state maximum acquisition cost, if any, estab-
lished pursuant to paragraph (e) of this subdivision; [or] (4) the
dispensing pharmacy's usual and customary price charged to the general
public; OR (5) THE AVERAGE ACQUISITION COST IF AVAILABLE, AND THE
DEPARTMENT OF HEALTH TOGETHER WITH THE PHARMACY ADVISORY COMMITTEE SHALL
DETERMINE THE IMPACT OF SUCH UPPER LIMIT PAYMENTS FOR DRUGS IMPLEMENTED
UNDER THE DEFICIT REDUCTION ACT OF 2005 AND SHALL REPORT TO THE DIRECTOR
OF THE DIVISION OF THE BUDGET, SECRETARY OF THE SENATE FINANCE COMMITTEE
AND SECRETARY OF THE ASSEMBLY WAYS AND MEANS COMMITTEE ON SUCH IMPACT
AND SHALL ADJUST PHARMACY DISPENSING FEES FOR MULTIPLE SOURCE
PRESCRIPTION DRUGS TO COMPENSATE FOR ANY REDUCTION AS A RESULT OF THE
UPPER LIMITS IMPLEMENTED UNDER THE DEFICIT REDUCTION ACT OF 2005 AT SUCH
TIME THAT THE NEW UPPER LIMITS ARE IMPLEMENTED; (B) if the drug
dispensed is available without a prescription as required by section
sixty-eight hundred ten of the education law but is reimbursed as an
item of medical assistance pursuant to paragraph (a) of subdivision four
of section three hundred sixty-five-a of this title, the lower of (1) an
amount equal to the national average drug acquisition cost set by the
federal centers for medicare and medicaid services for the drug, if any,
or if such amount is not available, the wholesale acquisition cost of
the drug based on the package size dispensed from, as reported by the
prescription drug pricing service used by the department, (2) the feder-
al upper limit, if any, established by the federal centers for medicare
and medicaid services; (3) the state maximum acquisition cost if any,
established pursuant to paragraph (e) of this subdivision; or (4) the
dispensing pharmacy's usual and customary price charged to the general
public;
§ 3. This act shall take effect immediately provided, however, that
the amendments to subdivision 9 of section 367-a of the social services
law, made by section two of this act, shall not affect the expiration
and reversion of such subdivision pursuant to section 4 of chapter 19 of
the laws of 1998, as amended, and shall be deemed to expire therewith.