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.