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Sponsors
15 Co-sponsors
History
- Referred to health
- Delivered to senate
- Passed assembly
- Amended on third reading 8782a
- Ordered to third reading cal.623
- Returned to assembly
- Died in senate
- Referred to rules
- Delivered to senate
- Passed assembly
- Ordered to third reading rules cal.413
- Rules report cal.413
Show 4 earlier actions
- Reported
- Reported referred to rules
- Reported referred to ways and means
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Directs the department of health to evaluate and report on Medicaid prescription drug reimbursement to retail pharmacies
In Senate Committee · Health · Sponsor David J. Valesky
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:A8782A
Title of bill
An act to direct the department of health to evaluate and report on Medicaid prescription drug reimbursement to retail pharma- cies
Purpose or general idea of bill
This bill directs the Department of Health to evaluate and report on Medicaid prescription drug reimburse- ment to retail pharmacies.
Summary of specific provisions
Section one of the bill creates a work- group within the Department of Health to assist the Commissioner of Health in studying Medicaid prescription drug reimbursement to retail pharmacies. Section two outlines the different factors to be considered in the study. Section three requires the Commissioner of Health to issue a report to the Governor and the Legislature. Section four sets forth the effective date.
Justification
It has become important for the legislature to have access to factual information on which to base policy and budget deci- sions with regard to payments to pharmacies. This legislation requires the Health Department, working with representatives of organized pharma- cy and other stakeholders, to gather information and prepare a report to inform about the adequacy of present reimbursement in terms of actual costs both for medications and professional services.
Compounding the pharmacy reimbursement matter further is the use of the term 'Average Wholesale Price' (AWP) that, combined with a discount, forms the payment formula for brand drugs. For generics, New York State law allows the Department of Health to calculate 'State Maximum Allow- able Cost' (SMAC). Pharmacies report that SMAC pricing is not based on any known methodology and it brings payment levels unrealistically low. Access to generics is an important key to our cost-containment strate- gies, and we should have confidence that our reimbursement policy is set appropriately.
As enumerated in this legislation, pharmacy overhead costs cover a wide range of elements that must be considered as part of a fair and reason- able payment standard. For consumers, the professional service compo- nents may represent the real value of having a local pharmacy with an accessible pharmacist, who has filled the prescription, checked for drug interactions and can provide important information about how to take the medicine prescribed for them. In this time of limited resources, it becomes more important that our Medicaid and EPIC beneficiaries derive the maximum therapeutic benefit from the medicines they are prescribed so that they can remain at home living independently as long as possi- ble. Local pharmacies represent healthcare outreach into communities and a valuable cost-containment strategy.
Prior legislative history
2009: A.8782 - Passed Assembly.
Fiscal implications
To be determined.
Effective date
Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.