Bill S6745-2011

Provides that the initial prescription or dispensing of a controlled substance for acute pain shall be limited to a 3 - 10 day supply

Provides that the initial prescription or dispensing of a controlled substance for acute pain shall be limited to a 3-10 day supply; prohibits the imposition of an additional health insurance copayment if a subsequent prescription is issued for an aggregate of not more than a 30 day supply of such controlled substance.

Details

Actions

  • Jun 21, 2012: COMMITTED TO RULES
  • Mar 29, 2012: ADVANCED TO THIRD READING
  • Mar 28, 2012: 2ND REPORT CAL.
  • Mar 27, 2012: 1ST REPORT CAL.467
  • Mar 16, 2012: REFERRED TO HEALTH

Meetings

Votes

VOTE: COMMITTEE VOTE: - Health - Mar 27, 2012
Ayes (14): Hannon, Ball, Farley, Fuschillo, Golden, Larkin, McDonald, Seward, Young, Adams, Montgomery, Rivera, Smith, Stewart-Cousins
Ayes W/R (2): Gianaris, Peralta
Nays (1): Duane

Memo

BILL NUMBER:S6745

TITLE OF BILL: An act to amend the public health law, in relation to limiting the initial prescription of a controlled substance for the alleviation of acute pain to between a three to ten day supply; and to amend the insurance law, in relation to coverage of such prescriptions

PURPOSE OR GENERAL IDEA OF BILL: This bill would limit the number of schedule II or III controlled substance pain pills initially prescribed to someone suffering from acute pain. This serves two important purposes: (1) it encourages patients whose acute pain lasts longer than initially expected to follow up with a doctor, and (2) it lessens the number of pills left in medicine cabinets and available for diversion.

SUMMARY OF PROVISIONS: Section 1 of the bill adds subsections (b) and (c) to Subdivision 5 of section 3331 of the public health law. Subsection (b) permits authorized practitioners, within the scope of their professional opinion or discretion, to dispense between three and ten days of any schedule II or III controlled substance to a patient suffering from acute pain. Subsection (c), which provides a definition of acute pain. The term encompasses accidental and intentional pain lasting only a short or finite period of time. The subsection expressly excludes chronic pain, cancer pain, or palliative care practices from the definition of acute pain.

Sections 2 through 4 of the bill amend section 3216, 3221, and 4303 of the insurance law respectively. The limitation shall apply only to the amount of prescription drug constituting a thirty day supply, including the limited supply provided pursuant to Subdivision 5 of section 3331 of the public health law.

Section 5 of the bill provides for an effective date.

JUSTIFICATION: Prescription drug abuse is a growing crisis in both New York State and the country at large. In this state, there has been armed violence, deaths by overdose and suicide, and increasing rates of addiction. To address this crisis, the Senate Standing Committee on Health held two Roundtables on the topic in August 2011 and February 2012. The Roundtables included panelists from all aspects of this debate, including law enforcement, doctors, addiction specialists, government agencies, and family members who have lost loved ones to prescription painkiller abuse. One overwhelming comment from these Roundtables concerned the volume of prescription pain medicine sitting unattended in medicine cabinets throughout the state.

In 2010, there were 22.5 million prescriptions issued for prescription painkillers-not including refills-in New York State. That is more two million more prescriptions written than there are citizens in this state. This bill resolves two major recommendations from the Roundtable, (a) eliminating excess medication for the treatment of acute pain and (b) decreasing the volume of pills left in medicine cabinets. Treating acute pain often involves patients recovering from

surgical procedures, short-term trauma, or dental procedures. By definition, acute pain is also finite pain-with the exception of certain situations involving terminal cancer pain. However, it is not uncommon for a doctor to prescribe 30 pills for pain following a dental procedure. Most patients will use 2-3 pills and the excess sits in their medicine cabinets, where it runs the risk of diversion. Recent news tells the story of teenagers taking whatever pills are available in the home medicine cabinet and taking or selling them on the street. Prescription painkillers are a wonderful tool, and allow us to treat pain as never before in human history, but they are also highly addictive.

This bill ameliorates the excess volume of pills on the street, but it also provides better continuity of care. Acute pain can be a powerful diagnostic tool for medical professionals. It is common for this form of pain to follow various timelines. If pain worsens or lasts for a longer time, it can be an important signal that something else is happening. Providing excess medication helps patients dampen their current pain, but it also prevents them from seeking additional medical help that they might need. This bill limits the amount of medication, so that patients feeling additional pain will seek medical intervention earlier. The bill also ensures patients will only pay a single copayment for the first 30 days of medication, even if the medication comes in the form of several prescriptions over the course of those 30 days.

PRIOR LEGISLATIVE HISTORY: New bill

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: On the sixtieth day after it shall have become law.


Text

STATE OF NEW YORK ________________________________________________________________________ 6745 IN SENATE March 16, 2012 ___________
Introduced by Sens. HANNON, GOLDEN, LARKIN, MARTINS, MAZIARZ, McDONALD -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to limiting the initial prescription of a controlled substance for the alleviation of acute pain to between a three to ten day supply; and to amend the insurance law, in relation to coverage of such prescriptions THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 5 of section 3331 of the public health law, as amended by chapter 965 of the laws of 1974, is amended to read as follows: 5. (A) No more than a thirty day supply or, pursuant to regulations of the commissioner enumerating conditions warranting specified greater supplies, no more than a three month supply of a schedule II, III or IV substance, as determined by the directed dosage and frequency of dosage, may be dispensed by an authorized practitioner at one time. (B) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDIVI- SION, AN AUTHORIZED PRACTITIONER, WITHIN THE SCOPE OF HIS OR HER PROFES- SIONAL OPINION OR DISCRETION, MAY DISPENSE OR PRESCRIBE NO MORE THAN BETWEEN A THREE AND TEN DAY SUPPLY OF ANY SCHEDULE II OR III CONTROLLED SUBSTANCE TO AN ULTIMATE USER UPON THE INITIAL CONSULTATION OR TREATMENT OF SUCH USER FOR ACUTE PAIN. THEREAFTER, THE DISPENSING AND PRESCRIBING OF THE CONTROLLED SUBSTANCE SHALL BE SUBJECT TO THE PROVISIONS OF PARA- GRAPH (A) OF THIS SUBDIVISION. (C) FOR THE PURPOSES OF THIS SUBDIVISION, "ACUTE PAIN" MEANS PAIN, WHETHER ACCIDENTAL OR INTENTIONAL, THAT LASTS ONLY A SHORT OR FINITE PERIOD OF TIME. SUCH TERM SHALL NOT INCLUDE CHRONIC PAIN, CANCER PAIN OR PALLIATIVE CARE PRACTICES. S 2. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 29 to read as follows: (29) NO POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS AND WHICH PROVIDES FOR COPAY- MENTS BY COVERED PERSONS, SHALL IMPOSE UPON ANY COVERED PERSON, WHO IS
PRESCRIBED A LIMITED AMOUNT OF A PRESCRIPTION DRUG FOR ACUTE PAIN IN ACCORDANCE WITH PARAGRAPH (B) OF SUBDIVISION FIVE OF SECTION THIRTY-THREE HUNDRED THIRTY-ONE OF THE PUBLIC HEALTH LAW, AN ADDITIONAL COPAYMENT IF AN AUTHORIZED PRESCRIBER, WITHIN THE SCOPE OF HIS OR HER PROFESSIONAL OPINION, PRESCRIBES AN ADDITIONAL AMOUNT OF A PRESCRIPTION DRUG FOR ACUTE PAIN, AS DEFINED IN SUCH SUBDIVISION. THIS LIMITATION SHALL APPLY ONLY TO THE AMOUNT OF PRESCRIPTION DRUG CONSTITUTING A THIR- TY DAY SUPPLY, INCLUDING THE LIMITED SUPPLY PROVIDED PURSUANT TO SUCH PARAGRAPH. S 3. Subsection (k) of section 3221 of the insurance law is amended by adding a new paragraph 18 to read as follows: (18) NO GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN THE STATE WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS AND WHICH PROVIDES FOR COPAYMENTS BY COVERED PERSONS, SHALL IMPOSE UPON ANY COVERED PERSON, WHO IS PRESCRIBED A LIMITED AMOUNT OF A PRESCRIPTION DRUG FOR ACUTE PAIN IN ACCORDANCE WITH PARAGRAPH (B) OF SUBDIVISION FIVE OF SECTION THIRTY-THREE HUNDRED THIRTY-ONE OF THE PUBLIC HEALTH LAW, AN ADDITIONAL COPAYMENT IF AN AUTHORIZED PRESCRIBER, WITHIN THE SCOPE OF HIS OR HER PROFESSIONAL OPINION, PRESCRIBES AN ADDITIONAL AMOUNT OF A PRESCRIPTION DRUG FOR ACUTE PAIN, AS DEFINED IN SUCH SUBDIVISION. THIS LIMITATION SHALL APPLY ONLY TO THE AMOUNT OF PRESCRIPTION DRUG CONSTI- TUTING A THIRTY DAY SUPPLY, INCLUDING THE LIMITED SUPPLY PROVIDED PURSU- ANT TO SUCH PARAGRAPH. S 4. Section 4303 of the insurance law is amended by adding a new subsection (ii) to read as follows: (II) NO MEDICAL EXPENSE INDEMNITY CORPORATION, HOSPITAL SERVICE CORPO- RATION OR HEALTH SERVICE CORPORATION WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS AND WHICH PROVIDES FOR COPAYMENTS BY COVERED PERSONS, SHALL IMPOSE UPON ANY COVERED PERSON, WHO IS PRESCRIBED A LIMITED AMOUNT OF A PRESCRIPTION DRUG FOR ACUTE PAIN IN ACCORDANCE WITH PARAGRAPH (B) OF SUBDIVISION FIVE OF SECTION THIRTY-THREE HUNDRED THIRTY-ONE OF THE PUBLIC HEALTH LAW, AN ADDITIONAL COPAYMENT IF AN AUTHORIZED PRESCRIBER, WITHIN THE SCOPE OF HIS OR HER PROFESSIONAL OPINION, PRESCRIBES AN ADDI- TIONAL AMOUNT OF A PRESCRIPTION DRUG FOR ACUTE PAIN, AS DEFINED IN SUCH SUBDIVISION. THIS LIMITATION SHALL APPLY ONLY TO THE AMOUNT OF PRESCRIPTION DRUG CONSTITUTING A THIRTY DAY SUPPLY, INCLUDING THE LIMIT- ED SUPPLY PROVIDED PURSUANT TO SUCH PARAGRAPH. S 5. This act shall take effect on the sixtieth day after it shall have become a law.

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