This bill has been amended

Bill S1221-2011

Limits cost-sharing responsibilities of participants in the elderly pharmaceutical insurance coverage program

Limits cost-sharing responsibilities of participants in the elderly pharmaceutical insurance coverage program for both comprehensive and catastrophic coverages to no more than five percent of the eligible participant's gross income.

Details

Actions

  • Jan 4, 2012: REFERRED TO AGING
  • Jan 6, 2011: REFERRED TO AGING

Memo

BILL NUMBER:S1221

TITLE OF BILL: An act to amend the elder law, in relation to limiting the cost-sharing responsibilities of eligible participants in the elderly pharmaceutical insurance coverage program

PURPOSE OF THE BILL: Caps the out-of-pocket expenses (COPE) of an individual participant in either the Fee Plan or the Deductible Plan of the Elderly Pharmaceutical Insurance Coverage Program (EPIC) at five percent (5%) of annual gross income.

SUMMARY OF PROVISIONS: Section 247 and 248 of the elder law are amended to add new subdivision 5. Caps out-of-pocket expenses (COPE) at five percent of annual gross income for the Fee Plan of the Elderly Pharmaceutical Insurance Coverage Program (EPIC).

Caps out-of-pocket expenses (COPE) at five percent of annual gross income for the Deductible Plan of the Elderly Pharmaceutical Insurance Coverage Program (EPIC).

JUSTIFICATION: The cost of prescription drugs for senior citizens is a well-documented issue that looms over the political landscape in New York and throughout the country. As drug prices continue to rise, there is an ever-increasing burden on senior incomes. Federal Medicare HMO's continue to dump seniors.

In New York, the Elderly Pharmaceutical Insurance Coverage (EPIC) Plan has picked up some of the burden. EPIC requires that participants pay a variety of premiums, fees, co-pays and deductibles. This currently ranges from 4 to 7 percent of their incomes. COPE ensures that no one will pay more than 5 percent of their income. This will save seniors as much as $170 million. COPE will pick up the cost, pointing to a renewed urgency for Congress to resolve the issue in order to offset the States commitment.

FISCAL IMPLICATIONS: NYS costs would be $170 million in the event of no federal support.

LEGISLATIVE HISTORY: This bill has previously been introduced.

EFFECTIVE DATE: This act shall take effect on the 120th day after it shall have become a law.


Text

STATE OF NEW YORK ________________________________________________________________________ 1221 2011-2012 Regular Sessions IN SENATE January 6, 2011 ___________
Introduced by Sen. STAVISKY -- read twice and ordered printed, and when printed to be committed to the Committee on Aging AN ACT to amend the elder law, in relation to limiting the cost-sharing responsibilities of eligible participants in the elderly pharmaceu- tical insurance coverage program THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 247 of the elder law is amended by adding a new subdivision 5 to read as follows: 5. COST-SHARING RESPONSIBILITIES LIMIT. AT NO TIME DURING A COVERAGE PERIOD SHALL THE COST-SHARING RESPONSIBILITIES, WHICH ARE COMPRISED OF THE SUM OF THE ANNUAL REGISTRATION FEE AND CO-PAYMENTS, EXCEED FIVE PERCENT OF THE ELIGIBLE PROGRAM PARTICIPANT'S GROSS INCOME, EFFECTIVE IMMEDIATELY. S 2. Section 248 of the elder law is amended by adding a new subdivi- sion 5 to read as follows: 5. COST-SHARING RESPONSIBILITIES LIMIT. AT NO TIME DURING A COVERAGE PERIOD SHALL THE COST-SHARING RESPONSIBILITIES, WHICH ARE COMPRISED OF THE SUM OF THE ANNUAL DEDUCTIBLE AND CO-PAYMENTS, EXCEED FIVE PERCENT OF THE ELIGIBLE PROGRAM PARTICIPANT'S GROSS INCOME, EFFECTIVE IMMEDIATELY. S 3. This act shall take effect on the one hundred twentieth day next succeeding the date on which it shall have become a law.

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.

Discuss!

blog comments powered by Disqus