S3510B-2011 Actions

• Jun 20, 2011: SUBSTITUTED BY A5502B
• Jun 20, 2011: ORDERED TO THIRD READING CAL.1383
• Jun 20, 2011: COMMITTEE DISCHARGED AND COMMITTED TO RULES
• May 17, 2011: PRINT NUMBER 3510B
• May 17, 2011: AMEND AND RECOMMIT TO INSURANCE
• Apr 25, 2011: PRINT NUMBER 3510A
• Apr 25, 2011: AMEND AND RECOMMIT TO INSURANCE
• Feb 24, 2011: REFERRED TO INSURANCE

S3510B-2011 Meetings

S3510B-2011 Votes

S3510B-2011 Memo

BILL NUMBER:S3510B

TITLE OF BILL:
An act
to amend the insurance law,
in relation to the purchase of
prescription drugs

PURPOSE OR GENERAL IDEA OF BILL:
Prohibits health insurance policies from mandating their insured to
purchase prescribed drugs from a mail order pharmacy.

SUMMARY OF PROVISIONS:
Subsection (i) of Section 3216 of the insurance law is amended to
preclude health insurance policies from mandating that their insured
purchase prescribed drugs from mail order pharmacies, provided that
the non mail order pharmacy offers to accept a comparable price. Such
policies are also precluded from imposing a co-payment fee or other
condition on an insured who chooses not to purchase from a designated
mail order pharmacy.

A new paragraph 18 is also added to subsection (1) of Section 3221 of
such law and a new Subsection (hh) is likewise added to section 4303
to impose such a prohibition on all policies of health insurance in
the state including those issued by health services or medical
expense indemnity corporations issuing group contracts.

JUSTIFICATION:
This legislation will provide freedom of choice to consumers who have
coverage for prescribed drugs as part of their health insurance. When
a policy mandates purchase from a specific mail order pharmacy the
consumer is forced to purchase an interim supply of the prescribed
drug from his or her neighborhood pharmacist who is familiar with his
or her medical history. The risk to the consumer in this situation is
obvious.
This bill also offers cost protections for consumers and insurance
carriers by ensuring that the protections offered in this bill are
only applied when a non-mail order pharmacy offers a comparable price.

Furthermore, the neighborhood pharmacy in these situations is forced
to bear the burden of educating the patient as to the use and
potential effects of the prescribed drug. The inability of the
consumer to purchase the full prescription from the neighborhood
pharmacy imposes this burden inequitably, thereby providing the mail
order house with an economic advantage that the local provider cannot
overcome.

Finally, many consumers, especially senior citizens, rely on their
local pharmacist for the service that they provide with respect to
monitoring
the regimen of drugs that they take. A mandate of purchase by mail
denies them of this important service and confidence.

PRIOR LEGISLATIVE HISTORY:


S.6007 (2009-2010), Referred to Insurance
A.2808/S.8775 (2007-2008)
A.6934 (2005-2006)

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This act shall take effect on the thirtieth day after it shall have
become law and shall apply to all policies and contracts issued,
renewed, modified, altered or amended on or after such effective date.

S3510B-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 3510--B
 2011-2012 Regular Sessions
 I N  SENATE
 February 24, 2011
 
 Introduced  by  Sens.  MAZIARZ, BRESLIN, ADDABBO, AVELLA, BALL, BONACIC,
 DUANE, GALLIVAN, GOLDEN,  GRIFFO,  HANNON,  HUNTLEY,  JOHNSON,  KLEIN,
 KRUEGER,  KRUGER, LANZA, LARKIN, LAVALLE, LIBOUS, MARCELLINO, MARTINS,
 MONTGOMERY,  OPPENHEIMER,  PERALTA,  PERKINS,  RANZENHOFER,  STAVISKY,
 ZELDIN  --  read  twice  and  ordered  printed, and when printed to be
 committed to the Committee on Insurance -- committee discharged,  bill
 amended,  ordered reprinted as amended and recommitted to said commit
 tee --  committee  discharged,  bill  amended,  ordered  reprinted  as
 amended and recommitted to said committee
 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.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 28 to read as follows:

 (28) ANY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION  DRUGS  SHALL
 PERMIT  EACH PARTICIPANT TO FILL ANY MAIL ORDER COVERED PRESCRIPTION, AT
 HIS OR HER OPTION, AT ANY MAIL ORDER PHARMACY OR  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. ANY POLICY WHICH PROVIDES COVERAGE FOR
 PRESCRIPTION DRUGS 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  MAIL  ORDER  PHARMACY;
 PROVIDED,  HOWEVER, THAT THE PROVISIONS OF THIS SECTION SHALL NOT SUPER
 SEDE 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 2. Subsection (1) of section 3221 of the insurance law is amended by
 adding a new paragraph 18 to read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD09145-07-1
 
       S. 3510--B                          2
 (18)  ANY  INSURER  DELIVERING  A GROUP OR BLANKET POLICY OR ISSUING A
 GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES COVER
 AGE FOR PRESCRIPTION DRUGS SHALL PERMIT EACH  PARTICIPANT  TO  FILL  ANY
 MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT ANY MAIL ORDER
 PHARMACY  OR 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. ANY POLICY
 WHICH PROVIDES COVERAGE  FOR  PRESCRIPTION  DRUGS  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 DESIG
 NATED  MAIL  ORDER  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 RECOGNIZED  OR  CERTIFIED
 EMPLOYEE ORGANIZATION.
 

S  3. 

Section  4303  of  the insurance law is amended by adding a new
 subsection (hh) to read as follows:

 (HH) ANY POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY  CORPORATION,  A
 HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH SERVICES CORPORATION WHICH
 PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL PERMIT  EACH  PARTICIPANT
 TO  FILL  ANY  MAIL ORDER COVERED PRESCRIPTION, AT HIS OR HER OPTION, AT
 ANY MAIL ORDER PHARMACY OR 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.  ANY  POLICY  WHICH  PROVIDES  COVERAGE FOR PRESCRIPTION DRUGS
 SHALL NOT IMPOSE A COPAYMENT 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 MAIL ORDER 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.
 

S 4.  If any clause, subparagraph, subsection, section or  other  part
 of  this  act,  or the   application thereof be held to be invalid, such
 holding shall not affect, impair or invalidate  the  remainder  of  this
 act, or the application of such section or part of a section held inval
 id.
 

S  5.  This  act shall take effect on the thirtieth day after it shall
 have become a law and shall apply to all policies and contracts  issued,
 renewed, modified, altered or amended on or after such effective date.

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