S5799-2011 Actions

• Jun 21, 2011: SUBSTITUTED BY A7779
• Jun 21, 2011: ORDERED TO THIRD READING CAL.1489
• Jun 16, 2011: REFERRED TO RULES

S5799-2011 Meetings

S5799-2011 Calendars

S5799-2011 Votes

S5799-2011 Memo

BILL NUMBER:S5799

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

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to ensure
that fertility drugs may be purchased locally without additional
financial burden to the insured person.

SUMMARY OF SPECIFIC PROVISIONS:
This bill would amend the insurance
law with respect to HMOs, and individual, group and not-for-profit
insurance policies by requiring all policies that provide coverage
for fertility drugs and require or permit a mail order pharmacy
benefit to cover prescription fertility drugs purchased at a non-mail
order pharmacy without any additional cost sharing to the covered
individual.

JUSTIFICATION:
In an effort to streamline the delivery of prescription
drugs while maintaining the affordability of coverage, many health
insurance policies require or incentivize the use of a mail order
pharmacy.
Nevertheless, the effectiveness of many fertility drugs relies on a
strict treatment regimen that is often difficult or impossible to
maintain when using a mail order pharmacy. Shipping and processing
delays may impair these drugs' ability to produce the desired effect
at a cost to both insureds and insurance companies themselves. This
bill would ensure that individuals with prescription drug coverage
have an equal opportunity to purchase fertility drugs from either a
mail order or non-mail order pharmacy.

PRIOR LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None.

EFFECTIVE DATE:
Thirty days following enactment and shall apply to all
policies and contracts issued, renewed, modified, altered or amended
on or after such effective date.

S5799-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 
                                         5799
 2011-2012 Regular Sessions
 I N  SENATE
 June 16, 2011
 
 Introduced  by  Sen.  SKELOS -- read twice and ordered printed, and when
 printed to be committed to the Committee on Rules
 

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 13-a to read as follows:

 (13-A)  EVERY POLICY THAT PROVIDES COVERAGE FOR PRESCRIPTION FERTILITY
 DRUGS AND REQUIRES OR PERMITS PRESCRIPTION DRUGS TO BE PURCHASED THROUGH
 A MAIL ORDER PHARMACY SHALL PROVIDE THE SAME COVERAGE  FOR  PRESCRIPTION
 FERTILITY  DRUGS  WHEN  SUCH DRUGS ARE PURCHASED FROM A PHARMACY THAT IS
 NOT A MAIL ORDER PHARMACY. SUCH POLICY SHALL NOT IMPOSE  ANY  ADDITIONAL
 FEE,  CO-PAYMENT,  CO-INSURANCE,  DEDUCTIBLE  OR  OTHER CONDITION ON ANY
 INSURED WHO DOES NOT ELECT  TO  PURCHASE  PRESCRIPTION  FERTILITY  DRUGS
 THROUGH A MAIL ORDER PHARMACY.
 

S  2.  Paragraph  6 of subsection (k) of section 3221 of the insurance
 law is amended by adding a new subparagraph (D) to read as follows:

 (D) EVERY POLICY THAT PROVIDES  COVERAGE  FOR  PRESCRIPTION  FERTILITY
 DRUGS AND REQUIRES OR PERMITS PRESCRIPTION DRUGS TO BE PURCHASED THROUGH
 A  MAIL  ORDER PHARMACY SHALL PROVIDE THE SAME COVERAGE FOR PRESCRIPTION
 FERTILITY DRUGS WHEN SUCH DRUGS ARE PURCHASED FROM A  PHARMACY  THAT  IS
 NOT  A  MAIL ORDER PHARMACY. SUCH POLICY SHALL NOT IMPOSE ANY ADDITIONAL
 FEE, CO-PAYMENT, CO-INSURANCE, DEDUCTIBLE  OR  OTHER  CONDITION  ON  ANY
 COVERED  PERSON  WHO  DOES  NOT ELECT TO PURCHASE PRESCRIPTION FERTILITY
 DRUGS THROUGH A MAIL ORDER PHARMACY.
 

S 3. Subsection (s) of section 4303 of the insurance law,  as  amended
 by  section 2 of part K of chapter 82 of the laws of 2002, is amended by
 adding a new paragraph 4 to read as follows:

 (4) EVERY POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,  A
 HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH  SERVICES CORPORATION THAT
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD10740-02-1
 
       S. 5799                             2
 PROVIDES COVERAGE FOR  PRESCRIPTION  FERTILITY  DRUGS  AND  REQUIRES  OR
 PERMITS PRESCRIPTION DRUGS TO BE PURCHASED THROUGH A MAIL ORDER PHARMACY
 SHALL  PROVIDE  THE  SAME COVERAGE FOR PRESCRIPTION FERTILITY DRUGS WHEN
 SUCH  DRUGS ARE PURCHASED FROM A PHARMACY THAT IS NOT A MAIL ORDER PHAR
 MACY. SUCH POLICY SHALL  NOT  IMPOSE  ANY  ADDITIONAL  FEE,  CO-PAYMENT,
 CO-INSURANCE,  DEDUCTIBLE  OR  OTHER CONDITION ON ANY COVERED PERSON WHO
 DOES NOT ELECT TO PURCHASE PRESCRIPTION FERTILITY DRUGS THROUGH  A  MAIL
 ORDER PHARMACY.
 

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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