NY State Senate Bill 2021-S4883

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
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Delivered to Governor
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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 05, 2022	referred to health
Feb 17, 2021	referred to health

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2021-S4883 (ACTIVE) - Details

See Assembly Version of this Bill:: A194
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add Art 28-CC §2894, Pub Health L; add §95-j, St Fin L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S7771, A10054
2023-2024: S3222, A7853

2021-S4883 (ACTIVE) - Summary

Establishes an emergency insulin program and corresponding emergency insulin program trust fund to facilitate emergency access to analog insulins.

2021-S4883 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S4883

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law and the state finance law, in
relation to an emergency insulin program

 
PURPOSE OR GENERAL IDEA OF BILL:

To create an Emergency Insulin Program to ensure that those dependent on
insulin for their survival can access emergency supplies.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 of the bill establishes a new article 28-CC of the public
health law creating an Emergency Insulin Program. The program shall
ensure that recipients of the program can access emergency supplies of
analog insulins and related supplies no later than April 1, 2021, assum-
ing an appropriation or sufficient funds are in the program trust fund
established pursuant to section two. A recipient is a person diagnosed

with type one diabetes, or type two insulin dependent diabetes and who
is at risk of experiencing serious adverse health effects due to a lack
of analog insulins, and who is uninsured or underinsured. It also allows
providers to prescribe analog insulins under a non-patient specific
prescription and a pharmacist may dispense through a non-patient specif-
ic prescription to a recipient, similar to the successful state opioid
prevention program which ensures access to naloxone to reverse over-
doses.

This section also requires any pharmacy with twenty or more locations in
the state and any article 28 facility with a 340B drug discount program
to pursue or maintain a non-patient specific prescription to dispense
analog insulins and to register with the department as an emergency
insulin program by January 1, 2021.

This section further directs the Commissioner of Health to immediately
begin to work with analog insulin manufacturers in creating such
programs to have a public-private partnership to support the state's
streamlined Emergency Insulin Program that may replicate patient support
programs such manufactures have. It also allows the Commissioner to
establish a sliding scale for cost sharing for certain recipients which
shall not exceed one hundred dollars for a thirty day supply of analog
insulins and related supplies. Finally, this section directs the Commis-
sioner to publish findings on the program and share them with the Gover-
nor and legislature within one year of the effective date and every two
years thereafter.

Section 2 amends the state finance law by adding a new section 97-tttt
which creates a special revenue fund in the joint custody of the state
comptroller and the commissioner of taxation and finance to be known as
the Emergency Insulin Program Trust Fund to support the Emergency Insu-
lin Program.

Section 3 provides for the effective date.

 
JUSTIFICATION:


2.1 million New Yorkers have diabetes and 30% of type two diabetics are
insulin dependent. There are 20,000 hospitalizations in New York State
each year with a principal diagnosis of diabetes related complications
including diabetic ketoacidosis. Type 1 and some Type 2 diabetics depend
upon insulin for their very survival. In 2016, the average person with
type 1 diabetes incurred annual insulin costs of $5,705.00. While some
pay less, many others pay many times this amount. When patients can't
afford insulin, which can cost thousands of dollars even for those who
are insured, patients can resort to rationing the little medication they
can afford.  In fact, one study found that one in four people with type
1 diabetes admitted to not taking their insulin as prescribed, or
rationing, due to the cost. Complications from rationing insulin are
extreme and can lead to amputations, Diabetic KETOACIDOSIS, also
referred to as DKA, and even death.

This legislation creates an Emergency Insulin Program, modeled after New
York State's Opioid Prevention Program which has made access to life
saving Naloxone to reverse an opioid overdose widely available in our
state. Under the Emergency Insulin Program, individuals who are unin-
sured or underinsured would be able to get analog insulin through a
non-patient specific prescription at certain pharmacies, including clin-
ic and hospital pharmacies. The Department of Health would be able to
establish a sliding scale for certain cost sharing, which would be
capped at $100 for a thirty day supply of insulins and supplies.

The bill directs the Department of Health to immediately engage analog
insulin manufactures to support the state program and facilitate quick
access to affordable analog insulin in emergency situations through a
public private partnership to streamline existing patient support
programs such manufactures have. The three manufactures of analog insu-
lin each have programs designed to help people access their products at
a reduced rate or for free, however each program is different and advo-
cates argue they are difficult to access, especially in emergency situ-
ations. Recognizing that manufactures want to make sure everyone can
access the life-saving medications they hold patents on, this bill
establishes an Emergency Insulin Program Trust fund to accept funds for
the statewide program. Like New York's highly successful Opioid
Prevention Program which makes naloxone widely available, this program
would allow for non-patient specific prescriptions for analog insulins
and utilize chain pharmacies and 340B pharmacies, which are able to
provide the lowest cost medications, to distribute the insulins and
supplies to recipients who qualify.

While it is true there are some types of human insulin that can be
accessed over the counter and for a relatively low fee, these are often
referred to as "dead in bed" insulin because they do not provide the
level of support many type 1 and some type 2 diabetics require.

These low cost human insulins are less commonly prescribed by doctors
precisely because of their unpredictable rate of absorption, which can
result in more frequent low and high blood sugars. They require more
monitoring and more supplies and, according to advocates when people
transition from the newer, more costly analog insulins the risk of dead
in bed syndrome is greatly increased. In recent years, the Opioid Over-
does Prevention Program has been expanded to provide access in pharma-
cies, not just through community based organizations. Like overdose, the
risk of death from a lack of insulin occurs far too often and quickly.
New York State must do all it can to make sure that diabetics who depend
on insulin for their survival can access emergency supplies of analog
insulin, just as we currently insure the friends, families and first
responders are equipped with like saving naloxone in the case of an
overdose. There is no question that a person who depends on daily insu-
lin for their survival is at grave risk without timely access to afford-
able insulin.  Nobody should die from rationing or running out of insu-
lin, or from being forced to switch to less reliable human insulin. The
Emergency Insulin Program can make sure New York, with the cooperation
of manufac- tures of analog insulins, is doing all it can to ensure
those in need can access this life saving medication.

 
PRIOR LEGISLATIVE HISTORY:

2019-2020: S7771/A10054 Gottfried

 
FISCAL IMPLICATIONS:

To be determined, but potential savings as expensive hospitalizations as
a result of severe adverse reactions from patients rationing or running
out of insulin is avoided.

 
EFFECTIVE DATE:

2021-S4883 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4883
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 17, 2021
                                ___________
 
 Introduced   by  Sens.  RIVERA,  GOUNARDES,  KAMINSKY,  KRUEGER,  MYRIE,
   PERSAUD, SEPULVEDA -- read twice and ordered printed, and when printed
   to be committed to the Committee on Health
 
 AN ACT to amend the public health law and  the  state  finance  law,  in
   relation to an emergency insulin program

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The public health law is amended by adding  a  new  article
 28-CC to read as follows:
                               ARTICLE 28-CC
                         EMERGENCY INSULIN PROGRAM
 SECTION 2894. EMERGENCY INSULIN PROGRAM.
   §  2894.  EMERGENCY INSULIN PROGRAM. 1. THE COMMISSIONER IS AUTHORIZED
 AND DIRECTED TO ESTABLISH AN EMERGENCY INSULIN PROGRAM  TO  ENSURE  THAT
 RECIPIENTS  OF THE PROGRAM CAN ACCESS EMERGENCY SUPPLIES OF ANALOG INSU-
 LINS AND RELATED SUPPLIES.   THE COMMISSIONER SHALL  IMMEDIATELY  ENGAGE
 ANALOG INSULIN MANUFACTURERS TO SUPPORT THE STATE PROGRAM AND FACILITATE
 QUICK  ACCESS TO AFFORDABLE ANALOG INSULINS IN EMERGENCY SITUATIONS. THE
 COMMISSIONER SHALL ESTABLISH STANDARDS FOR  APPROVAL  OF  ANY  EMERGENCY
 INSULIN  PROGRAM,  AND  ANALOG INSULIN PRESCRIBING, DISPENSING, DISTRIB-
 UTION, AND POSSESSION PURSUANT TO THIS SECTION WHICH  MAY  INCLUDE,  BUT
 NOT BE LIMITED TO, STANDARDS FOR PROGRAM DIRECTORS, APPROPRIATE CLINICAL
 OVERSIGHT, TRAINING, RECORD KEEPING AND REPORTING. THE EMERGENCY INSULIN
 PROGRAM  SHALL,  PURSUANT TO AN APPROPRIATION OR SUFFICIENT FUNDS IN THE
 EMERGENCY INSULIN PROGRAM TRUST FUND,  BE  AVAILABLE  TO  RECIPIENTS  NO
 LATER THAN APRIL FIRST, TWO THOUSAND TWENTY-TWO.
   2. (A) AS USED IN THIS SECTION:
   (I)  "ANALOG  INSULINS" MEANS AT A MINIMUM SHORT-ACTING, RAPID-ACTING,
 INTERMEDIATE AND LONG ACTING INSULIN DRUGS APPROVED BY THE FOOD AND DRUG
 ADMINISTRATION THAT, WHEN ADMINISTERED, TO CERTAIN RECIPIENTS ARE  LIFE-
 SAVING,  AND HELP AVOID SERIOUS ADVERSE EFFECTS ASSOCIATED WITH TYPE ONE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD00578-01-1

 S. 4883                             2
 
 DIABETES AND IN SOME LIMITED CASES TYPE TWO DIABETES, AND OTHER  MEDICA-
 TIONS AND SUPPLIES APPROVED BY THE DEPARTMENT FOR SUCH PURPOSE.
   (II) "HEALTH CARE PROFESSIONAL" MEANS A PERSON LICENSED, REGISTERED OR
 AUTHORIZED  PURSUANT  TO  TITLE  EIGHT OF THE EDUCATION LAW TO PRESCRIBE
 PRESCRIPTION DRUGS.
   (III) "PHARMACIST" MEANS A PERSON LICENSED OR AUTHORIZED  TO  PRACTICE
 PHARMACY  PURSUANT  TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION
 LAW.
   (IV) "RECIPIENT" MEANS A PERSON: (1) DIAGNOSED WITH TYPE ONE DIABETES,
 OR TYPE TWO INSULIN DEPENDENT DIABETES; AND (2) WHO IS AT RISK OF  EXPE-
 RIENCING  SERIOUS  ADVERSE  HEALTH EFFECTS DUE TO A LACK OF ANALOG INSU-
 LINS; AND (3) WHO IS UNINSURED OR UNDERINSURED; OR (4)  AN  ORGANIZATION
 REGISTERED AS AN EMERGENCY INSULIN PROGRAM PURSUANT TO THIS SECTION.
   (B)(I)  A HEALTH CARE PROFESSIONAL MAY PRESCRIBE BY A PATIENT-SPECIFIC
 OR NON-PATIENT-SPECIFIC PRESCRIPTION, DISPENSE OR  DISTRIBUTE,  DIRECTLY
 OR INDIRECTLY, ANALOG INSULINS TO A RECIPIENT.
   (II) A PHARMACIST MAY DISPENSE ANALOG INSULINS, THROUGH A PATIENT-SPE-
 CIFIC  OR  NON-PATIENT-SPECIFIC PRESCRIPTION PURSUANT TO THIS PARAGRAPH,
 TO A RECIPIENT.
   (III) THE PROVISIONS OF THIS PARAGRAPH SHALL NOT BE DEEMED TO  REQUIRE
 A  PRESCRIPTION  FOR ANY ANALOG INSULINS THAT DO NOT OTHERWISE REQUIRE A
 PRESCRIPTION; NOR SHALL IT BE DEEMED TO LIMIT THE AUTHORITY OF A  HEALTH
 CARE  PROFESSIONAL TO PRESCRIBE, DISPENSE OR DISTRIBUTE, OR OF A PHARMA-
 CIST TO DISPENSE, ANALOG INSULINS UNDER ANY OTHER PROVISION OF LAW.
   (IV) ANY PHARMACY WITH TWENTY OR MORE LOCATIONS IN THE STATE, AND  ANY
 FACILITY  ESTABLISHED  PURSUANT  TO ARTICLE TWENTY-EIGHT OF THIS CHAPTER
 WHICH HAS A DRUG DISCOUNT PROGRAM AUTHORIZED  BY  SECTION  340B  OF  THE
 FEDERAL  PUBLIC HEALTH SERVICE ACT 42 U.S.C § 256B SHALL PURSUE OR MAIN-
 TAIN A NON-PATIENT-SPECIFIC PRESCRIPTION WITH AN AUTHORIZED HEALTH  CARE
 PROFESSIONAL TO DISPENSE ANALOG INSULINS TO A RECIPIENT UPON REQUEST, AS
 AUTHORIZED BY THIS SECTION; AND REGISTER WITH THE DEPARTMENT AS AN EMER-
 GENCY  INSULIN PROGRAM NO LATER THAN JANUARY FIRST, TWO THOUSAND TWENTY-
 TWO.
   3. USE OR DISPENSING OF ANALOG INSULINS PURSUANT TO THIS SECTION SHALL
 BE CONSIDERED FIRST AID OR EMERGENCY TREATMENT FOR THE  PURPOSE  OF  ANY
 STATUTE RELATING TO LIABILITY.
   4.  THE COMMISSIONER SHALL IMMEDIATELY BEGIN TO WORK WITH ANALOG INSU-
 LIN MANUFACTURERS IN CREATING SUCH PROGRAM TO ENSURE  THEY  ARE  WORKING
 WITH  THE  STATE  IN A PUBLIC-PRIVATE PARTNERSHIP TO SUPPORT THE STATE'S
 STREAMLINED EMERGENCY INSULIN PROGRAM THAT MAY REPLICATE PATIENT SUPPORT
 PROGRAMS SUCH MANUFACTURERS HAVE.  A MANUFACTURER MAY CONTRIBUTE TO  THE
 PROGRAM  THROUGH  THE  EMERGENCY  INSULIN PROGRAM TRUST FUND ESTABLISHED
 PURSUANT TO SECTION NINETY-FIVE-J OF THE STATE FINANCE LAW.
   5. THE COMMISSIONER MAY ESTABLISH A SLIDING SCALE FOR COST SHARING FOR
 CERTAIN RECIPIENTS WHICH SHALL NOT EXCEED  ONE  HUNDRED  DOLLARS  FOR  A
 THIRTY-DAY SUPPLY OF ANALOG INSULINS AND RELATED SUPPLIES.
   6.  THE  COMMISSIONER  SHALL PUBLISH FINDINGS ON THE EMERGENCY INSULIN
 PROGRAM INCLUDING BUT NOT LIMITED TO THE NUMBER OF PROGRAMS ESTABLISHED,
 THE NUMBER OF RECIPIENTS SERVED, THE TYPES AND AMOUNTS OF  ANALOG  INSU-
 LINS  PROVIDED,  THE  COSTS AND SAVINGS ASSOCIATED WITH THE PROGRAM, AND
 WHAT PUBLIC-PRIVATE PARTNERSHIPS THE STATE HAS  FACILITATED  TO  SUPPORT
 THIS  PROGRAM  TO THE GOVERNOR AND THE CHAIRS OF THE SENATE AND ASSEMBLY
 HEALTH COMMITTEES WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS  ARTICLE
 AND EVERY TWO YEARS THEREAFTER.
   §  2. The state finance law is amended by adding a new section 95-j to
 read as follows:

 S. 4883                             3
 
   § 95-J. EMERGENCY INSULIN PROGRAM  TRUST  FUND.  1.  THERE  IS  HEREBY
 ESTABLISHED  IN  THE  JOINT  CUSTODY  OF  THE  STATE COMPTROLLER AND THE
 COMMISSIONER OF TAXATION AND FINANCE A SPECIAL FUND TO BE KNOWN  AS  THE
 "EMERGENCY INSULIN PROGRAM TRUST FUND".
   2.  SUCH FUND SHALL CONSIST OF ALL MONIES APPROPRIATED FOR ITS PURPOSE
 AND ALL MONIES RECEIVED, OR TO BE PAID INTO OR CREDITED TO SUCH FUND  BY
 ANALOG  INSULIN  MANUFACTURERS  PURSUANT  TO SUBDIVISION FOUR OF SECTION
 TWENTY-EIGHT HUNDRED NINETY-FOUR OF THE  PUBLIC  HEALTH  LAW.    NOTHING
 CONTAINED  HEREIN  SHALL  PREVENT  THE STATE FROM RECEIVING ASSESSMENTS,
 GRANTS, GIFTS OR BEQUESTS FOR THE PURPOSES OF THE  FUND  AS  DEFINED  IN
 THIS SECTION AND DEPOSITING THEM INTO THE FUND ACCORDING TO LAW.
   3.  MONIES OF THE FUND SHALL BE EXPENDED ONLY TO SUPPORT THE EMERGENCY
 INSULIN PROGRAM ESTABLISHED PURSUANT TO ARTICLE TWENTY-EIGHT-CC  OF  THE
 PUBLIC  HEALTH  LAW  ADMINISTERED  BY THE COMMISSIONER OF HEALTH AND FOR
 FUNDING EMERGENCY ACCESS TO ANALOG INSULINS.
   4. MONIES SHALL BE PAYABLE FROM THE FUND ON THE AUDIT AND  WARRANT  OF
 THE  COMPTROLLER  ON VOUCHERS APPROVED AND CERTIFIED BY THE COMMISSIONER
 OF HEALTH.
   § 3. This act shall take effect immediately.

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Senate Bill S4883

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

co-Sponsors

2021-S4883 (ACTIVE) - Details

2021-S4883 (ACTIVE) - Summary

2021-S4883 (ACTIVE) - Sponsor Memo

2021-S4883 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S4883

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Sponsored By

Gustavo Rivera

Archive: Last Bill Status - In Senate Committee Health Committee

co-Sponsors

Andrew Gounardes

Todd Kaminsky

Liz Krueger

Zellnor Myrie

2021-S4883 (ACTIVE) - Details

2021-S4883 (ACTIVE) - Summary

2021-S4883 (ACTIVE) - Sponsor Memo

2021-S4883 (ACTIVE) - Bill Text download pdf

Comments