What's happening
This bill requires managed care providers to cover home delivery of prescription drugs by any non-mail-order retail pharmacy in their network.
Why it matters
Expands patient choice and convenience. By requiring managed care providers to cover home delivery from any in-network retail pharmacy (not just mail-order services), patients who rely on local pharmacies gain greater flexibility, potentially improving adherence to medication regimens.
Supports local pharmacies. The bill helps level the playing field for community-based, non-mail-order pharmacies, which might otherwise lose business to designated mail-order services, potentially preserving local jobs and pharmacy access.
Addresses barriers for vulnerable populations. Home delivery by local pharmacies can especially benefit individuals with mobility issues, disabilities, or transportation challenges, ensuring they can receive necessary medications without extra hardship.
Could impact costs and negotiations. By mandating coverage for home delivery from all in-network pharmacies, managed care organizations may need to renegotiate contracts and reimbursement rates, which could have downstream effects on plan costs and pharmacy participation.
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Who cares
Headline styles
Require Prescription Home Delivery
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to health
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2771
2019-2020 Regular Sessions
IN ASSEMBLY
January 25, 2019
Introduced by M. of A. BICHOTTE -- read once and referred to the Committee on Health
AN ACT to amend the social services law, in relation to requiring managed care providers that provide coverage for prescription drugs to provide coverage for home delivery of any covered prescription drug by any non-mail-order retail pharmacy in the managed care provider network
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraph (u) of subdivision 4 of section 364-j of the social services law, as amended by section 12 of part A of chapter 56 of the laws of 2013, is amended to read as follows:
(u) A managed care provider that provides coverage for prescription drugs shall permit each participant to fill any mail order covered prescription, at his or her option, at any mail order pharmacy or nonmail-order retail pharmacy in the managed care provider network. A managed care provider that provides coverage for prescription drugs shall also provide coverage for home delivery of any covered prescription drug by any non-mail-order retail pharmacy in the managed care provider network. If the managed care provider has designated one or more pharmacies for filling prescriptions for a particular drug or drugs, then such prescriptions may be filled, at the participant's option, at any other pharmacy in the network, if the network pharmacy chosen by the participant offers to accept a price that is comparable to that of the pharmacy designated by the managed care provider. For the purposes of this section, "mail order pharmacy" means a pharmacy whose primary business is to receive prescriptions by mail, telefax or through electronic submissions, and to dispense medication to patients through the use of the United States mail or other common or contract carrier services, and provides any consultation with patients electronically rather than face to face. Every non-mail-order retail pharmacy in the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00423-01-9
A. 2771 2
managed care provider's network with respect to any prescription drug shall be deemed to be in the managed care provider's network for every covered prescription drug.
§ 2. This act shall take effect on the one hundred eightieth day after it shall have become a law, and shall apply to all contracts, agreements and leases entered into on or after such date; provided that the amendments to section 364-j of the social services law made by section one of this act shall not affect the repeal of such section and shall be deemed repealed therewith.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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