New York New Legislative Entries

New York A.B. 10543

Category:

Generic Substitution

Last Action:

MARCH 25, 2002; To ASSEMBLY Committee on HEALTH.

Synopsis:

Relates to certain prohibitions in contracts or agreements by health maintenance organizations; prohibits clauses which entitles reimbursement at the lowest price or rate, prohibits contracts which restrict referal of patients based solely upon a health care provider's status with a managed care product, and prohibits disclosure of an enrollee's diagnosis as a condition for authorizing coverage for payment or dispensing of a prescription.

Synopsis Additional:

8. NO HEALTH CARE PLAN SHALL BY CONTRACT, WRITTEN POLICY OR WRITTEN PROCEDURE REQUIRE THE DISCLOSURE OF AN ENROLLEE'S DIAGNOSIS AS A CONDITION FOR DISPENSING OF A PHARMACEUTICAL  DRUG  OR AGENT, UNLESS OTHERWISE REQUIRED BY LAW.

9. NO HEALTH CARE PLAN SHALL BY CONTRACT, WRITTEN POLICY OR PROCEDURE PROVIDE FOR OR ALLOW THE  SUBSTITUTION  OF A PHARMACEUTICAL  DRUG  OR AGENT (OTHER THAN A  GENERIC SUBSTITUTION)  BY ANY PERSON OTHER THAN THE PRESCRIBING HEALTH CARE PROFESSIONAL.

(J) NO INSURER WHICH MAINTAINS A  DRUG FORMULARY,  OR WHICH CONTRACTS WITH ANOTHER ENTITY TO MAINTAIN A  DRUG FORMULARY,  SHALL BY CONTRACT, WRITTEN POLICY OR PROCEDURE PROVIDE FOR OR ALLOW THE  SUBSTITUTION  OF A PHARMACEUTICAL   DRUG  OR AGENT (OTHER THAN A  GENERIC SUBSTITUTION)  BY ANY PERSON OTHER THAN THE PRESCRIBING HEALTH CARE PROFESSIONAL.

Status:

03/25/2002 INTRODUCED.

03/25/2002 To ASSEMBLY Committee on HEALTH.

Sponsor Information:

Richard N. Gottfried (D-Majority); Committees: Health (Chairman); Higher Education; Insurance; Judiciary; Rules; Social Services.  Serving since 1970.

Sponsor:

Gottfried