S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4015
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 8, 2023
                                ___________
 
 Introduced by M. of A. ARDILA -- read once and referred to the Committee
   on Health
 
 AN  ACT to amend the social services law, in relation to synchronization
   of multiple prescriptions; and to amend a chapter of the laws of  2022
   amending the social services law relating to synchronization of multi-
   ple  prescriptions,  as proposed in legislative bills numbers S. 431-A
   and A. 187, in relation to the effectiveness thereof
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (i)  of  subdivision 9 of section 367-a of the
 social services law, as added by a chapter of the laws of 2022  amending
 the   social  services  law  relating  to  synchronization  of  multiple
 prescriptions, as proposed in legislative bills numbers S. 431-A and  A.
 187, is amended to read as follows:
   (i)(i) The department of health shall establish a program for synchro-
 nization  of  medications.  UNDER  THE SYNCHRONIZATION PROGRAM, A HEALTH
 CARE PRACTITIONER MAY PRESCRIBE A REFILL OF ONE OR MORE OF THE PATIENT'S
 MEDICATIONS FOR A SHORTER PERIOD THAN WOULD ORDINARILY BE PROVIDED,  FOR
 THE  PURPOSE  OF  SYNCHRONIZING  REFILL  DATES  OF  ONE  OR  MORE OF THE
 PATIENT'S MEDICATIONS SUBJECT TO THE SYNCHRONIZATION when it  is  agreed
 among  the  recipient,  [a  provider] THE HEALTH CARE PRACTITIONER and a
 pharmacist that synchronization of multiple prescriptions for the treat-
 ment of a chronic illness is in the best interest of the patient for the
 management or treatment of a chronic illness provided that the FOLLOWING
 APPLY TO SUCH medications:
   (A) are covered by the department of health pursuant to this title;
   (B) are used for treatment and management of  A  chronic  [conditions]
 ILLNESS that are subject to refills;
   (C)  are  not  a  schedule II controlled substance, nor a schedule III
 controlled substance that contains hydrocodone OR OTHER  OPIOID  MEDICA-
 TION  AS  SCHEDULED  IN  SECTION  THIRTY-THREE HUNDRED SIX OF THE PUBLIC
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04021-01-3
              

 A. 4015                             2
 
 HEALTH LAW, OR A  CONTROLLED  SUBSTANCE  UNDER  THE  FEDERAL  CONTROLLED
 SUBSTANCES ACT;
   (D)  meet all prior authorization criteria specific to the medications
 at the time of the synchronization request;
   (E) are of a formulation that can be effectively [split] AND  LAWFULLY
 ALIGNED over required short fill periods to achieve synchronization; and
   (F) do not have quantity limits or dose optimization criteria or STATE
 OR  FEDERAL requirements that would be violated in fulfilling synchroni-
 zation.
   (ii) The department of health shall not deny coverage for the dispens-
 ing of a medication by a pharmacy for a partial supply when  it  is  for
 the  purpose of synchronizing the patient's medications. When applicable
 to permit synchronization, the department of health shall allow a  phar-
 macy  to  override  any  denial  codes indicating that a prescription is
 being refilled too soon for the purposes of medication synchronization.
   (iii) [To permit synchronization, the department of health shall apply
 a prorated daily cost-sharing rate to  any  medication  dispensed  by  a
 pharmacy pursuant to this section.
   (iv)  The  dispensing  fee  paid  to  a pharmacy contracted to provide
 services pursuant to this section for a partial supply associated with a
 medication synchronization shall be  paid  in  full  and  shall  not  be
 prorated.
   (v)]  THE  DISPENSING  FEE  PAID TO THE PHARMACY CONTRACTED TO PROVIDE
 SERVICES PURSUANT TO THIS SECTION FOR A PARTIAL SUPPLY  ASSOCIATED  WITH
 MEDICATION SYNCHRONIZATION SHALL BE PAID IN ACCORDANCE WITH THE MEDICAID
 STATE  PLAN  AS  APPROVED  BY  THE  CENTERS  FOR  MEDICARE  AND MEDICAID
 SERVICES.
   (IV) The requirement of this paragraph  applies  only  once  for  each
 prescription  drug  subject  to  medication  synchronization except when
 either of the following occurs:
   (I) the prescriber changes the dosage or frequency  of  administration
 of the prescription drug subject to a medication synchronization; or
   (II) the prescriber prescribes a different drug.
   [(vi)] (V) Nothing in this paragraph shall be deemed to require health
 care  practitioners  and  pharmacists  to  synchronize  the refilling of
 multiple prescriptions for a recipient.
   (VI) THE PROVISIONS OF THIS PARAGRAPH ARE SUBJECT TO  COMPLIANCE  WITH
 ALL  APPLICABLE  FEDERAL  AND  STATE LAWS AND REGULATIONS, INCLUDING THE
 CENTERS FOR MEDICARE AND MEDICAID SERVICES APPROVED MEDICAID STATE PLAN.
 THE COMMISSIONER SHALL APPLY FOR WAIVERS AND SUBMIT STATE MEDICAID  PLAN
 AMENDMENTS AS ARE NECESSARY TO IMPLEMENT THE PROGRAM FOR SYNCHRONIZATION
 OF MEDICATIONS.
   §  2.  Paragraph  (w)  of subdivision 4 of section 364-j of the social
 services law, as added by a chapter of the laws  of  2022  amending  the
 social   services   law   relating   to   synchronization   of  multiple
 prescriptions, as proposed in legislative bills  numbers  S.  431-A  and
 A.187, is amended to read as follows:
   (w)(i)  The  department  of  health  or  a  managed  care organization
 contracted to provide services pursuant to this section shall  establish
 a program for synchronization of medications.  UNDER THE SYNCHRONIZATION
 PROGRAM,  A  HEALTH  CARE  PRACTITIONER MAY PRESCRIBE A REFILL OF ONE OR
 MORE OF THE PATIENT'S MEDICATIONS FOR A SHORTER PERIOD THAN WOULD  ORDI-
 NARILY BE PROVIDED, FOR THE PURPOSE OF SYNCHRONIZING REFILL DATES OF ONE
 OR  MORE  OF  THE  PATIENT'S MEDICATIONS SUBJECT TO THE SYNCHRONIZATION,
 when it is agreed among the recipient,  [a  provider]  THE  HEALTH  CARE
 PRACTITIONER   and   a   pharmacist  that  synchronization  of  multiple
 A. 4015                             3
 
 prescriptions for the treatment of a chronic  illness  is  in  the  best
 interest  of  the  patient  for the management or treatment of a chronic
 illness provided that the FOLLOWING APPLY TO SUCH medications:
   (A)  are  covered  by Medicaid services or a managed care organization
 contracted to provide services pursuant to this chapter;
   (B) are used for treatment and management of  A  chronic  [conditions]
 ILLNESS that are subject to refills;
   (C)  are  not  a  schedule II controlled substance, nor a schedule III
 controlled substance that contains hydrocodone OR OTHER  OPIOID  MEDICA-
 TION  AS  SCHEDULED  IN  SECTION  THIRTY-THREE HUNDRED SIX OF THE PUBLIC
 HEALTH LAW, OR A  CONTROLLED  SUBSTANCE  UNDER  THE  FEDERAL  CONTROLLED
 SUBSTANCES ACT;
   (D)  meet all prior authorization criteria specific to the medications
 at the time of the synchronization request;
   (E) are of a formulation that can be effectively [split] AND  LAWFULLY
 ALIGNED over required short fill periods to achieve synchronization; and
  (F)  do not have quantity limits or dose optimization criteria or STATE
 OR FEDERAL requirements that would be violated in fulfilling  synchroni-
 zation.
   (ii)   The  department  of  health  or  a  managed  care  organization
 contracted to provide services under this section shall not deny  cover-
 age  for  the  dispensing  of  a  medication by a pharmacy for a partial
 supply when it is for the purpose of synchronizing the patient's medica-
 tions. When applicable to  permit  synchronization,  the  department  of
 health  or  a  managed  care organization contracted to provide services
 under this title shall allow a pharmacy to  override  any  denial  codes
 indicating  that  a  prescription  is  being  refilled  too soon for the
 purposes of medication synchronization.
   (iii) [To permit  synchronization,  the  department  of  health  or  a
 managed  care  organization  contracted  to provide services pursuant to
 this title shall apply a prorated daily cost-sharing rate to any medica-
 tion dispensed by a pharmacy pursuant to this section.
   (iv) The dispensing fee paid  to  a  pharmacy  contracted  to  provide
 services pursuant to this section for a partial supply associated with a
 medication  synchronization  shall  be  paid  in  full  and shall not be
 prorated.
   (v)] THE DISPENSING FEE PAID TO THE  PHARMACY  CONTRACTED  TO  PROVIDE
 SERVICES  PURSUANT  TO THIS SECTION FOR A PARTIAL SUPPLY ASSOCIATED WITH
 MEDICATION SYNCHRONIZATION SHALL BE PAID IN ACCORDANCE WITH THE MEDICAID
 STATE PLAN  AS  APPROVED  BY  THE  CENTERS  FOR  MEDICARE  AND  MEDICAID
 SERVICES.
   (IV)  The  requirement  of  this  paragraph applies only once for each
 prescription drug subject  to  medication  synchronization  except  when
 either of the following occurs:
   (A)  the  prescriber changes the dosage or frequency of administration
 of the prescription drug subject to a medication synchronization; or
   (B) the prescriber prescribes a different drug.
   [(vi)] (V) Nothing in this paragraph shall be deemed to require health
 care practitioners and  pharmacists  to  synchronize  the  refilling  of
 multiple prescriptions for a covered individual.
   (VI)  THE  PROVISIONS OF THIS PARAGRAPH ARE SUBJECT TO COMPLIANCE WITH
 ALL APPLICABLE FEDERAL AND STATE LAWS  AND  REGULATIONS,  INCLUDING  THE
 CENTERS FOR MEDICARE AND MEDICAID SERVICES APPROVED MEDICAID STATE PLAN.
 THE  COMMISSIONER SHALL APPLY FOR WAIVERS AND SUBMIT STATE MEDICAID PLAN
 AMENDMENTS AS ARE NECESSARY TO IMPLEMENT THE PROGRAM FOR SYNCHRONIZATION
 OF MEDICATIONS.
 A. 4015                             4
 
   § 3. Section 3 of a chapter of the laws of 2022  amending  the  social
 services  law  relating to synchronization of multiple prescriptions, as
 proposed in legislative bills numbers S. 431-A and A. 187, is amended to
 read as follows:
   §  3.  This  act  shall  take effect [on the one hundred twentieth day
 after it shall have become a law] JANUARY 1,  2024.  The  amendments  to
 subdivision  9  of  section  367-a  of  the social services law, made by
 section one of this act, shall not affect the expiration of that  subdi-
 vision, and shall expire therewith.
   The  amendments  to  section 364-j of the social services law, made by
 section two of this act, shall not affect the repeal  of  that  section,
 and  shall  be  deemed  repealed  therewith.  Effective immediately, the
 commissioner of health shall make regulations  and  take  other  actions
 reasonably necessary to implement this act on that date.
   §  4.  This act shall take effect immediately; provided, however, that
 sections one and two of this act shall take effect on the same date  and
 in  the same manner as a chapter of the laws of 2022 amending the social
 services law relating to synchronization of multiple  prescriptions,  as
 proposed in legislative bills numbers S. 431-A and A. 187, takes effect.
 The  amendments to subdivision 9 of section 367-a of the social services
 law, made by section one of this act, shall not affect the expiration of
 that subdivision, and shall expire therewith.
   The amendments to section 364-j of the social services  law,  made  by
 section  two  of  this act, shall not affect the repeal of that section,
 and shall be deemed repealed  therewith.    Effective  immediately,  the
 commissioner  of  health  shall make regulations and take other actions,
 including applying for federal waivers  and  submitting  state  Medicaid
 plan  amendments,  reasonably  necessary  to  implement this act on that
 date.