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
              

 A. 7119                             2
 
 PROVISIONS  OF THIS PARAGRAPH SHALL 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.
   § 2. This act shall take effect on the one hundred eightieth day after
 it shall have become a law; and shall apply to all contracts, agreements
 and  leases  entered  into on or after such date, provided, however that
 the amendments to section 364-j of  the  social  services  law  made  by
 section  one of this act shall not affect the repeal of such section and
 shall be deemed repealed therewith.