S T A T E O F N E W Y O R K
________________________________________________________________________
7119
2025-2026 Regular Sessions
I N A S S E M B L Y
March 20, 2025
___________
Introduced by M. of A. BICHOTTE HERMELYN, GIBBS -- read once and
referred to the Committee on Health
AN ACT to amend the social services law, in relation to requiring each
managed care provider to annually provide each participant in its
program with a written list of mail-order pharmacies with which the
managed care provider has a contract for coverage of prescription
drugs
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph (u) of subdivision 4 of section 364-j of the
social services law, as amended by section 12 of part A of chapter 56 of
the laws of 2013, is amended to read as follows:
(u) A managed care provider that provides coverage for prescription
drugs shall permit each participant to fill any mail order covered
prescription, at [his or her] THE PARTICIPANT'S option, at any mail
order pharmacy or non-mail-order retail pharmacy in the managed care
provider network. If the managed care provider has designated one or
more pharmacies for filling prescriptions for a particular drug or
drugs, then such prescriptions may be filled, at the participant's
option, at any other pharmacy in the network, if the network pharmacy
chosen by the participant offers to accept a price that is comparable to
that of the pharmacy designated by the managed care provider. For the
purposes of this section, "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. Every non-mail-order retail pharmacy in the
managed care provider's network with respect to any prescription drug
shall be deemed to be in the managed care provider's network for every
covered prescription drug. EACH MANAGED CARE PROVIDER SUBJECT TO THE
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10987-01-5
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