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S6446Senate2013-2014 SessionSame asA5349

Relates to medicaid payment for co-payments due under Medicare Part D

Sponsor Gustavo RiveraSD-33Affects Health
Status
In Senate Committee
Health
Impact
Pending
Passage
Pending

Bill progress

Step 2 of 7

In committee · Health

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Who cares

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Sponsors

Primary sponsor
Gustavo Rivera

Senator · Senate District 33

No co-sponsors yet.

History

  1. 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.

A5349Assembly

Relates to medicaid payment for co-payments due under Medicare Part D

In Assembly Committee · Health · Sponsor Richard Gottfried

Full text

The text isn't available here yet. Check nysenate.gov.

Sponsor's memo

BILL NUMBER:S6446

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 or general idea of bill

To aid dual-eligible Medicare Part D recipients with prescription drug co-payments.

Summary of specific 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-pay- ments). 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.

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 can to prescription drugs provided under the Part D program, a right that all other Medicaid recipients currently enjoy.

Prior legislative history

2006: A11377 (Friedman) - passed Assembly 2007: A3598-A (Gottfried) - referred to Ways and Means 2008: A3598-A (Gottfried) - referred to Ways and Means 2009-10: A.884 - referred to Ways and Means 2011-12; A.576 - referred to Health

Fiscal implications

Minimal

Effective date

This bill shall take effect on the first of April next succeeding the data 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.