NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1671A
SPONSOR: Gottfried TITLE OF BILL:
An act to amend part FFF of chapter 56 of the laws of 2020, amending the
public health law relating to extending and enhancing the Medicaid drug
cap and to reduce unnecessary pharmacy benefit manager costs to the
Medicaid program, in relation to temporarily exempting covered entities
under the federal 340B program and comprehensive HIV special needs plans
PURPOSE OR GENERAL IDEA OF BILL:
To delay for 3 years the transition from managed care to fee-for-service
for Medicaid pharmacy benefits under the federal 340B program and
Comprehensive HIV special needs plans.
SUMMARY OF SPECIFIC PROVISIONS:
Chap. 56, Part14+ of the 2020-21 enacted budget transfers the Medicaid
prescription drug benefit from Medicaid managed care to fee-for-service
Medicaid by April 1, 2021. This bill adds a new § 1-b to postpone this
carve-out until April 2024 for prescriptions under the federal 340B
progam and Medicaid HIV special needs plans.
JUSTIFICATION:
The federal 340B prescription drug program was created to lower drug
prices for government funded health clinics "to enable these entities to
stretch scarce Federal resources as far as possible, reaching more
eligible patients and providing more comprehensive services." The
savings are used by 340B providers (especially community health centers)
to provide health care services to needy patients. See: H.R. Rep. No.
102-384(11), at 12 (1992).
Medicaid HIV special needs plans provide enhanced care coordination
encompassing all aspect of HIV therapeutics, including prescription drug
regimen and adjustment, which is the key factor in survival with HIV.
They are concerned that carving out the prescription drug benefit will
undermine their ability to do enhanced care coordination. Carving out
the Medicaid drug benefit and putting it under the fee-for-service
Preferred Drug Progana will have fiscal and patient care benefits.
However, the abrupt transition will endanger 340B providers and HIV
SNPs. Delaying implementation for these two programs will enable them,
the Health Department and the Legislature to consider ways to avoid or
minimize the negative impact.
PRIOR LEGISLATIVE *HISTORY:
2020: A.10960 - referred to Health Committee
FISCAL IMPLICATIONS:
To be determined.
EFFECTIVE DATE:
Immediately.
STATE OF NEW YORK
________________________________________________________________________
1671--A
2021-2022 Regular Sessions
IN ASSEMBLY
January 11, 2021
___________
Introduced by M. of A. GOTTFRIED, REYES, HEVESI, L. ROSENTHAL, GUNTHER,
DICKENS, RODRIGUEZ, TAYLOR, HUNTER, BARRON, BRAUNSTEIN, PERRY, JOYNER,
EPSTEIN, DINOWITZ, ABINANTI, O'DONNELL, PEOPLES-STOKES, THIELE, ENGLE-
BRIGHT, NOLAN, CRUZ, GALEF, SIMON, PAULIN, GOODELL, BRONSON, ABBATE,
CYMBROWITZ, GALLAGHER, LUPARDO -- read once and referred to the
Committee on Health -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
AN ACT to amend part FFF of chapter 56 of the laws of 2020, amending the
public health law relating to extending and enhancing the Medicaid
drug cap and to reduce unnecessary pharmacy benefit manager costs to
the Medicaid program, in relation to temporarily exempting covered
entities under the federal 340B program and comprehensive HIV special
needs plans
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Part FFF of chapter 56 of the laws of 2020, amending the
2 public health law relating to extending and enhancing the Medicaid drug
3 cap and to reduce unnecessary pharmacy benefit manager costs to the
4 Medicaid program, is amended by adding a new section 1-b to read as
5 follows:
6 § 1-b. Notwithstanding any provision of this part or other law, no
7 action shall be taken by the commissioner of health or the department of
8 health to remove the pharmacy benefit from the managed care benefit
9 package under medical assistance (Medicaid) before April 1, 2024 for the
10 following entities: (a) an eligible provider under section 340B of the
11 federal Public Health Service Act and (b) a comprehensive HIV special
12 needs plan under section 4403-c of the public health law.
13 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD04057-04-1
