S T A T E O F N E W Y O R K
________________________________________________________________________
1040
2025-2026 Regular Sessions
I N A S S E M B L Y
January 8, 2025
___________
Introduced by M. of A. KIM, GIBBS -- Multi-Sponsored by -- M. of A. COOK
-- read once and referred to the Committee on Aging
AN ACT to amend the elder law, in relation to establishing the expanded
pharmaceutical insurance coverage panel
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The elder law is amended by adding a new section 242-a to
read as follows:
§ 242-A. EXPANDED PHARMACEUTICAL INSURANCE COVERAGE PANEL. 1. THERE
IS HEREBY ESTABLISHED WITHIN THE EXECUTIVE DEPARTMENT, A PANEL TO BE
KNOWN AS THE "EXPANDED PHARMACEUTICAL INSURANCE COVERAGE PANEL". FOR THE
PURPOSES OF THIS SECTION, THE TERM "THE PANEL" SHALL MEAN THE EXPANDED
PHARMACEUTICAL INSURANCE COVERAGE PANEL.
2. THE PANEL SHALL CONSIST OF THE COMMISSIONERS OF THE DEPARTMENTS OF
EDUCATION AND HEALTH, THE SUPERINTENDENT OF THE DEPARTMENT OF FINANCIAL
SERVICES, AND THE DIRECTORS OF THE OFFICE FOR THE AGING AND THE DIVISION
OF THE BUDGET. EACH PANEL MEMBER MAY DESIGNATE AN OFFICER OF THEIR
RESPECTIVE DEPARTMENT, OFFICE, OR DIVISION TO REPRESENT AND EXERCISE ALL
THE POWERS OF SUCH PANEL MEMBER AT ANY MEETING OF THE PANEL FROM WHICH
SUCH PANEL MEMBER MAY BE ABSENT.
3. THE DIRECTOR OF THE OFFICE FOR THE AGING AND THE COMMISSIONER OF
HEALTH SHALL SERVE AS CO-CHAIRS OF THE PANEL.
4. THE PANEL SHALL MEET AT SUCH TIMES AS MAY BE REQUESTED BY THE
CO-CHAIRS, PROVIDED THAT THE PANEL SHALL MEET AT LEAST TWO TIMES A YEAR.
5. THE PANEL SHALL:
(A) SUBJECT TO THE APPROVAL OF THE DIRECTOR OF THE BUDGET, PROMULGATE
PROGRAM REGULATIONS PURSUANT TO SECTION TWO HUNDRED FORTY-SIX OF THIS
TITLE;
(B) DETERMINE THE ANNUAL SCHEDULE OF COST-SHARING RESPONSIBILITIES OF
ELIGIBLE PROGRAM PARTICIPANTS PURSUANT TO SECTIONS TWO HUNDRED FORTY-
SEVEN AND TWO HUNDRED FORTY-EIGHT OF THIS TITLE;
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00974-01-5
A. 1040 2
(C) ENTER INTO CONTRACTS PURSUANT TO SECTION TWO HUNDRED FORTY-THREE
OF THIS TITLE;
(D) RECOMMEND AND IMPLEMENT ALTERNATIVE PROGRAM IMPROVEMENTS FOR THE
EFFICIENT AND EFFECTIVE OPERATION OF THE PROGRAM IN ACCORDANCE WITH THE
PROVISIONS OF THIS TITLE WITH THE ADVICE OF THE ADVISORY COMMITTEE AS
DEFINED IN SUBDIVISION SEVEN OF THIS SECTION;
(E) DEVELOP AND IMPLEMENT, IN COOPERATION WITH AREA OFFICES FOR THE
AGING, AN OUTREACH PROGRAM TO INFORM ELIGIBLE APPLICANTS OF BENEFITS
THEY MAY BE ENTITLED TO PURSUANT TO THIS TITLE, AND TO MAKE AVAILABLE
INFORMATION CONCERNING THE PROGRAM FOR EXPANDED PHARMACEUTICAL INSURANCE
COVERAGE AND BENEFITS TO WHICH THEY MAY BE ENTITLED THROUGH A
PRESCRIPTION DRUG COVERAGE PROGRAM FUNDED BY THE FEDERAL GOVERNMENT; AND
(F) PREPARE AN ANNUAL REPORT AND SUBMIT SUCH REPORT TO THE GOVERNOR,
THE TEMPORARY PRESIDENT OF THE SENATE, AND THE SPEAKER OF THE ASSEMBLY
NO LATER THAN THE FIRST DAY OF JANUARY OF EACH YEAR. THE PANEL SHALL
INCLUDE IN SUCH REPORT, AT A MINIMUM, ANNUAL STATISTICAL INFORMATION
REGARDING THE NUMBER OF PERSONS ENROLLED IN THE PROGRAM BY MARITAL
STATUS AND INCOME LEVEL AND AGE, AN ESTIMATE OF THE PER CENT OF ELIGIBLE
NEW YORK RESIDENTS THAT ARE ENROLLED, THE TOTAL NUMBER OF ENROLLEES THAT
RECEIVE AN INCOME-RELATED SUBSIDY UNDER SECTION 1860D-14 OF THE FEDERAL
SOCIAL SECURITY ACT, AND THE NUMBER THAT SO QUALIFY THROUGH THEIR
ENROLLMENT IN THE MEDICARE SAVINGS PROGRAM, THE NUMBERS OF PARTICIPATING
PROVIDER PHARMACIES, RECIPIENTS AND PAYMENTS BY COUNTY, A SUMMARY OF THE
ADMINISTRATIVE COST CONTAINMENT INITIATIVES COMPLETED DURING THE YEAR,
PROJECTIONS OF PROGRAM COSTS FOR THE FOLLOWING TWO YEARS, AND AN EVALU-
ATION OF THE PERFORMANCE OF THE PROGRAM CONTRACTOR OR CONTRACTORS AND OF
THE COST EFFECTIVENESS OF ALL OUTREACH EFFORTS.
6. THE PANEL MEMBERS SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES
AS PANEL MEMBERS.
7. THERE SHALL BE AN ADVISORY COMMITTEE TO THE PANEL COMPRISED OF
TWELVE PERSONS. FOUR MEMBERS SHALL BE APPOINTED BY THE GOVERNOR, THREE
MEMBERS SHALL BE APPOINTED BY THE TEMPORARY PRESIDENT OF THE SENATE, ONE
MEMBER SHALL BE APPOINTED BY THE MINORITY LEADER OF THE SENATE, THREE
MEMBERS SHALL BE APPOINTED BY THE SPEAKER OF THE ASSEMBLY AND ONE MEMBER
SHALL BE APPOINTED BY THE MINORITY LEADER OF THE ASSEMBLY. THE COMMIT-
TEE MEMBERS SHALL BE REPRESENTATIVES OF CONSUMERS, PHARMACISTS, PHARMA-
CEUTICAL DRUG MANUFACTURERS AND PHARMACEUTICAL WHOLESALERS. NO LESS THAN
SIXTY PERCENT OF THE COMMITTEE MEMBERSHIP SHALL REPRESENT CONSUMERS.
COMMITTEE MEMBERS SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES BUT
SHALL BE ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES INCURRED IN THE
PERFORMANCE OF THEIR DUTIES.
§ 2. This act shall take effect immediately.