Assembly Bill A5854A

Signed By Governor
2021-2022 Legislative Session

Relates to the purchase of prescription drugs

download bill text pdf

Sponsored By

Archive: Last Bill Status Via S3566 - Signed by Governor


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Actions
Votes

Bill Amendments

co-Sponsors

2021-A5854 - Details

See Senate Version of this Bill:
S3566
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2013-2014: A5723, S3995
2015-2016: A6194, S2530
2017-2018: A3119, S1743
2019-2020: A3043, S4463

2021-A5854 - Summary

Relates to the purchase of prescription drugs by pharmacies; establishes the same reimbursement amount shall be provided to all pharmacies.

2021-A5854 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5854
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 1, 2021
                                ___________
 
 Introduced  by  M.  of A. JOYNER, COOK, AUBRY, LAVINE, RODRIGUEZ, SIMON,
   STECK, GALEF -- read once and referred to the Committee on Insurance
 
 AN ACT to amend the insurance  law,  in  relation  to  the  purchase  of
   prescription drugs
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph 28 of subsection  (i)  of  section  3216  of  the
 insurance  law, as amended by chapter 11 of the laws of 2012, is amended
 to read as follows:
   (28) (A) DEFINITIONS. FOR THE PURPOSE OF THIS PARAGRAPH:
   (1) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
 UNDER SUBPARAGRAPH (B) OF THIS PARAGRAPH SHALL PROVIDE THE  SAME  BENCH-
 MARK  INDEX,  INCLUDING THE SAME AVERAGE WHOLESALE PRICE, MAXIMUM ALLOW-
 ABLE COST AND NATIONAL PRESCRIPTION DRUG CODES TO REIMBURSE ALL  PHARMA-
 CIES  PARTICIPATING  IN  THE  INSURANCE  NETWORK REGARDLESS OF WHETHER A
 PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
   (2) "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.
   (B) Any policy that provides coverage  for  prescription  drugs  shall
 permit  each  insured  to  fill  any  covered  prescription  that may be
 obtained at a network participating mail order or other non-retail phar-
 macy, at the insured's option, at a network participating non-mail order
 retail pharmacy provided that the network participating  non-mail  order
 retail pharmacy agrees [in advance, through a contractual network agree-
 ment,] to the same reimbursement amount[, as well as the same applicable
 terms  and conditions,] that the insurer has established for the network
 participating mail order or other non-retail pharmacy. In such  a  case,
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

co-Sponsors

2021-A5854A (ACTIVE) - Details

See Senate Version of this Bill:
S3566
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2013-2014: A5723, S3995
2015-2016: A6194, S2530
2017-2018: A3119, S1743
2019-2020: A3043, S4463

2021-A5854A (ACTIVE) - Summary

Relates to the purchase of prescription drugs by pharmacies; establishes the same reimbursement amount shall be provided to all pharmacies.

2021-A5854A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5854--A
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 1, 2021
                                ___________
 
 Introduced  by  M.  of A. JOYNER, COOK, AUBRY, LAVINE, RODRIGUEZ, SIMON,
   STECK, GALEF -- read once and referred to the Committee  on  Insurance
   --  committee  discharged,  bill amended, ordered reprinted as amended
   and recommitted to said committee
 
 AN ACT to amend the insurance  law,  in  relation  to  the  purchase  of
   prescription drugs

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph 28 of subsection  (i)  of  section  3216  of  the
 insurance  law, as amended by chapter 11 of the laws of 2012, is amended
 to read as follows:
   (28) (A) DEFINITIONS. FOR THE PURPOSE OF THIS PARAGRAPH:
   (I) "SAME REIMBURSEMENT AMOUNT" SHALL MEAN THAT ANY COVERAGE DESCRIBED
 UNDER SUBPARAGRAPH (B) OF THIS PARAGRAPH SHALL PROVIDE THE  SAME  BENCH-
 MARK  INDEX,  INCLUDING THE SAME AVERAGE WHOLESALE PRICE, MAXIMUM ALLOW-
 ABLE COST AND NATIONAL PRESCRIPTION DRUG CODES TO REIMBURSE ALL  PHARMA-
 CIES  PARTICIPATING  IN  THE  INSURANCE  NETWORK REGARDLESS OF WHETHER A
 PHARMACY IS A MAIL ORDER PHARMACY OR A NON-MAIL ORDER PHARMACY.
   (II) "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.
   (B) Any policy that provides coverage  for  prescription  drugs  shall
 permit  each  insured  to  fill  any  covered  prescription  that may be
 obtained at a network participating mail order or other non-retail phar-
 macy, at the insured's option, at a network participating non-mail order
 retail pharmacy provided that the network participating  non-mail  order
 retail pharmacy agrees [in advance, through a contractual network agree-
 ment,] to the same reimbursement amount[, as well as the same applicable

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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