NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1163
SPONSOR: McDonald TITLE OF BILL:
An act to amend the education law, in relation to requiring the consent
of the patient or an authorized individual to consent on the patient's
behalf before a prescription is delivered
PURPOSE OR GENERAL IDEA OF BILL:
To reduce medication waste and improve patient compliance and adherence
by prohibiting pharmacies from automatically delivering prescriptions to
patients without their consent or an individual authorized on the
patient's behalf.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends subdivision 2 of section 6810 of the education law, as
added by chapter 881 of the laws of 1972, requiring that a pharmacy
registered with the department pursuant to section sixty-eight hundred
eight of the education law may not deliver a new or refilled
prescription without the consent of the patient or an individual author-
ized to consent on the patient's behalf. Consent shall include one of
the following:
(1) the patient or authorized individual's signature of acceptance of
each prescription delivered;
(2) the pharmacy may contact the patient or other authorized individual
for consent to deliver and must document consent in the patient record;
or
(3) for pharmacies that administer refill reminder or medication adher-
ence programs and deliver off premises, if a signature is not received
on each prescription, then the refill reminder program or medication
adherence program shall be an OPT-IN program that is updated with
patient consent every 180 days accompanied by a documented patient
record review by a licensed pharmacist from the providing pharmacy and
the patient before continuation of medication delivery can occur.
Pharmacy providers who deliver medication without patient or authorized
individual consent will be required to accept the return of the medica-
tion from the patient, provide that patient credit for any charges they
may have paid, and will be required to destroy those medications sent
without consent on delivery in accordance with applicable state and
federal law. Nothing in this section shall be deemed to interfere with
the requirements for refill reminder or medication adherence programs.
Nothing in this section is intended to apply to long-term care pharmacy
dispensing and delivery.
Section 2 provides effective date.
JUSTIFICATION:
The intent of this bill is to reduce medication waste, control cost,
provide consumer protection and improve patient compliance by prohibit-
ing pharmacies from automatically delivering new or refilled
prescription medications to patients without their consent or the
consent of an authorized individual on their behalf.
Prescription medications, when taken appropriately under the supervision
of a prescriber and consultation with a pharmacist, can be safe and
effective. Unfortunately, as the utilization of prescription drugs has
grown, medication waste has also increased both statewide and
nationally. As excessive medication quantities accumulate in households
they can fall into the wrong hands and lead to medical emergencies and
even death and/or consequences that are tragic, avoidable and costly.
Furthermore, excessive supplies of prescription products can easily
cause patients to become confused, take the wrong medication, or take it
incorrectly. Medication errors such as these translate directly into
impaired health, therapy failures and increased hospitalizations.
Discussion of medication waste is becoming more prevalent and a signif-
icant discussion in public policy circles. In the Centers for Medicare &
Medicaid Services (CMS) call letter dated April 1, 2013 sent to Medicare
Advantage plans stated the following, "We received a number of comments
that indicate beneficiaries return large quantities of unneeded medica-
tions to community pharmacies for take-back programs because they were
unable to stop auto-ship refill programs." This has led to consideration
of a new CMS policy designed to cut waste and save taxpayer dollars by
prohibition of auto-filling of prescriptions at the national level with
federally funded Medicare Part D Plans. This is sound public policy that
keeps the consumer in charge. It is a model that should be enacted at
the state level.
The United States Drug Enforcement Administration's National
Prescription Drug Take-Back Initiative, which is aimed at providing a
safe, convenient, and responsible means of disposing of prescription
drugs, has taken back nearly three million pounds of unused and expired
medications as a result of six nationwide take-back events. Addi-
tionally, the National Pharmacy Community Pharmacists Association
"Dispose my Meds" program has netted more than 150,000 lbs. of unused or
expired non-controlled prescription medications. Pharmacies participat-
ing in take-back programs in New York have taken back very costly medi-
cations from people in their communities including one pharmacy in
upstate New York that had taken back more than $125,000 of unused medi-
cations from just three patients of which the prescriptions were paid
for by federal, state and local taxpayers. Hundreds of such examples
exist. Excessive supplies of prescription drugs in homes represent a
waste of taxpayer dollars, an opportunity for diversion and misuse, and
the potential for real patient harm.
PRIOR LEGISLATIVE HISTORY:
2019-2020: A.7555
2021-2022: A.3083
FISCAL IMPLICATIONS:
None to the State
EFFECTIVE DATE:
This bill shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
1163
2023-2024 Regular Sessions
IN ASSEMBLY
January 13, 2023
___________
Introduced by M. of A. McDONALD -- read once and referred to the Commit-
tee on Higher Education
AN ACT to amend the education law, in relation to requiring the consent
of the patient or an authorized individual to consent on the patient's
behalf before a prescription is delivered
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision 2 of section 6810 of the education law, as
2 amended by chapter 413 of the laws of 2014, the second undesignated
3 paragraph of paragraph (a) as amended by section 7 of part A of chapter
4 57 of the laws of 2015, is amended to read as follows:
5 2. (a) A prescription may not be refilled unless it bears a contrary
6 instruction and indicates on its face the number of times it may be
7 refilled. A prescription may not be refilled more times than allowed on
8 the prescription. The date of each refilling must be indicated on the
9 original prescription. Prescriptions for controlled substances shall be
10 refilled only pursuant to article thirty-three of the public health law.
11 A pharmacy registered with the department pursuant to section sixty-
12 eight hundred eight or sixty-eight hundred eight-b of this article may
13 not deliver a new or refilled prescription off premises without the
14 express consent of the patient or an individual authorized to consent on
15 the patient's behalf or action taken in lieu of indicating the express
16 consent of the patient to receive the prescription. For the purposes of
17 this section, express consent [may be obtained in the same manner and
18 process by which consent is deemed acceptable under the federal Medicare
19 Part D program] shall include at least one of the following:
20 (1) the patient or authorized individual's physical or electronic
21 signature authorizing each prescription delivered;
22 (2) the pharmacy may contact the patient or authorized individual for
23 verbal, electronic or written consent to deliver and must document
24 consent in the patient record; or
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02562-01-3
A. 1163 2
1 (3) for pharmacies that administer refill reminder or medication
2 adherence programs and deliver off premises, if an express consent is
3 not received on each prescription, then the refill reminder program or
4 medication adherence program shall be an OPT-IN program that is updated
5 as to patient consent every one hundred eighty days.
6 (b) Pharmacy providers who deliver medication without patient or
7 authorized individual express consent will be required to accept the
8 return of the medication from the patient, provide that patient credit
9 for any charges they may have paid, provide credit to the medical plan
10 for charges paid, and will be required to destroy those medications sent
11 without consent on delivery in accordance with applicable state and
12 federal law. Nothing in this section shall be deemed to interfere with
13 the requirements for refill reminder or medication adherence programs.
14 Nothing in this section is intended to apply to long-term care pharmacy
15 dispensing and delivery.
16 (c) Pharmacy providers who deliver medications shall provide a state-
17 ment of rights upon delivery on an annual basis that outlines the
18 patient's rights regarding consent and prescription delivery options.
19 § 2. This act shall take effect immediately.
