PSSNY's Legislative Center
Recapping the 2019 Legislative Session
The first year of the 2019-2020 legislative session ended Friday, June 21st. Over 15,000 bills were introduced. PSSNY has been actively monitoring 168.
This report focuses on high priority PSSNY bills. Those that have passed both houses will be sent to the Governor over the coming weeks and months and could become law.
License and regulate PBMs. Passed!
The high point of the 2019 legislative session occurred in the final week when both houses passed the PBM licensing bill. National sources have described the legislation as the toughest, most comprehensive legislation in the country.
The bill, A2836-A/S6531, creates PBM oversight to both the Health Department and the Department of Financial Services (DFS). The Senate passed the bill on a 49-13 vote. The Assembly passed it unanimously.
Read the bill A2836-A/S6531 and PSSNY’s support memo.
- Requires PBMs to register with DFS by April 1, 2020 and to be licensed by January 1, 2021 in order to operate in New York.
- Requires PBMs to eliminate conflicts of interest, deceptive and anti-competitive practices, conduct fair audits and process claims fairly;
- Requires PBMs to disclose contract terms (including rebates and pharmacy dispensing fees) under penalty of perjury;
- Prohibits PBMs from imposing accreditation or certification requirements on network pharmacies that go beyond state laws or regulations; ·
- Gives any patient or pharmacy harmed by the actions of a PBM to sue the PBM.
The bill has the support of legislative leaders Assembly Speaker Carl Heastie and Senate Leader Andrea Stewart-Cousins. It includes the language twice proposed by the Governor in his Executive Budget. The powerful chairs of the Insurance and Health Committees are the bill’s sponsors, and they collaborated on the language of the bill. Senators Breslin and Rivera and Assembly Members Gottfried and Cahill stood firm and resisted efforts by the bill’s opponents to amend, delay and derail the bill, efforts that continued up until the moment it passed.
Rallies, media efforts and grassroots lobbying campaigns during and after budget season helped to keep the PBM issue on the radar at the capitol. Thank you to everyone who stepped out of comfort zones to participate in the campaign. The Society will continue to monitor developments and report to members over the coming weeks.
In addition to PSSNY, the following groups have issued memos in support of the bill: The Community Pharmacy Association of New York State (formerly the Chain Pharmacy Association), the New York Blood Center, the New York State Osteopathic Medical Society, NCPA, APhA, New York Oncology Hematology and the Hemophilia Society of New York. Check the weekly E-Script for updates.
Reinstate Medicaid Fee for Service. Did not pass.
Despite PSSNY’s focused campaign and strong support from individual senators and assembly members, the effort to pass S5923/A2795 to remove the pharmacy benefit from Medicaid managed care and reinstate pharmacy as a Fee for Service benefit failed to pass largely due to the estimated cost to the state to be at or near $200 million. In the last days of session hospitals voiced strong opposition to the bill because it jeopardized funds from the 340b program.
AMMO Reform. Almost.
With the Senate Insurance Chair, Senator Neil Breslin, as the sponsor of S4463, the Senate passed AMMO reform in another clear signal that the NYS Senate has a new majority. The Assembly had passed a nearly identical bill A3043 sponsored by Assembly Member Latoya Joyner weeks earlier. Differences between the two bills could not be resolved in the final hectic days of the session, but the outlook for a solution over the summer is very good. The bill applies to mandatory mail order programs and removes roadblocks that have prevented network pharmacies from dispensing covered medications to patients who prefer their local pharmacy over the mail order alternative.
Synchronization of Medicaid prescriptions. Passed.
When a pharmacist determines that synchronization is appropriate and the patient agrees, the Medicaid fee for service program will reimburse the pharmacy for a partial fill and will pay the full dispensing fee amount. S3118-A/A2785-A was carried by Senator Brad Hoylman and Assembly Member Richard Gottfried.
Synchronization of prescriptions covered by insurance. Passed.
The same rules apply to prescriptions covered by private insurance under S4078/A3009. Insurers and their contracted PBMs would be required to reimburse pharmacies for partial fills and pay the full dispensing fee amount. The bill was sponsored in the Senate by the Insurance Chair Neil Breslin. The Assembly sponsor is Assembly Member Dan Quart. Although the bill has passed the Assembly a number of times, this is the first year it passed the Senate.
Allow Partial-Fill of Controlled Substance Rxs upon request. Passed.
At the request of a patient or a prescriber, a pharmacist may dispense a lesser amount if requested by the patient or the prescriber. The authorization applies to prescriptions for schedule II, III or IV controlled substances that may be partially filled within 30 days of the date written. The balance remains available for dispensing within regulatory requirements (i.e. still within 30 days of date written and used in conformity with the directions indicated on the prescription). The Senate Health Committee Chair Senator Gustavo Rivera and Assembly Member John McDonald are the primary sponsors of S1813/A3918. This legislation was a PSSNY House of Delegates resolution and is a victory for the Society.
Prohibit Mid-Year Formulary Changes. Passed.
This bill prohibits a health plan or its PBM from changing prescription drug coverage during the contract year. S2849-A/A2969 is sponsored by Senate Insurance Chair Neil Breslin and Assembly Majority Leader Crystal Peoples-Stokes. The bill prohibits increases in co-pay amounts and any additional restrictions (e.g. new prior authorization requirements), but plans can add medications to formulary coverage. Patient advocacy organizations worked hard for this bill over several legislative session. PSSNY supported the measure.
Provisions for licensure of certain technicians. Passed.
This bill defines the practice of registered pharmacy technicians in Article 28 facilities only, allowing the registered techs to assist in compounding activities. S6517/A8319 increases the allowable ratio of unlicensed persons to pharmacists from 2:1 to 4:1 in every practice setting. Sponsored by Senator Stavisky and Assembly Member Romeo, this bill also adds two registered pharmacy technicians to the NY State Board of Pharmacy. PSSNY weighed in on many other versions of technician legislation this session; ultimately, this is the one that passed.
This information is current as of June 25, 2019.
Interns as Immunizers June 21, 2019
Interns may now submit applications for Immunization Certification! The New York State Board of Pharmacy website has all the details needed to get started. College deans or appropriate faculty officials will need to attest to completion of the required training, and many have already begun the process. For current intern limited permit holders, these attestations are submitted by each college in bulk via form PH20-I. Per the State Board, individuals who have received training other than from a college of pharmacy would use that same form, submitted by the authorized official or instructor. The Board has "all hands on deck" to process this influx of paperwork, and their plan is to complete each college's batch before moving on to the next. Once SBOP enters the intern into the system, a "U" certification will appear the next day on the License Verification Search website and the intern will receive an updated permit in the mail.
Pharmacy students applying for an intern permit for the first time will have the immunization certification processed simultaneously with the permit request.
Note that there is currently no added fee for immunization certification for interns. When a graduate seeks licensure as a pharmacist, however, the certification will not carry over to the license. It will be necessary to complete the Pharmacist Immunization Certification Form and submit the fee and supporting documentation at that time. The "U" designation will then be changed to "I".
Allowing pharmacy interns to vaccinate patients under the immediate personal supervision of a licensed pharmacist certified to immunize is an important addition to the hands-on training our students need to become competent, confident professionals. Read more
Reminder to supervising pharmacists and owners: Be sure to add interns to any standing orders you have and update the physician/nurse practitioner authorization signature/s accordingly.
New State Excise Tax on Opioids Starts July 1st
NY Dept of Taxation guidance
Help PSSNY monitor developments.
Although the first excise tax payments will not be due until January 1, 2020, the tax on the first sale of a prescription opioid in New York goes into effect on July 1. It will be a tiered tax based on the Morphine Milligram Equivalents (MMEs) and WAC of the product that is sold.
In a meeting earlier this week with state officials PSSNY representatives learned that a guidance document will be available shortly to provide implementation details. According to one official, manufacturers will continue to ship products to wholesalers in New York, making the manufacturer liable for paying the tax.
You may recall that the new state law does not prohibit the additional cost to be passed down through the chain of distribution. Although manufacturers will pay the tax it is likely they will pass it down to wholesalers in higher prices or extra fees. Wholesalers may then pass the extra cost down to pharmacies in some form.
State officials believe the impact of the new excise tax on pharmacies and consumers will be minimal. Manufacturers appear willing to pay the excise tax, thereby ensuring that patients will have access to the medications. The impact on wholesalers and pharmacies is an unknown at this time. PSSNY continues to monitor developments.
The Society urges pharmacists to contact wholesalers and ask how they plan to handle the extra cost and how it will affect pharmacies' costs. Remember to send relevant documents to PSSNY and remember to redact any information that identifies your pharmacy or a patient.
PSSNY is actively monitoring the implementation of this controversial tax on prescription drugs and will keep members informed about what is learned.
NYS DOH Opiod Tax Information Page
2019 Patients Right to Care Legislative Agenda
The Pharmacy Patient's Right to Care
Transforming access to healthcare for the pharmacy patient in New York State
Expand Patient Access to Care:
- Improve the Appeals Process for Below-Cost Payments for Generic Drugs
- Expand Immunization Authority for Pharmacists
- Comprehensive Medication Management
- Expand Patient Access to Simple Lab Tests
Protect the Safety of Patients
- Strengthen Patient Protections Against Mandatory Mail Order for Prescription Drugs
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