Requires managed care providers to annually provide each participant in their programs with a written list of mail-order pharmacies with which the managed care provider has a contract for coverage of prescription drugs.
STATE OF NEW YORK
________________________________________________________________________
3891
2023-2024 Regular Sessions
IN ASSEMBLY
February 8, 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 each
managed care provider to annually provide each participant in its
program with a written list of mail-order pharmacies with which the
managed care provider has a contract for coverage of prescription
drugs
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. If the
8 managed care provider has designated one or more pharmacies for filling
9 prescriptions for a particular drug or drugs, then such prescriptions
10 may be filled, at the participant's option, at any other pharmacy in the
11 network, if the network pharmacy chosen by the participant offers to
12 accept a price that is comparable to that of the pharmacy designated by
13 the managed care provider. For the purposes of this section, "mail order
14 pharmacy" means a pharmacy whose primary business is to receive
15 prescriptions by mail, telefax or through electronic submissions, and to
16 dispense medication to patients through the use of the United States
17 mail or other common or contract carrier services, and provides any
18 consultation with patients electronically rather than face to face.
19 Every non-mail-order retail pharmacy in the managed care provider's
20 network with respect to any prescription drug shall be deemed to be in
21 the managed care provider's network for every covered prescription drug.
22 Each managed care provider subject to the provisions of this paragraph
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05476-01-3
A. 3891 2
1 shall annually provide each participant in its program with a written
2 list of mail-order pharmacies with which the managed care provider has a
3 contract for coverage of prescription drugs.
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, however that
7 the amendments to section 364-j of the social services law made by
8 section one of this act shall not affect the repeal of such section and
9 shall be deemed repealed therewith.
