Prohibits health insurers from requiring insureds purchase prescribed drugs from mail order pharmacy

14 Co-sponsors

• Richard Gottfried
• Steven Cymbrowitz
• N. Nick Perry
• Vito Lopez
• Jose Rivera
• Joseph Giglio
• Dennis H. Gabryszak
• Joan Millman
• Ellen C. Jaffee
• Daniel Burling
• Audrey Pheffer
• Jeffrey Dinowitz
• Ginny Fields
• Kenneth Zebrowski

26 Multi-sponsors

• Thomas Alfano
• Robert Barra
• William Boyland
• Nancy Calhoun
• Joan Christensen
• Barbara Clark
• RoAnn Destito
• Deborah Glick
• Aileen Gunther
• Stephen Hawley
• Earlene Hooper
• Susan John
• Rory Lancman
• George Latimer
• Margaret Markey
• John McEneny
• Joel Miller
• Catherine Nolan
• Amy Paulin
• Crystal Peoples-Stokes
• Annette Robinson
• Linda Rosenthal
• William Scarborough
• Robert Sweeney
• Harvey Weisenberg
• Keith L.T. Wright

BILL NUMBER:A1267A

Title of bill

An act to amend the insurance law, in relation to the purchase of prescription drugs

Purpose or general idea of bill

Prohibits health insurance policies from mandating their insured to purchase prescribed drugs from a mail order pharmacy.

Summary of specific provisions

* §1.- Subsection (i) of Section 3216 of the insurance law is amended by adding a new paragraph (26) to preclude health insurance policies from mandating that their insured purchase prescribed drugs from mail order pharmacies. Such policies are also precluded from imposing a co-payment fee or other condition on an insured who chooses not to purchase from a designated mail order pharmacy.

* §2-3 A new paragraph (18) is also added to subsection (1) of Section 3221 of such law and a new Subsection (fir) is likewise added to section 4303 to impose such a prohibition on all policies of health insurance in the state including those issued by health services or medical expense indemnity corporations issuing group contracts.

* §4. Paragraph (25) of subsection (b) of section 4322 of the insurance law is amended to require that no direct pay Health maintenance organ- izations shall mandate that prescription drugs be purchased by the insured from a mail order pharmacy.

* §5. This section adds a severance clause to the legislation

* The amended sections above shall not supersede the terms of a collec- tive bargaining agreement entered into between an employer and a certi- fied employee organization.

* Additionally, this shall not alter any provisions in sections thirteen and thirteen-a of the workers' compensation law regarding the purchase of prescription drugs and the use of mail order pharmacy.

Justification

This legislation will provide freedom of choice to consumers who have coverage for prescribed drugs as part of their health insurance. When a policy mandates purchase from a specific mail order pharmacy the consumer is forced to purchase an interim supply of the prescribed drug from his or her neighborhood pharmacist who is familiar with his or her medical history. The risk to the consumer in this situ- ation is obvious.

Furthermore, the neighborhood pharmacy in these situations is forced to bear the burden of educating the patient as to the use and potential effects of the prescribed drug. The inability of the consumer to purchase the full prescription from the neighborhood pharmacy imposes

this burden inequitably, thereby providing the until order house with an economic advantage that the local provider cannot over-come.

Finally, many consumers, especially senior citizens, rely on their local pharmacist for the service that they provide with respect to monitoring the regimen of drugs that they take. A mandate of purchase by mail denies them of this important service and confidence.

Prior legislative history

2008 - A,2808/Insurance; S.8775/Rules 2007 - A.2808/Insurance; S.8775/Rules 2006 - A.6934/Insurance 2005 - A.6934/Insurance 2004 - Referred to Insurance 2003 -Referred to Insurance 2002 - Referred to Insurance 2001 - Referred to Insurance 2000- Referred to Insurance 1999- Referred to Insurance

Fiscal implications

None

Effective date

This act Shall take effect on the thirtieth day after it shall have become law and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such effective date.