New York Senate Bill S03370 Latest Draft

   
  STATE OF NEW YORK ________________________________________________________________________ 3370 2023-2024 Regular Sessions  IN SENATE January 31, 2023 ___________ Introduced by Sen. SKOUFIS -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to coverage of prescriptions obtained by mail order or at a non-retail pharmacy The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The opening paragraph of paragraph 28 of subsection (i) of 2 section 3216 of the insurance law, is designated subparagraph (A) and a 3 new subparagraph (B) is added to read as follows: 4 (B) Notwithstanding any other provision of this paragraph, if a pres- 5 criber, after consulting with the insurer regarding the appropriateness 6 of mail order delivery given: (i) the residence or delivery location of 7 the insured; (ii) the medical condition of the insured; (iii) the stor- 8 age requirements of the drug; (iv) the availability of the insured to 9 receive the prescription; or (v) the insured's ability to comprehend 10 pharmaceutical guidance and support over the telephone, determines that 11 a drug as prescribed on an individual basis is most appropriately filled 12 at a retail location, provided that an in-network retail pharmacy of the 13 patient's choosing agrees to the same reimbursement amount and is able 14 to fill the prescription, the prescriber's determination shall be final. 15 § 2. Paragraph 18 of subsection (l) of section 3221 of the insurance 16 law is amended by adding a new subparagraph (C) to read as follows: 17 (C) Notwithstanding any other provision of this paragraph, if a pres- 18 criber, after consulting with the insurer regarding the appropriateness 19 of mail order delivery given: (i) the residence or delivery location of 20 the insured; (ii) the medical condition of the insured; (iii) the stor- 21 age requirements of the drug; (iv) the availability of the insured to 22 receive the prescription; or (v) the insured's ability to comprehend 23 pharmaceutical guidance and support over the telephone, determines that 24 a drug as prescribed on an individual basis is most appropriately filled 25 at a retail location, provided that an in-network retail pharmacy of the EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04814-01-3 
 S. 3370 2 1 patient's choosing agrees to the same reimbursement amount and is able 2 to fill the prescription, the prescriber's determination shall be final. 3 § 3. Subsection (kk) of section 4303 of the insurance law is amended 4 by adding a new paragraph 3 to read as follows: 5 (3) Notwithstanding any other provision of this subsection, if a pres- 6 criber, after consulting with the insurer regarding the appropriateness 7 of mail order delivery given: (A) the residence or delivery location of 8 the covered person; (B) the medical condition of the covered person; (C) 9 the storage requirements of the drug; (D) the availability of the 10 covered person to receive the prescription; or (E) the covered person's 11 ability to comprehend pharmaceutical guidance and support over the tele- 12 phone, determines that a drug as prescribed on an individual basis is 13 most appropriately filled at a retail location, provided that an in-net- 14 work retail pharmacy of the patient's choosing agrees to the same 15 reimbursement amount and is able to fill the prescription, the 16 prescriber's determination shall be final. 17 § 4. This act shall take effect immediately.