S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________

                                         8858

                              2009-2010 Regular Sessions

                                 I N  A S S E M B L Y

                                     June 11, 2009
                                      ___________

       Introduced  by  M.  of  A. GUNTHER, SAYWARD, CHRISTENSEN, REILLY, SPANO,
         DUPREY, BURLING, BACALLES, KOLB, SCOZZAFAVA, RAIA,  MOLINARO,  CALHOUN
         --  Multi-Sponsored by -- M.  of A. CROUCH, EDDINGTON, McKEVITT, WEIS-
         ENBERG -- read once and referred to the Committee on Aging

       AN ACT to amend the elder law and the social services law,  in  relation
         to  pharmaceutical  reimbursement  under the EPIC program and Medicaid
         for certain pharmacies

         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:

    1    Section 1. Subparagraph 1 of paragraph (b) of subdivision 1 of section
    2  250 of the elder law, as amended by section 1 of part A of chapter 58 of
    3  the laws of 2008, is amended and a new subparagraph 1-a is added to read
    4  as follows:
    5    (1)  Average wholesale price discounted by sixteen and twenty-five one
    6  hundredths percent, plus a dispensing fee as defined in paragraph (c) of
    7  this subdivision, [or]
    8    (1-A) AVERAGE WHOLESALE PRICE DISCOUNTED BY  FOURTEEN  PERCENT  FOR  A
    9  SMALL  PHARMACY,  PLUS  A  DISPENSING FEE AS DEFINED IN PARAGRAPH (C) OF
   10  THIS SUBDIVISION. FOR THE PURPOSES OF THIS SUBPARAGRAPH, A "SMALL  PHAR-
   11  MACY"  SHALL  MEAN  A  PHARMACY, APPROVED BY THE COMMISSIONER OF HEALTH,
   12  WHICH IS DETERMINED BY THE COMMISSIONER OF HEALTH TO DISPENSE ON AVERAGE
   13  UNDER TWO HUNDRED SCRIPTS A DAY, OR
   14    S 2. Subparagraph (ii) of paragraph (b) of subdivision  9  of  section
   15  367-a  of  the social services law, as amended by section 4 of part C of
   16  chapter 58 of the laws of 2008, is amended and a new  paragraph  (i)  is
   17  added to read as follows:
   18    (ii) if the drug dispensed is a multiple source prescription drug or a
   19  brand-name  prescription drug for which no specific upper limit has been
   20  set by such federal agency, the lower of the estimated acquisition  cost
   21  of  such  drug  to  pharmacies,  or  the dispensing pharmacy's usual and
   22  customary price charged to the general public.  For  sole  and  multiple

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD00965-03-9
       A. 8858                             2

    1  source  brand  name  drugs, estimated acquisition cost means the average
    2  wholesale price of a prescription  drug  based  upon  the  package  size
    3  dispensed  from,  as  reported  by the prescription drug pricing service
    4  used  by  the  department,  less  sixteen and twenty-five one hundredths
    5  percent thereof, and updated monthly by  the  department;  FOR  A  SMALL
    6  PHARMACY,  AS  DEFINED IN PARAGRAPH (I) OF THIS SUBDIVISION, ACQUISITION
    7  COSTS MEANS THE AVERAGE WHOLESALE PRICE OF  A  PRESCRIPTION  DRUG  BASED
    8  UPON  THE  PACKAGE  SIZE DISPENSED FROM, AS REPORTED BY THE PRESCRIPTION
    9  DRUG PRICING SERVICE USED BY THE DEPARTMENT, LESS FOURTEEN PERCENT THER-
   10  EOF, AND UPDATED MONTHLY BY THE DEPARTMENT; or, for  a  specialized  HIV
   11  pharmacy,  as  defined in paragraph (f) of this subdivision, acquisition
   12  cost means the average wholesale price of a prescription drug based upon
   13  the package size dispensed from, as reported by  the  prescription  drug
   14  pricing service used by the department, less twelve percent thereof, and
   15  updated  monthly  by  the department. For multiple source generic drugs,
   16  estimated acquisition cost means the  lower  of  the  average  wholesale
   17  price  of  a prescription drug based on the package size dispensed from,
   18  as reported by the prescription drug pricing service used by the depart-
   19  ment, less twenty-five percent thereof, or the maximum acquisition cost,
   20  if any, established pursuant to paragraph (e) of this  subdivision;  or,
   21  for  a  specialized  HIV  pharmacy,  as defined in paragraph (f) of this
   22  subdivision, acquisition cost means the lower of the  average  wholesale
   23  price  of  a prescription drug based on the package size dispensed from,
   24  as reported by the prescription drug pricing service used by the depart-
   25  ment, less twelve percent thereof, or the maximum acquisition  cost,  if
   26  any, established pursuant to paragraph (e) of this subdivision.
   27    (I)  FOR PURPOSES OF THIS SECTION, A SMALL PHARMACY SHALL MEAN A PHAR-
   28  MACY WHICH IS INDEPENDENTLY  OWNED,  APPROVED  BY  THE  COMMISSIONER  OF
   29  HEALTH,  AND  WHICH  IS  DETERMINED  BY  THE  COMMISSIONER  OF HEALTH TO
   30  DISPENSE ON AVERAGE UNDER TWO HUNDRED SCRIPTS A DAY.
   31    S 3. This act shall take effect immediately; provided,  however,  that
   32  the  amendments to subdivision 9 of section 367-a of the social services
   33  law made by section two of this act shall not affect the  expiration  of
   34  such  subdivision  and  shall  be deemed to expire therewith.  Effective
   35  immediately, the addition, amendment and/or repeal of any rule or  regu-
   36  lation  necessary  for  the  implementation of this act on its effective
   37  date is authorized and directed to be made and completed  on  or  before
   38  such effective date.