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A07853 Summary:

BILL NOA07853
 
SAME ASSAME AS S03222
 
SPONSORCunningham
 
COSPNSRForrest
 
MLTSPNSR
 
Add Art 28-CC §2894, Pub Health L; add §95-l, St Fin L
 
Establishes an emergency insulin program and corresponding emergency insulin program trust fund to facilitate emergency access to analog insulins.
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A07853 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A7853
 
SPONSOR: Cunningham
  TITLE OF BILL: An act to amend the public health law and the state finance law, in relation to an emergency insulin program   PURPOSE OR GENERAL IDEA OF BILL: To create an Emergency Insulin Program to ensure that those dependent on insulin for their survival can access emergency supplies   SUMMARY OF PROVISIONS: Section 1 establishes an Emergency Insulin Program. This program shall ensure that recipients can access emergency supplies of analog insulins and related supplies no later than April 1, 2024, assuming an appropri- ation or sufficient funds. A recipient is a person diagnosed with type 1 diabetes, or type 2 insulin dependent diabetes and who is at risk of experiencing serious adverse health effects due to a lack of analog insulins, and who is uninsured or underinsured. Other definitions are provided. The program also allows providers to prescribe analog insulins under a non-patient specific prescription. Any pharmacy with 20+ locations in the state and any facility with a drug discount program shall pursue or maintain a non-patient specific prescription to dispense analog insulins and to register with the department as an emergency insulin program by January 1, 2024. The commissioner of health shall immediately begin to work with analog insulin manufacturers to create a public-private partnership to support the state's streamlined Emergency Insulin Program that may replicate patient support programs such manufactures already have. The commis- sioner may establish a sliding scale for cost sharing for certain recip- ients which shall not exceed $100 for a 3C day supply of analog insulins and related supplies. The commissioner shall publish findings on the program and share them with the governor and legislature within 1 year of the effective date and every 2 years thereafter. Section 2 creates a special revenue fund in the joint custody of the state comptroller and the commissioner of taxation and finance to be known as the Emergency Insulin Program Trust Fund to support the Emer- gency Insulin Program. Section 3 provides for an immediate effective date.   DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE): N/A   JUSTIFICATION: 2.1 million New Yorkers have diabetes, and there are 20,000 hospitaliza- tions in NY each year with a principal diagnosis of diabetes-related complications. Type 1 and some type 2 diabetics depend upon insulin for their very survival. In 2016, the average person with type 1 diabetes incurred annual insulin costs of $ 5,705. When patients can't afford insulin, which can cost thousands of dollars even for those who are insured, they resort to rationing the little medication they can afford. One study found that 1 in 4 people with type 1 diabetes admitted to not taking their insulin as prescribed, or rationing, due to the cost. Complications from rationing insulin can be extreme, such as diabetic ketoacidosis (DKA), amputations, and even death. This legislation creates an Emergency Insulin Program, modeled after New York State's Opioid Prevention Program, which has made access to life- saving naloxone to reverse an opioid overdose widely available in our state. Under the Emergency Insulin Program, individuals who are unin- sured or underinsured will be able to get analog insulin through a non- patient specific prescription at certain pharmacies, including clinic and hospital pharmacies. The Department of Health (DOH) would be able to establish a sliding scale for certain cost sharing but it would be capped at $100 for a 30 day supply of insulin and supplies. The bill directs DOH to immediately engage analog insulin manufacturers to support the state program and facilitate quick access to affordable analog insulins in emergency situations. A public-private partnership can streamline existing patient support programs such manufactures have. The three manufactures of analog insulin each have programs designed to help people access their products at a reduced rate or for free; howev- er, each program is different and they can be difficult to access, espe- cially in emergency situations. Recognizing that these manufacturers want to make sure everyone can access life-saving medications, this bill establishes an Emergency Insulin Program Trust Fund to accept funds for the statewide program. While it is true that some types of human insulin can be accessed over the counter and for a relatively low fee, these are often referred to as "dead in bed" insulin because they do not provide the level of support many diabetics require. These low-cost human insulins are less commonly prescribed by doctors precisely because of their unpredictable rate of absorption, which can result in more frequent low and high blood sugar. They require more monitoring and more supplies and when people transi- tion from the newer, more costly analog insulins the risk of dead in bed syndrome is greatly increased. New York must do all it can to make sure that diabetics who depend on insulin for their survival can access emergency supplies of analog insu- lin, just as we currently ensure that friends, families, and first responders are equipped with life-saving naloxone in the case of an overdose. A person who depends on daily insulin for their survival is at grave risk without timely access to affordable insulin. Nobody should die from rationing or running out of insulin, or from being forced to switch to less reliable human insulin. This Emergency Insulin Program will ensure that those in need can access this life-saving medication.   PRIOR LEGISLATIVE HISTORY: 2021-22: A194 - Referred to Health 2019-20: A10054 - Referred to Health   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: To be determined, but there are potential savings as expensive hospital- izations as a result of severe adverse reactions from patients rationing or running out of insulin are avoided.   EFFECTIVE DATE: Immediately.
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A07853 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7853
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                      July 7, 2023
                                       ___________
 
        Introduced  by  M.  of  A.  CUNNINGHAM  -- read once and referred to the
          Committee on Health
 
        AN ACT to amend the public health law and  the  state  finance  law,  in
          relation to an emergency insulin program
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The public health law is amended by adding  a  new  article
     2  28-CC to read as follows:
     3                                ARTICLE 28-CC
     4                          EMERGENCY INSULIN PROGRAM
     5  Section 2894. Emergency insulin program.
     6    §  2894.  Emergency insulin program. 1. The commissioner is authorized
     7  and directed to establish an emergency insulin program  to  ensure  that
     8  recipients  of the program can access emergency supplies of analog insu-
     9  lins and related supplies.   The commissioner shall  immediately  engage
    10  analog insulin manufacturers to support the state program and facilitate
    11  quick  access to affordable analog insulins in emergency situations. The
    12  commissioner shall establish standards for  approval  of  any  emergency
    13  insulin  program,  and  analog insulin prescribing, dispensing, distrib-
    14  ution, and possession pursuant to this section which  may  include,  but
    15  not be limited to, standards for program directors, appropriate clinical
    16  oversight, training, record keeping and reporting. The emergency insulin
    17  program  shall,  pursuant to an appropriation or sufficient funds in the
    18  emergency insulin program trust fund,  be  available  to  recipients  no
    19  later than April first, two thousand twenty-four.
    20    2. (a) As used in this section:
    21    (i)  "Analog  insulins" means at a minimum short-acting, rapid-acting,
    22  intermediate and long acting insulin drugs approved by the Food and Drug
    23  Administration that, when administered, to certain recipients are  life-
    24  saving,  and help avoid serious adverse effects associated with type one
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05256-01-3

        A. 7853                             2
 
     1  diabetes and in some limited cases type two diabetes, and other  medica-
     2  tions and supplies approved by the department for such purpose.
     3    (ii) "Health care professional" means a person licensed, registered or
     4  authorized  pursuant  to  title  eight of the education law to prescribe
     5  prescription drugs.
     6    (iii) "Pharmacist" means a person licensed or authorized  to  practice
     7  pharmacy  pursuant  to article one hundred thirty-seven of the education
     8  law.
     9    (iv) "Recipient" means a person: (1) diagnosed with type one diabetes,
    10  or type two insulin dependent diabetes; and (2) who is at risk of  expe-
    11  riencing  serious  adverse  health effects due to a lack of analog insu-
    12  lins; and (3) who is uninsured or underinsured; or (4)  an  organization
    13  registered as an emergency insulin program pursuant to this section.
    14    (b)(i)  A health care professional may prescribe by a patient-specific
    15  or non-patient-specific prescription, dispense or  distribute,  directly
    16  or indirectly, analog insulins to a recipient.
    17    (ii) A pharmacist may dispense analog insulins, through a patient-spe-
    18  cific  or  non-patient-specific prescription pursuant to this paragraph,
    19  to a recipient.
    20    (iii) The provisions of this paragraph shall not be deemed to  require
    21  a  prescription  for any analog insulins that do not otherwise require a
    22  prescription; nor shall it be deemed to limit the authority of a  health
    23  care  professional to prescribe, dispense or distribute, or of a pharma-
    24  cist to dispense, analog insulins under any other provision of law.
    25    (iv) Any pharmacy with twenty or more locations in the state, and  any
    26  facility  established  pursuant  to article twenty-eight of this chapter
    27  which has a drug discount program authorized  by  section  340B  of  the
    28  Federal  Public Health Service act 42 U.S.C § 256b shall pursue or main-
    29  tain a non-patient-specific prescription with an authorized health  care
    30  professional to dispense analog insulins to a recipient upon request, as
    31  authorized by this section; and register with the department as an emer-
    32  gency  insulin program no later than January first, two thousand twenty-
    33  four.
    34    3. Use or dispensing of analog insulins pursuant to this section shall
    35  be considered first aid or emergency treatment for the  purpose  of  any
    36  statute relating to liability.
    37    4.  The commissioner shall immediately begin to work with analog insu-
    38  lin manufacturers in creating such program to ensure  they  are  working
    39  with  the  state  in a public-private partnership to support the state's
    40  streamlined emergency insulin program that may replicate patient support
    41  programs such manufacturers have.  A manufacturer may contribute to  the
    42  program  through  the  emergency  insulin program trust fund established
    43  pursuant to section ninety-five-1 of the state finance law.
    44    5. The commissioner may establish a sliding scale for cost sharing for
    45  certain recipients which shall not exceed  one  hundred  dollars  for  a
    46  thirty-day supply of analog insulins and related supplies.
    47    6.  The  commissioner  shall publish findings on the emergency insulin
    48  program including but not limited to the number of programs established,
    49  the number of recipients served, the types and amounts of  analog  insu-
    50  lins  provided,  the  costs and savings associated with the program, and
    51  what public-private partnerships the state has  facilitated  to  support
    52  this  program  to the governor and the chairs of the senate and assembly
    53  health committees within one year of the effective date of this  article
    54  and every two years thereafter.
    55    §  2. The state finance law is amended by adding a new section 95-1 to
    56  read as follows:

        A. 7853                             3
 
     1    § 95-1. Emergency insulin program  trust  fund.  1.  There  is  hereby
     2  established  in  the  joint  custody  of  the  state comptroller and the
     3  commissioner of taxation and finance a special fund to be known  as  the
     4  "emergency insulin program trust fund".
     5    2.  Such fund shall consist of all monies appropriated for its purpose
     6  and all monies received, or to be paid into or credited to such fund  by
     7  analog  insulin  manufacturers  pursuant  to subdivision four of section
     8  twenty-eight hundred ninety-four of the  public  health  law.    Nothing
     9  contained  herein  shall  prevent  the state from receiving assessments,
    10  grants, gifts or bequests for the purposes of the  fund  as  defined  in
    11  this section and depositing them into the fund according to law.
    12    3.  Monies of the fund shall be expended only to support the emergency
    13  insulin program established pursuant to article twenty-eight-CC  of  the
    14  public  health  law  administered  by the commissioner of health and for
    15  funding emergency access to analog insulins.
    16    4. Monies shall be payable from the fund on the audit and  warrant  of
    17  the  comptroller  on vouchers approved and certified by the commissioner
    18  of health.
    19    § 3. This act shall take effect immediately.
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