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Who cares
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Sponsors
1 Co-sponsor
History
- Reported and committed to finance
- Referred to health
- Reported and committed to finance
- 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.
Relates to medicaid payment for co-payments due under Medicare Part D
In Assembly Committee · Ways And Means · Sponsor Richard Gottfried
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
Title of bill
An act to amend the public health law and the social services law, in relation to medicaid payment for co-payments due under Medicare Part D
Purpose
To aid dual-eligible Medicare Part D recipients with prescription drug copayments.
Summary of provisions
The bill provides for Medicaid to pay the Medicare Part D co-payments for dual-eligible Medicare-Medicaid recipients, once the recipient has reached the Medicaid $200-a-year co-payment cap (counting Part D co-payments). Coverage for these co-payments would be exempt from Medicaid prior authorization. It directs the Commissioner of Health to create a system that allows pharmacists to register a dual-eligible individual's Medicare Part D co-payments in the Medicaid system, and establishes that Medicaid shall provide for payment of the Part D co-payment after $200 in co-payments have been made.
Existing law
None.
Justification
Medicaid's co-payment system has always allowed an individual to receive their medications, even if they do not have the ability to pay their co-payment. But under Medicare Part D (which they are required to participate in), these individuals are required to pay the co-payments required by their Part D plan. When they cannot afford to pay, they go without necessary medications and then receive much more costly medical care, at the expense of the Medicaid program. This law will remove a loophole from the Medicaid law, where individuals who are eligible for both Medicare and Medicaid receive an inferior level of care than those only eligible for Medicaid by extending the co-payment cap to prescription drugs provided under the Part D program, a right that all other Medicaid recipients currently enjoy.
Legislative history
This is a new bill.
Fiscal implications
To be determined.
Local fiscal implications
To be determined.
Effective date
This bill shall take effect on the first of April next succeeding the date on which it shall have become law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.