Directs the commissioner of health to develop a standard prior prescription drug authorization form for managed care providers.

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S7384-2011 Actions

• Jun 20, 2012: SUBSTITUTED BY A10248B
• Jun 20, 2012: ORDERED TO THIRD READING CAL.1441
• Jun 12, 2012: PRINT NUMBER 7384A
• Jun 12, 2012: AMEND (T) AND RECOMMIT TO RULES
• Jun 11, 2012: REPORTED AND COMMITTED TO RULES
• May 2, 2012: REFERRED TO HEALTH

S7384-2011 Meetings

Health: Jun 11, 2012

S7384-2011 Votes

S7384-2011 Memo

BILL NUMBER:S7384

TITLE OF BILL:
An act
to amend the social services law, in relation to directing the
commissioner of health to develop a uniform prior prescription drug
authorization form for managed care providers

PURPOSE:
This bill directs the Department of Health to develop a uniform prior
authorization form for prescription drug benefits within Medicaid
Managed Care.

SUMMARY OF PROVISIONS:
The bill would add new subdivision 26 of section 364-j of the social
services law, which would direct the Department of Health to develop
a uniform prior authorization form to be used by Medicaid managed
care providers to determine coverage of prescription drug benefits.

JUSTIFICATION:
The 2011-12 New York State Budget, as part of a comprehensive redesign
of the Medicaid program, moved the overwhelming majority of
prescription drug coverage from the Medicaid fee-for-service program
into Medicaid Managed Care. As a result of this change, health care
providers now have more than twenty formularies and prior
authorization processes to contend with when writing prescriptions
for their Medicaid patients. Navigating this system has proven to be
a significant administrative burden for health care providers who are
already stretched thin when providing critical safety net services to
New York's most vulnerable populations.

This bill directs the Department of Health to develop a uniform form
to be used for prior authorizations related to the prescription drug
benefit within Medicaid Managed Care. By standardizing this process,
health care providers will be relieved of a substantial
administrative burden and will be better able to spend their time
caring for patients.

LEGISLATIVE HISTORY:
New bill.

FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
Immediately.

S7384-2011 Text

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

                                    7384

                              I N  SENATE

                                 May 2, 2012
                                 ___________

  Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
    printed to be committed to the Committee on Health

  AN ACT to amend the social services law, in relation  to  directing  the
    commissioner  of  health  to develop a uniform prior prescription drug
    authorization form for managed care providers

    THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
  BLY, DO ENACT AS FOLLOWS:


    Section  1.  Section  364-j  of  the social services law is amended by
  adding a new subdivision 26 to read as follows:

    26. ON OR BEFORE JANUARY FIRST, TWO THOUSAND THIRTEEN, THE COMMISSION-
  ER OF HEALTH SHALL DEVELOP A UNIFORM  PRIOR  AUTHORIZATION  FORM  TO  BE
  UTILIZED  BY  ALL  MANAGED  CARE  PROVIDERS  FOR PURPOSES OF DETERMINING
  COVERAGE OF PRESCRIPTION DRUG BENEFITS UNDER THIS TITLE.
    S 2. This act shall take effect immediately; provided,  however,  that
  the  amendment  to  section  364-j  of  the social services law, made by
  section one of this act shall not affect the repeal of such section  and
  shall be deemed repealed therewith.






   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD15724-01-2