Assembly Bill A7149

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7149
 
                        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, KIM -- read once and
   referred to the Committee on Health
 
 AN ACT to amend the  social  services  law,  in  relation  to  requiring
   managed care providers that provide coverage for prescription drugs to
   provide coverage for home delivery of any covered prescription drug by
   any  non-mail-order  retail  pharmacy  in  the  managed  care provider
   network
 
   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.  A MANAGED CARE PROVIDER THAT  PROVIDES  COVERAGE  FOR
 PRESCRIPTION  DRUGS SHALL ALSO PROVIDE COVERAGE FOR HOME DELIVERY OF ANY
 COVERED PRESCRIPTION DRUG BY ANY NON-MAIL-ORDER RETAIL PHARMACY  IN  THE
 MANAGED  CARE  PROVIDER NETWORK. If the managed care provider has desig-
 nated one or more pharmacies for filling prescriptions for a  particular
 drug  or  drugs,  then  such prescriptions may be filled, at the partic-
 ipant'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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10955-01-5
              

 A. 7149                             2
 
 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.
   § 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 that the amend-
 ments 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.