Assembly Bill A3605

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3605
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 29, 2025
                                ___________
 
 Introduced  by  M.  of  A.  SEAWRIGHT  --  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. 3605                             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.