S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6409
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              March 17, 2021
                                ___________
 
 Introduced  by  M.  of A. BICHOTTE HERMELYN -- read once and referred to
   the Committee on Health
 
 AN ACT to amend the social services law, in relation to  requiring  each
   managed  care  provider  to  annually  provide each participant in its
   program with a written list of mail-order pharmacies  with  which  the
   managed  care  provider  has  a  contract for coverage of prescription
   drugs
 
   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. 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  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.
 EACH MANAGED CARE PROVIDER SUBJECT TO THE PROVISIONS OF  THIS  PARAGRAPH
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD06485-01-1

 A. 6409                             2
 
 SHALL  ANNUALLY  PROVIDE  EACH PARTICIPANT IN ITS PROGRAM WITH A WRITTEN
 LIST OF MAIL-ORDER PHARMACIES WITH WHICH THE MANAGED CARE PROVIDER HAS A
 CONTRACT FOR COVERAGE OF PRESCRIPTION DRUGS.
   § 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, however that
 the amendments 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.