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A05502 Summary:

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A05502 Floor Votes:

A05502 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5502--B
 
                               2011-2012 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 22, 2011
                                       ___________
 
        Introduced by M. of A. HEASTIE, GOTTFRIED, COLTON, ROSENTHAL, M. MILLER,
          CYMBROWITZ,  MOYA,  O'DONNELL, THIELE, GALEF, CASTRO, DenDEKKER, BENE-
          DETTO, GUNTHER, SCHROEDER, MAISEL, SPANO, SCHIMEL,  V. LOPEZ,  WEISEN-
          BERG,  LAVINE,  WEPRIN,  ENGLEBRIGHT, SWEENEY, PAULIN, DINOWITZ, MENG,
          RODRIGUEZ, HOYT, GABRYSZAK, TITONE -- Multi-Sponsored by -- M.  of  A.

          ABBATE,  ABINANTI,  BOYLE, BURLING, CASTELLI, CERETTO, CORWIN, CRESPO,
          CROUCH, DUPREY, GIGLIO, GRAF, HAYES, JACOBS, KATZ, LATIMER,  P. LOPEZ,
          LOSQUADRO,   MALLIOTAKIS,  J. MILLER,  MONTESANO,  MURRAY,  PALMESANO,
          PEOPLES-STOKES,  RA,  RAIA,  P. RIVERA,  ROBERTS,  SALADINO,  SAYWARD,
          SMARDZ  --  read  once  and  referred to the Committee on Insurance --
          committee discharged, bill amended, ordered reprinted as  amended  and
          recommitted  to  said  committee -- again reported from said committee
          with amendments, ordered reprinted as amended and recommitted to  said
          committee
 
        AN  ACT  to  amend  the  insurance  law,  in relation to the purchase of
          prescription drugs
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 

     1    Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
     2  amended by adding a new paragraph 28 to read as follows:
     3    (28) Any policy which provides coverage for prescription  drugs  shall
     4  permit  each participant to fill any mail order covered prescription, at
     5  his or her option, at any mail order pharmacy or  network  participating
     6  non-mail  order  retail  pharmacy  if the network participating non-mail
     7  order retail pharmacy offers to accept a price  that  is  comparable  to
     8  that  of the mail order pharmacy. Any policy which provides coverage for
     9  prescription drugs shall not impose a co-payment fee or other  condition
    10  on any insured who elects to purchase drugs from a network participating

    11  non-mail  order  retail  pharmacy  which is not also imposed on insureds
    12  electing to purchase  drugs  from  a  designated  mail  order  pharmacy;
    13  provided,  however, that the provisions of this section shall not super-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09145-06-1
        A. 5502--B                          2
 
     1  sede the terms of a collective bargaining agreement or apply to a policy
     2  that is the result of  a  collective  bargaining  agreement  between  an
     3  employer and a recognized or certified employee organization.
     4    § 2. Subsection (1) of section 3221 of the insurance law is amended by

     5  adding a new paragraph 18 to read as follows:
     6    (18)  Any  insurer  delivering  a group or blanket policy or issuing a
     7  group or blanket policy for delivery in this state which provides cover-
     8  age for prescription drugs shall permit each  participant  to  fill  any
     9  mail order covered prescription, at his or her option, at any mail order
    10  pharmacy  or network participating non-mail order retail pharmacy if the
    11  network participating non-mail order retail pharmacy offers to accept  a
    12  price  that is comparable to that of the mail order pharmacy. Any policy
    13  which provides coverage  for  prescription  drugs  shall  not  impose  a
    14  co-payment  fee or other condition on any insured who elects to purchase

    15  drugs from a network participating non-mail order retail pharmacy  which
    16  is not also imposed on insureds electing to purchase drugs from a desig-
    17  nated  mail  order  pharmacy;  provided, however, that the provisions of
    18  this section shall not supersede the terms of  a  collective  bargaining
    19  agreement  or  apply  to  a  policy  that  is the result of a collective
    20  bargaining agreement between an employer and a recognized  or  certified
    21  employee organization.
    22    §  3.  Section  4303  of  the insurance law is amended by adding a new
    23  subsection (hh) to read as follows:
    24    (hh) Any policy issued by a medical expense indemnity  corporation,  a
    25  hospital  service  corporation  or  a  health services corporation which

    26  provides coverage for prescription drugs shall permit  each  participant
    27  to  fill  any  mail order covered prescription, at his or her option, at
    28  any mail order pharmacy or network participating non-mail  order  retail
    29  pharmacy  if  the  network  participating non-mail order retail pharmacy
    30  offers to accept a price that is comparable to that of  the  mail  order
    31  pharmacy.  Any  policy  which  provides  coverage for prescription drugs
    32  shall not impose a copayment fee or other condition on any  insured  who
    33  elects  to  purchase  drugs  from a network participating non-mail order
    34  retail pharmacy which is  not  also  imposed  on  insureds  electing  to
    35  purchase drugs from a designated mail order pharmacy; provided, however,

    36  that  the  provisions of this section shall not supersede the terms of a
    37  collective bargaining agreement or apply to a policy that is the  result
    38  of  a  collective  bargaining agreement between an employer and a recog-
    39  nized or certified employee organization.
    40    § 4.  If any clause, subparagraph, subsection, section or  other  part
    41  of  this  act,  or the   application thereof be held to be invalid, such
    42  holding shall not affect, impair or invalidate  the  remainder  of  this
    43  act, or the application of such section or part of a section held inval-
    44  id.
    45    §  5.  This  act shall take effect on the thirtieth day after it shall
    46  have become a law and shall apply to all policies and contracts  issued,
    47  renewed, modified, altered or amended on or after such effective date.