STATE OF NEW YORK ________________________________________________________________________ 1331 2023-2024 Regular Sessions IN SENATE January 11, 2023 ___________ Introduced by Sen. HOYLMAN-SIGAL -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the social services law, in relation to synchronization of multiple prescriptions; and to amend a chapter of the laws of 2022 amending the social services law relating to synchronization of multi- ple prescriptions, as proposed in legislative bills numbers S. 431-A and A. 187, in relation to the effectiveness thereof The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph (i) of subdivision 9 of section 367-a of the 2 social services law, as added by a chapter of the laws of 2022 amending 3 the social services law relating to synchronization of multiple 4 prescriptions, as proposed in legislative bills numbers S. 431-A and A. 5 187, is amended to read as follows: 6 (i)(i) The department of health shall establish a program for synchro- 7 nization of medications. Under the synchronization program, a health 8 care practitioner may prescribe a refill of one or more of the patient's 9 medications for a shorter period than would ordinarily be provided, for 10 the purpose of synchronizing refill dates of one or more of the 11 patient's medications subject to the synchronization when it is agreed 12 among the recipient, [a provider] the health care practitioner and a 13 pharmacist that synchronization of multiple prescriptions for the treat- 14 ment of a chronic illness is in the best interest of the patient for the 15 management or treatment of a chronic illness provided that the following 16 apply to such medications: 17 (A) are covered by the department of health pursuant to this title; 18 (B) are used for treatment and management of a chronic [conditions] 19 illness that are subject to refills; 20 (C) are not a schedule II controlled substance, nor a schedule III 21 controlled substance that contains hydrocodone or other opioid medica- 22 tion as scheduled in section thirty-three hundred six of the public EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04021-01-3
S. 1331 2 1 health law, or a controlled substance under the federal Controlled 2 Substances Act; 3 (D) meet all prior authorization criteria specific to the medications 4 at the time of the synchronization request; 5 (E) are of a formulation that can be effectively [split] and lawfully 6 aligned over required short fill periods to achieve synchronization; and 7 (F) do not have quantity limits or dose optimization criteria or state 8 or federal requirements that would be violated in fulfilling synchroni- 9 zation. 10 (ii) The department of health shall not deny coverage for the dispens- 11 ing of a medication by a pharmacy for a partial supply when it is for 12 the purpose of synchronizing the patient's medications. When applicable 13 to permit synchronization, the department of health shall allow a phar- 14 macy to override any denial codes indicating that a prescription is 15 being refilled too soon for the purposes of medication synchronization. 16 (iii) [To permit synchronization, the department of health shall apply 17 a prorated daily cost-sharing rate to any medication dispensed by a 18 pharmacy pursuant to this section. 19 (iv) The dispensing fee paid to a pharmacy contracted to provide 20 services pursuant to this section for a partial supply associated with a 21 medication synchronization shall be paid in full and shall not be 22 prorated. 23 (v)] The dispensing fee paid to the pharmacy contracted to provide 24 services pursuant to this section for a partial supply associated with 25 medication synchronization shall be paid in accordance with the Medicaid 26 state plan as approved by the Centers for Medicare and Medicaid 27 Services. 28 (iv) The requirement of this paragraph applies only once for each 29 prescription drug subject to medication synchronization except when 30 either of the following occurs: 31 (I) the prescriber changes the dosage or frequency of administration 32 of the prescription drug subject to a medication synchronization; or 33 (II) the prescriber prescribes a different drug. 34 [(vi)] (v) Nothing in this paragraph shall be deemed to require health 35 care practitioners and pharmacists to synchronize the refilling of 36 multiple prescriptions for a recipient. 37 (vi) The provisions of this paragraph are subject to compliance with 38 all applicable federal and state laws and regulations, including the 39 Centers for Medicare and Medicaid Services approved Medicaid state plan. 40 The commissioner shall apply for waivers and submit state Medicaid plan 41 amendments as are necessary to implement the program for synchronization 42 of medications. 43 § 2. Paragraph (w) of subdivision 4 of section 364-j of the social 44 services law, as added by a chapter of the laws of 2022 amending the 45 social services law relating to synchronization of multiple 46 prescriptions, as proposed in legislative bills numbers S. 431-A and 47 A.187, is amended to read as follows: 48 (w)(i) The department of health or a managed care organization 49 contracted to provide services pursuant to this section shall establish 50 a program for synchronization of medications. Under the synchronization 51 program, a health care practitioner may prescribe a refill of one or 52 more of the patient's medications for a shorter period than would ordi- 53 narily be provided, for the purpose of synchronizing refill dates of one 54 or more of the patient's medications subject to the synchronization, 55 when it is agreed among the recipient, [a provider] the health care 56 practitioner and a pharmacist that synchronization of multiple
S. 1331 3 1 prescriptions for the treatment of a chronic illness is in the best 2 interest of the patient for the management or treatment of a chronic 3 illness provided that the following apply to such medications: 4 (A) are covered by Medicaid services or a managed care organization 5 contracted to provide services pursuant to this chapter; 6 (B) are used for treatment and management of a chronic [conditions] 7 illness that are subject to refills; 8 (C) are not a schedule II controlled substance, nor a schedule III 9 controlled substance that contains hydrocodone or other opioid medica- 10 tion as scheduled in section thirty-three hundred six of the public 11 health law, or a controlled substance under the federal Controlled 12 Substances Act; 13 (D) meet all prior authorization criteria specific to the medications 14 at the time of the synchronization request; 15 (E) are of a formulation that can be effectively [split] and lawfully 16 aligned over required short fill periods to achieve synchronization; and 17 (F) do not have quantity limits or dose optimization criteria or state 18 or federal requirements that would be violated in fulfilling synchroni- 19 zation. 20 (ii) The department of health or a managed care organization 21 contracted to provide services under this section shall not deny cover- 22 age for the dispensing of a medication by a pharmacy for a partial 23 supply when it is for the purpose of synchronizing the patient's medica- 24 tions. When applicable to permit synchronization, the department of 25 health or a managed care organization contracted to provide services 26 under this title shall allow a pharmacy to override any denial codes 27 indicating that a prescription is being refilled too soon for the 28 purposes of medication synchronization. 29 (iii) [To permit synchronization, the department of health or a 30 managed care organization contracted to provide services pursuant to 31 this title shall apply a prorated daily cost-sharing rate to any medica- 32 tion dispensed by a pharmacy pursuant to this section. 33 (iv) The dispensing fee paid to a pharmacy contracted to provide 34 services pursuant to this section for a partial supply associated with a 35 medication synchronization shall be paid in full and shall not be 36 prorated. 37 (v)] The dispensing fee paid to the pharmacy contracted to provide 38 services pursuant to this section for a partial supply associated with 39 medication synchronization shall be paid in accordance with the Medicaid 40 state plan as approved by the Centers for Medicare and Medicaid 41 Services. 42 (iv) The requirement of this paragraph applies only once for each 43 prescription drug subject to medication synchronization except when 44 either of the following occurs: 45 (A) the prescriber changes the dosage or frequency of administration 46 of the prescription drug subject to a medication synchronization; or 47 (B) the prescriber prescribes a different drug. 48 [(vi)] (v) Nothing in this paragraph shall be deemed to require health 49 care practitioners and pharmacists to synchronize the refilling of 50 multiple prescriptions for a covered individual. 51 (vi) The provisions of this paragraph are subject to compliance with 52 all applicable federal and state laws and regulations, including the 53 Centers for Medicare and Medicaid Services approved Medicaid state plan. 54 The commissioner shall apply for waivers and submit state Medicaid plan 55 amendments as are necessary to implement the program for synchronization 56 of medications.
S. 1331 4 1 § 3. Section 3 of a chapter of the laws of 2022 amending the social 2 services law relating to synchronization of multiple prescriptions, as 3 proposed in legislative bills numbers S. 431-A and A. 187, is amended to 4 read as follows: 5 § 3. This act shall take effect [on the one hundred twentieth day 6 after it shall have become a law] January 1, 2024. The amendments to 7 subdivision 9 of section 367-a of the social services law, made by 8 section one of this act, shall not affect the expiration of that subdi- 9 vision, and shall expire therewith. 10 The amendments to section 364-j of the social services law, made by 11 section two of this act, shall not affect the repeal of that section, 12 and shall be deemed repealed therewith. Effective immediately, the 13 commissioner of health shall make regulations and take other actions 14 reasonably necessary to implement this act on that date. 15 § 4. This act shall take effect immediately; provided, however, that 16 sections one and two of this act shall take effect on the same date and 17 in the same manner as a chapter of the laws of 2022 amending the social 18 services law relating to synchronization of multiple prescriptions, as 19 proposed in legislative bills numbers S. 431-A and A. 187, takes effect. 20 The amendments to subdivision 9 of section 367-a of the social services 21 law, made by section one of this act, shall not affect the expiration of 22 that subdivision, and shall expire therewith. 23 The amendments to section 364-j of the social services law, made by 24 section two of this act, shall not affect the repeal of that section, 25 and shall be deemed repealed therewith. Effective immediately, the 26 commissioner of health shall make regulations and take other actions, 27 including applying for federal waivers and submitting state Medicaid 28 plan amendments, reasonably necessary to implement this act on that 29 date.