Senate Passes Bill to Help Pharmacies Collect Co-Payments

John A. DeFrancisco

June 20, 2011

Senator John A. DeFrancisco (R-I-C Syracuse) announced that the New York State Senate today passed his bill (S4749), which would allow pharmacies to collect prescription drug co-payments at the point of sale.

Currently, recipients of Medicaid and Family Health Plus can refuse to pay a modest co-payment, which can range between $1 and $6 depending on the prescription. The pharmacy must still honor the prescription despite a beneficiary’s refusal to pay, resulting in significant financial losses to New York State pharmacies each year.

“In New York State 50 percent of the recipients refuse to pay their co-payment when filling their prescription, and in some cases in New York City, up to 90 percent don’t pay their co-payment. The revenue that could be generated from collection of these co-payments, especially in New York City, could be very significant,” said Senator DeFrancisco. “I find it hard to believe that the beneficiaries of these programs cannot find a way to come up with a dollar for medicine, yet citizens who pay for their own insurance are required to pay their co-pay or they will not be allowed to pick up their prescription,” said Senator DeFrancisco.

Without this change in legislation, at least 50 percent of the 4 million New Yorkers enrolled in these programs could continue to avoid co-payments, and the pharmacies cannot write off the bad debt. Additionally, New York State does nothing to make up for the losses suffered when a beneficiary of one of these programs chooses not to pay their co-payment.

“In addition, reimbursement rates to pharmacies for these programs are some of the lowest in the country, which is an additional hardship,” said Senator DeFrancisco.

"When Medicaid bills are going up and reimbursements rates to pharmacies are being cut, something’s got to give. This is only fair,” concluded Senator DeFrancisco.