S7384A-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

S7384A-2011 Meetings

S7384A-2011 Calendars

S7384A-2011 Votes

S7384A-2011 Memo

BILL NUMBER:S7384A

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

PURPOSE:
This bill directs the Department of Health to develop a standard prior
authorization request form or forms 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 standard prior authorization request form or forms 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 standard form
or forms 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.

S7384A-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 7384--A
 I N  SENATE
 May 2, 2012
 
 Introduced  by  Sens.  HANNON, LARKIN -- read twice and ordered printed,
 and when printed to  be  committed  to  the  Committee  on  Health  -
 reported  favorably from said committee and committed to the Committee
 on Rules -- committee discharged, bill amended, ordered  reprinted  as
 amended and recommitted to said committee
 AN  ACT  to  amend the social services law, in relation to directing the
 commissioner of health to develop a standard prior  prescription  drug
 authorization request 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. THE COMMISSIONER OF HEALTH SHALL DEVELOP A STANDARD PRIOR AUTHORI
 ZATION  REQUEST FORM OR FORMS TO BE UTILIZED BY ALL MANAGED CARE PROVID
 ERS FOR PURPOSES OF SUBMITTING A REQUEST FOR A UTILIZATION REVIEW DETER
 MINATION FOR COVERAGE OF PRESCRIPTION DRUG BENEFITS  UNDER  THIS  TITLE.
 THE  MANAGED  CARE  PROVIDER SHALL MAKE THE STANDARD PRIOR AUTHORIZATION
 REQUEST FORM OR FORMS AVAILABLE TO, AND SHALL ACCEPT IT  OR  THEM  FROM,
 PRESCRIBING PROVIDERS IN PAPER AND ELECTRONIC FORM.
 

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.
 LBD15724-03-2

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