A8904-2011 Actions

• Feb 17, 2012: signed chap.11
• Feb 7, 2012: delivered to governor
• Feb 6, 2012: RETURNED TO ASSEMBLY
• Feb 6, 2012: PASSED SENATE
• Feb 6, 2012: 3RD READING CAL.11
• Feb 6, 2012: SUBSTITUTED FOR S6054A
• Jan 18, 2012: REFERRED TO RULES
• Jan 18, 2012: delivered to senate
• Jan 18, 2012: passed assembly
• Jan 12, 2012: advanced to third reading cal.302
• Jan 10, 2012: reported
• Jan 4, 2012: referred to insurance

A8904-2011 Votes

A8904-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 
                                         8904
 I N  ASSEMBLY
 (PREFILED)
 January 4, 2012
 
 Introduced  by M. of A. HEASTIE, COLTON -- read once and referred to the
 Committee on Insurance
 

AN ACT to amend the insurance  law,  in  relation  to  the  purchase  of
 prescription drugs
 

THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM
 BLY, DO ENACT AS FOLLOWS:

 

Section 1. Paragraph 28 of subsection  (i)  of  section  3216  of  the
 insurance  law,  as added by chapter 597 of the laws of 2011, is amended
 to read as follows:

 (28) Any policy [which] THAT provides coverage for prescription  drugs
 shall permit each [participant] INSURED to fill any [mail order] covered
 prescription  THAT MAY BE OBTAINED AT A NETWORK PARTICIPATING MAIL ORDER
 OR OTHER NON-RETAIL PHARMACY, at [his or her] THE INSURED'S  option,  at
 [any  mail  order  pharmacy  or]  A network participating non-mail order
 retail pharmacy [if the  network  participating  non-mail  order  retail
 pharmacy offers to accept a price that is comparable to that of the mail
 order  pharmacy]  PROVIDED THAT THE NETWORK PARTICIPATING NON-MAIL ORDER
 RETAIL PHARMACY AGREES IN ADVANCE, THROUGH A CONTRACTUAL NETWORK  AGREE
 MENT,  TO  THE SAME REIMBURSEMENT AMOUNT, AS WELL AS THE SAME APPLICABLE
 TERMS AND CONDITIONS, THAT THE INSURER HAS ESTABLISHED FOR  THE  NETWORK
 PARTICIPATING  MAIL  ORDER  OR  OTHER NON-RETAIL PHARMACY.   [Any policy
 which provides coverage for prescription drugs]  IN  SUCH  A  CASE,  THE
 POLICY  shall  not  impose  a  co-payment  fee or other condition on any
 insured who elects to purchase PRESCRIPTION drugs from a network partic
 ipating non-mail order retail pharmacy which  is  not  also  imposed  on
 insureds  electing to purchase drugs from a [designated] NETWORK PARTIC
 IPATING mail order OR OTHER  NON-RETAIL  pharmacy[;  provided,  however,
 that  the  provisions of this section shall not supersede the terms of a
 collective bargaining agreement or apply to a policy that is the  result
 of  a  collective  bargaining agreement between an employer and a recog-
 nized or certified employee organization].
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD09145-09-2
 
       A. 8904                             2
 

S 2. Paragraph 18 of subsection (1) of section 3221 of  the  insurance
 law,  as added by chapter 597 of the laws of 2011, is amended to read as
 follows:

 (18)  Any  insurer  delivering  a group or blanket policy or issuing a
 group or blanket policy for delivery in this state [which] THAT provides
 coverage for prescription drugs shall permit each [participant]  INSURED
 to  fill any [mail order] covered prescription THAT MAY BE OBTAINED AT A
 NETWORK PARTICIPATING MAIL ORDER OR OTHER NON-RETAIL PHARMACY,  at  [his
 or  her] THE INSURED'S option, at [any mail order pharmacy or] A network
 participating non-mail order retail pharmacy [if the network participat-
 ing non-mail order retail pharmacy offers to  accept  a  price  that  is
 comparable to that of the mail order pharmacy] PROVIDED THAT THE NETWORK
 PARTICIPATING  NON-MAIL ORDER RETAIL PHARMACY AGREES IN ADVANCE, THROUGH
 A CONTRACTUAL NETWORK AGREEMENT, TO THE SAME  REIMBURSEMENT  AMOUNT,  AS
 WELL  AS  THE SAME APPLICABLE TERMS AND CONDITIONS, THAT THE INSURER HAS
 ESTABLISHED FOR THE NETWORK PARTICIPATING MAIL ORDER OR OTHER NON-RETAIL
 PHARMACY.  [Any policy which provides coverage for  prescription  drugs]
 IN  SUCH  A  CASE, THE POLICY shall not impose a co-payment fee or other
 condition on any insured who elects to purchase  drugs  from  a  network
 participating  non-mail  order retail pharmacy which is not also imposed
 on insureds electing to  purchase  drugs  from  a  [designated]  NETWORK
 PARTICIPATING  mail order OR OTHER NON-RETAIL pharmacy; provided, howev
 er, that the provisions of this section shall not supersede the terms of
 a collective bargaining agreement or apply  to  a  policy  that  is  the
 result  of  a  collective bargaining agreement between an employer and a
 recognized or certified employee organization.
 

S 3. Subsection (hh) of section 4303 of the insurance law, as added by
 chapter 597 of the laws of 2011, is amended to read as follows:

 (hh) Any [policy] CONTRACT  issued  by  a  medical  expense  indemnity
 corporation,  a hospital service corporation or a health services corpo
 ration [which] THAT  provides  coverage  for  prescription  drugs  shall
 permit  each  [participant]  COVERED  PERSON  to  fill  any [mail order]
 covered prescription THAT MAY BE OBTAINED  AT  A  NETWORK  PARTICIPATING
 MAIL  ORDER  OR  OTHER  NON-RETAIL PHARMACY, at [his or her] THE COVERED
 PERSON'S option, at [any mail order pharmacy or] A network participating
 non-mail order retail pharmacy [if the  network  participating  non-mail
 order  retail  pharmacy  offers  to accept a price that is comparable to
 that of the mail order pharmacy] PROVIDED THAT THE NETWORK PARTICIPATING
 NON-MAIL ORDER RETAIL PHARMACY AGREES IN ADVANCE, THROUGH A  CONTRACTUAL
 NETWORK AGREEMENT, TO THE SAME REIMBURSEMENT AMOUNT, AS WELL AS THE SAME
 APPLICABLE  TERMS  AND  CONDITIONS, THAT THE CORPORATION HAS ESTABLISHED
 FOR THE NETWORK PARTICIPATING MAIL ORDER OR OTHER  NON-RETAIL  PHARMACY.
 [Any  policy  which  provides coverage for prescription drugs] IN SUCH A
 CASE, THE CONTRACT shall not impose a copayment fee or  other  condition
 on  any  [insured]  COVERED  PERSON  who elects to purchase drugs from a
 network participating non-mail order retail pharmacy which is  not  also
 imposed  on [insureds] COVERED PERSONS electing to purchase drugs from a
 [designated] NETWORK PARTICIPATING mail order OR OTHER NON-RETAIL  phar
 macy;  provided,  however, that the provisions of this section shall not
 supersede the terms of a collective bargaining agreement or apply  to  a
 [policy]  CONTRACT  that is the result of a collective bargaining agree
 ment between an employer and a recognized or certified  employee  organ
 ization.
 

S  4.  This  act  shall  take  effect on the same date and in the same
 manner as chapter 597 of the laws of 2011, takes effect.

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