Requires managed care providers that provide coverage for prescription drugs to provide coverage for home delivery of any covered prescription by any non-mail-order retail pharmacy in the managed care provider network.
STATE OF NEW YORK
________________________________________________________________________
1036
2023-2024 Regular Sessions
IN ASSEMBLY
January 13, 2023
___________
Introduced by M. of A. BICHOTTE HERMELYN -- read once and referred to
the Committee on Health
AN ACT to amend the social services law, in relation to requiring
managed care providers that provide coverage for prescription drugs to
provide coverage for home delivery of any covered prescription drug by
any non-mail-order retail pharmacy in the managed care provider
network
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph (u) of subdivision 4 of section 364-j of the
2 social services law, as amended by section 12 of part A of chapter 56 of
3 the laws of 2013, is amended to read as follows:
4 (u) A managed care provider that provides coverage for prescription
5 drugs shall permit each participant to fill any mail order covered
6 prescription, at his or her option, at any mail order pharmacy or non-
7 mail-order retail pharmacy in the managed care provider network. A
8 managed care provider that provides coverage for prescription drugs
9 shall also provide coverage for home delivery of any covered
10 prescription drug by any non-mail-order retail pharmacy in the managed
11 care provider network. If the managed care provider has designated one
12 or more pharmacies for filling prescriptions for a particular drug or
13 drugs, then such prescriptions may be filled, at the participant's
14 option, at any other pharmacy in the network, if the network pharmacy
15 chosen by the participant offers to accept a price that is comparable to
16 that of the pharmacy designated by the managed care provider. For the
17 purposes of this section, "mail order pharmacy" means a pharmacy whose
18 primary business is to receive prescriptions by mail, telefax or through
19 electronic submissions, and to dispense medication to patients through
20 the use of the United States mail or other common or contract carrier
21 services, and provides any consultation with patients electronically
22 rather than face to face. Every non-mail-order retail pharmacy in the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01188-01-3
A. 1036 2
1 managed care provider's network with respect to any prescription drug
2 shall be deemed to be in the managed care provider's network for every
3 covered prescription drug.
4 § 2. This act shall take effect on the one hundred eightieth day after
5 it shall have become a law, and shall apply to all contracts, agreements
6 and leases entered into on or after such date; provided that the amend-
7 ments to section 364-j of the social services law made by section one of
8 this act shall not affect the repeal of such section and shall be deemed
9 repealed therewith.
