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.

---

S6745-2011 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

S6745-2011 Meetings

Health: Mar 27, 2012

S6745-2011 Calendars

Floor Calendar: Mar 28, 2012 , Floor Calendar: Mar 29, 2012 , Floor Calendar: Mar 30, 2012 , Floor Calendar: Apr 17, 2012 , Floor Calendar: Apr 18, 2012 , Floor Calendar: Apr 19, 2012 , Floor Calendar: Apr 25, 2012 , Floor Calendar: Apr 26, 2012 , Floor Calendar: Apr 30, 2012 , Floor Calendar: May 1, 2012 , Floor Calendar: May 2, 2012 , Floor Calendar: May 7, 2012 , Floor Calendar: May 8, 2012 , Floor Calendar: May 9, 2012 , Floor Calendar: May 14, 2012 , Floor Calendar: May 15, 2012 , Floor Calendar: May 16, 2012 , Floor Calendar: May 21, 2012 , Floor Calendar: May 22, 2012 , Floor Calendar: May 23, 2012 , Floor Calendar: May 30, 2012 , Floor Calendar: May 31, 2012 , Floor Calendar: Jun 4, 2012 , Floor Calendar: Jun 5, 2012 , Floor Calendar: Jun 6, 2012 , Floor Calendar: Jun 11, 2012 , Floor Calendar: Jun 12, 2012 , Floor Calendar: Jun 13, 2012 , Floor Calendar: Jun 14, 2012 , Floor Calendar: Jun 18, 2012 , Floor Calendar: Jun 19, 2012 , Floor Calendar: Jun 20, 2012 , Floor Calendar: Jun 21, 2012

S6745-2011 Votes

S6745-2011 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.

S6745-2011 Text

                      S T A T E   O F   N E W   Y O R K
  ________________________________________________________________________

                                    6745

                              I N  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

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD14760-04-2

 S. 6745                             2

  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.