- Summary
- Actions
- Committee Votes
- Floor Votes
- Memo
- Text
- LFIN
- Chamber Video/Transcript
A06733 Summary:
BILL NO | A06733 |
  | |
SAME AS | SAME AS S02763-A |
  | |
SPONSOR | Lavine |
  | |
COSPNSR | McDonald, Skoufis, Steck, Hevesi, Perry, Dinowitz, Abinanti, Giglio, McDonough, Crouch, Ra, Norris, Englebright, Titone, Zebrowski, Morinello, Montesano, Colton, Jaffee, Blake, Schimminger, Glick, Gottfried, Lawrence, Rivera, D'Urso, Miller B, Benedetto, Niou, Galef |
  | |
MLTSPNSR | Davila, Raia, Simon, Wright |
  | |
Add §280-c, Pub Health L | |
  | |
Enacts provisions governing the conduct of audits of pharmacies by pharmacy benefit managers; provides timeframes for reports, specifies documentation to be used; exempts certain investigations. |
A06733 Actions:
BILL NO | A06733 | |||||||||||||||||||||||||||||||||||||||||||||||||
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03/16/2017 | referred to health | |||||||||||||||||||||||||||||||||||||||||||||||||
01/03/2018 | referred to health | |||||||||||||||||||||||||||||||||||||||||||||||||
01/17/2018 | reported referred to codes | |||||||||||||||||||||||||||||||||||||||||||||||||
02/27/2018 | reported | |||||||||||||||||||||||||||||||||||||||||||||||||
03/01/2018 | advanced to third reading cal.694 | |||||||||||||||||||||||||||||||||||||||||||||||||
03/05/2018 | passed assembly | |||||||||||||||||||||||||||||||||||||||||||||||||
03/05/2018 | delivered to senate | |||||||||||||||||||||||||||||||||||||||||||||||||
03/05/2018 | REFERRED TO HEALTH |
A06733 Committee Votes:
Gottfried | Aye | Raia | Excused | ||||||
Schimminger | Aye | McDonough | Aye | ||||||
Galef | Aye | Ra | Aye | ||||||
Dinowitz | Aye | Walter | Aye | ||||||
Cahill | Aye | Garbarino | Aye | ||||||
Paulin | Aye | Byrne | Aye | ||||||
Cymbrowitz | Aye | Norris | Aye | ||||||
Gunther | Aye | ||||||||
Rosenthal | Aye | ||||||||
Hevesi | Aye | ||||||||
Lavine | Aye | ||||||||
Titone | Aye | ||||||||
Jaffee | Aye | ||||||||
Steck | Aye | ||||||||
Abinanti | Aye | ||||||||
Braunstein | Aye | ||||||||
Kim | Aye | ||||||||
Solages | Aye | ||||||||
Bichotte | Aye | ||||||||
Lentol | Aye | Curran | Aye | ||||||
Schimminger | Aye | Giglio | Aye | ||||||
Pretlow | Aye | Montesano | Aye | ||||||
Cook | Aye | Morinello | Aye | ||||||
Cymbrowitz | Aye | Palumbo | Absent | ||||||
Titus | Aye | Garbarino | Aye | ||||||
O'Donnell | Aye | ||||||||
Lavine | Aye | ||||||||
Perry | Aye | ||||||||
Zebrowski | Aye | ||||||||
Abinanti | Aye | ||||||||
Weprin | Aye | ||||||||
Mosley | Aye | ||||||||
Hevesi | Excused | ||||||||
Fahy | Aye | ||||||||
Seawright | Aye | ||||||||
Go to top
A06733 Floor Votes:
Yes
Abbate
Yes
Crouch
ER
Gunther
Yes
Mayer
Yes
Pichardo
Yes
Taylor
Yes
Abinanti
Yes
Curran
ER
Harris
Yes
McDonald
Yes
Pretlow
Yes
Thiele
Yes
Arroyo
Yes
Cusick
Yes
Hawley
ER
McDonough
Yes
Quart
Yes
Titone
Yes
Aubry
Yes
Cymbrowitz
Yes
Hevesi
Yes
Miller B
Yes
Ra
Yes
Titus
Yes
Barclay
Yes
Davila
Yes
Hikind
Yes
Miller MG
Yes
Raia
Yes
Vanel
Yes
Barnwell
Yes
De La Rosa
Yes
Hooper
Yes
Miller ML
Yes
Ramos
Yes
Walker
Yes
Barrett
Yes
DenDekker
Yes
Hunter
Yes
Montesano
ER
Richardson
Yes
Wallace
Yes
Barron
Yes
Dickens
Yes
Hyndman
Yes
Morelle
Yes
Rivera
Yes
Walsh
Yes
Benedetto
Yes
Dilan
Yes
Jaffee
Yes
Morinello
Yes
Rodriguez
Yes
Walter
Yes
Bichotte
Yes
Dinowitz
Yes
Jean-Pierre
ER
Mosley
Yes
Rosenthal D
Yes
Weinstein
Yes
Blake
Yes
DiPietro
Yes
Jenne
Yes
Murray
Yes
Rosenthal L
Yes
Weprin
Yes
Blankenbush
Yes
D'Urso
Yes
Johns
Yes
Niou
Yes
Rozic
Yes
Williams
Yes
Brabenec
Yes
Englebright
Yes
Jones
ER
Nolan
Yes
Ryan
Yes
Woerner
Yes
Braunstein
Yes
Errigo
Yes
Joyner
Yes
Norris
Yes
Santabarbara
Yes
Wright
Yes
Brindisi
Yes
Fahy
Yes
Kim
Yes
Oaks
Yes
Schimminger
Yes
Zebrowski
Yes
Bronson
Yes
Finch
Yes
Kolb
Yes
O'Donnell
Yes
Seawright
Yes
Mr. Speaker
Yes
Buchwald
Yes
Fitzpatrick
Yes
Lalor
Yes
Ortiz
Yes
Sepulveda
Yes
Butler
Yes
Friend
Yes
Lavine
Yes
Otis
Yes
Simon
Yes
Byrne
Yes
Galef
Yes
Lawrence
Yes
Palmesano
Yes
Simotas
Yes
Cahill
ER
Gantt
Yes
Lentol
Yes
Palumbo
ER
Skartados
Yes
Carroll
Yes
Garbarino
Yes
Lifton
Yes
Paulin
Yes
Skoufis
Yes
Castorina
Yes
Giglio
Yes
Lupardo
Yes
Pellegrino
Yes
Solages
Yes
Colton
Yes
Glick
Yes
Magee
Yes
Peoples-Stokes
Yes
Stec
Yes
Cook
Yes
Goodell
Yes
Magnarelli
Yes
Perry
Yes
Steck
Yes
Crespo
Yes
Gottfried
Yes
Malliotakis
Yes
Pheffer Amato
Yes
Stirpe
‡ Indicates voting via videoconference
A06733 Text:
Go to top STATE OF NEW YORK ________________________________________________________________________ 6733 2017-2018 Regular Sessions IN ASSEMBLY March 16, 2017 ___________ Introduced by M. of A. LAVINE -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to audits of pharma- cies The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new section 2 280-c to read as follows: 3 § 280-c. Pharmacy audits by pharmacy benefit managers. 1. Defi- 4 nitions. As used in this section, the following terms shall have the 5 following meanings: 6 (a) "Pharmacy benefit manager" shall have the same meaning as in 7 section two hundred eighty-a of this article. 8 (b) "Pharmacy" shall mean a pharmacy that has contracted with a phar- 9 macy benefit manager for the provision of pharmacy services. 10 2. When conducting an audit of a pharmacy's records, a pharmacy bene- 11 fit manager shall: 12 (a) not conduct an on-site audit of a pharmacy at any time during the 13 first three calendar days of a month; 14 (b) notify the pharmacy or its contracting agent no later than fifteen 15 days before the date of initial on-site audit. Such notification to the 16 pharmacy or its contracting agent shall be in writing delivered either 17 (i) by mail or common carrier, return receipt requested, or (ii) elec- 18 tronically with electronic receipt confirmation, addressed to the super- 19 vising pharmacist of record and pharmacy corporate office where applica- 20 ble, at least fifteen days before the date of an initial on-site audit; 21 (c) limit the audit period to twenty-four months after the date a 22 claim is submitted to or adjudicated by the pharmacy benefit manager; 23 (d) include in the written advance notice of an on-site audit the list 24 of specific prescription numbers to be included in the audit that may or 25 may not include the final two digits of the prescription numbers; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD06021-04-7A. 6733 2 1 (e) use the written and verifiable records of a hospital, physician or 2 other authorized practitioner, which are transmitted by any means of 3 communication, to validate the pharmacy records in accordance with state 4 and federal law; 5 (f) limit the number of prescriptions audited to no more than one 6 hundred randomly selected in a twelve-month period, except in cases of 7 fraud; 8 (g) provide the pharmacy or its contracting agent with a copy of the 9 preliminary audit report within forty-five days after the conclusion of 10 the audit; 11 (h) be allowed to conduct a follow-up audit on-site if a remote or 12 desk audit reveals the necessity for a review of additional claims; 13 (i) in the case of invoice audits, accept as validation invoices from 14 any wholesaler registered with the department of education from which 15 the pharmacy has purchased prescription drugs or, in the case of durable 16 medical equipment or sickroom supplies, invoices from an authorized 17 distributor other than a wholesaler; 18 (j) provide the pharmacy or its contracting agent with the ability to 19 provide documentation to address a discrepancy or audit finding, 20 provided that such documentation must be received by the pharmacy bene- 21 fit manager no later than the forty-fifth day after the preliminary 22 audit report was provided to the pharmacy or its contracting agent. The 23 pharmacy benefit manager shall consider a reasonable request from the 24 pharmacy for an extension of time to submit documentation to address or 25 correct any findings in the report; and 26 (k) provide the pharmacy or its contracting agent with the final audit 27 report no later than sixty days after the initial audit report was 28 provided to the pharmacy or its contracting agent. 29 3. Any claim that was retroactively denied for a clerical error, typo- 30 graphical error, scrivener's error or computer error shall be paid if 31 the prescription was properly and correctly dispensed, unless a pattern 32 of such errors exists, fraudulent billing is alleged or the error 33 results in actual financial loss to the entity. A clerical error is an 34 error that does not result in actual financial harm to the covered enti- 35 ty or consumer and does not include the dispensing of an incorrect dose, 36 amount or type of medication or dispensing a prescription drug to the 37 wrong person. 38 4. This section shall not apply to: 39 (a) audits in which suspected fraudulent activity or other intentional 40 or willful misrepresentation is evidenced by a physical review, review 41 of claims data or statements, or other investigative methods; or 42 (b) audits of claims paid for by federally funded programs; or 43 (c) concurrent reviews or desk audits that occur within three business 44 days of transmission of a claim and where no chargeback or recoupment is 45 demanded. 46 § 2. This act shall take effect on the sixtieth day after it shall 47 have become a law.