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.
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 of the elder law is amended to add new subdivision 5 to read:
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.
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: To be determined.
LEGISLATIVE HISTORY: This bill has previously been introduced.
EFFECTIVE DATE: This act shall take effect on the 120th day next succeeding the date on which it shall have become a law.
STATE OF NEW YORK ________________________________________________________________________ 1298 2013-2014 Regular Sessions IN SENATE (PREFILED) January 9, 2013 ___________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. This act shall take effect on the one hundred twentieth day next succeeding the date on which it shall have become a law.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD01913-02-3