2006 New York Code - Elderly Pharmaceutical Insurance Coverage Panel.

 
    §  244.  Elderly  pharmaceutical insurance coverage panel. 1. There is
  hereby established within the executive department, a panel to be  known
  as  the  elderly pharmaceutical insurance coverage panel hereinbefore or
  hereinafter referred to as the panel.
    2. The panel shall consist of the commissioners of the departments  of
  education and health, the superintendent of insurance, and the directors
  of  the  office for the aging and the division of the budget. Each panel
  member may designate an officer of his  or  her  respective  department,
  office,  or  division  to  represent and exercise all the powers of such
  panel member as the case may be at all meetings of the panel from  which
  such panel member may be absent.
    3.  The  director  and  the  commissioner  of  health  shall  serve as
  co-chairs of the panel.
    4. The panel shall meet at such times  as  may  be  requested  by  the
  co-chairs,  provided  that  the  panel  shall meet at least four times a
  year.
    5. The panel shall:
    (a) subject to the approval of the director of the budget,  promulgate
  program  regulations  pursuant  to section two hundred forty-six of this
  title;
    (b) determine the annual schedule of cost-sharing responsibilities  of
  eligible   program   participants   pursuant  to  sections  two  hundred
  forty-seven and two hundred forty-eight of this title;
    (c) enter into contracts pursuant to section two  hundred  forty-three
  of this title;
    (d)  recommend  and implement alternative program improvements for the
  efficient and effective operation of the program in accordance with  the
  provisions of this title;
    (e)  establish  or contract for a therapeutic drug monitoring program.
  Such program shall monitor therapeutic  drug  use  of  eligible  program
  participants  in  an  effort  to  prevent  the  incorrect or unnecessary
  consumption of such therapeutic drugs;
    (f) develop and implement, in cooperation with area  offices  for  the
  aging, an outreach program to inform the elderly of benefits they may be
  entitled  to  pursuant  to this title, and to make available information
  concerning the program for elderly pharmaceutical insurance coverage and
  benefits to which they may  be  entitled  through  a  prescription  drug
  coverage program funded by the federal government;
    (g)  prepare  an  annual report and submit such report to the governor
  and the legislature no later than the first day of January of each year.
  The panel should include in the report a summary of  the  administrative
  cost  containment  initiatives  completed  during  the year. Such report
  shall, at a minimum, contain annual  statistical  information  regarding
  the  number  of  persons  enrolled  in the program by marital status and
  income level, the total and per capita number  of  prescriptions  filled
  and  total  state reimbursement and participant co-payment expenditures,
  by income levels, the total numbers of prescriptions filled with generic
  drugs, brand name drugs and sole source  drugs,  the  authorization  and
  substitution  rate  for  the  total numbers of prescriptions filled with
  generic, brand name and sole source drugs, the distribution of  the  top
  three   hundred   most  commonly  used  drugs  by  volume  and  cost,  a
  distribution of all  prescriptions  by  volume  and  price,  the  annual
  percentage increase in the cost of these drugs, numbers of participating
  provider  pharmacies,  recipients  and payments by county, the amount of
  cost recoveries for the period covered in  the  report,  projections  of
  program  costs  for  the  following  two years, and an evaluation of the
  performance of the program contractor or contractors  and  of  the  cost
  effectiveness of all outreach efforts;
    (h)  prepare an evaluation report on the experience of the program for
  the governor and the legislature no later than November first,  nineteen
  hundred  ninety-five.  Such report should include the recommendations of
  the  panel  concerning  the  continuation  of  the  program  beyond  its
  expiration;
    (i)  establish  policies  and  procedures  to  allow  individuals  who
  participate  in   the   catastrophic   deductible   plan   on   December
  thirty-first,  two  thousand  to  continue to receive benefits under the
  provisions of section two hundred forty-eight of this title in effect on
  December thirty-first, two thousand, if and for as long as the  enrollee
  so chooses; and
    (j)  facilitate  implementation  of an expanded elderly pharmaceutical
  insurance coverage program  on  January  first,  two  thousand  one,  by
  commencing   no   later  than  October  first,  two  thousand,  outreach
  activities,  including  but  not  limited  to   the   dissemination   of
  information  to  local  governments and senior citizen provider advocacy
  groups  regarding  such  expanded  program.   The   panel   shall   make
  applications available for the expanded elderly pharmaceutical insurance
  coverage program on October first, two thousand.
    (k)  enter  into  an  agreement  with  one  or more sponsors of a drug
  discount card program or a prescription drug plan authorized under title
  XVIII of the federal social security act, to serve as an  endorsed  EPIC
  drug discount card program or prescription drug plan for the purposes of
  effective coordination of benefits.
    * (l)  implement  a  preferred  drug  program and clinical drug review
  program in accordance with the provisions of article two-A of the public
  health law, including taking  necessary  actions  consistent  with  this
  article  to  apply prior authorization under article two-A of the public
  health law to EPIC.
    * NB Repealed June 15, 2012
    6. The panel members shall receive no compensation for their  services
  as panel members.
    7.  There  shall  be  an  advisory committee to the panel comprised of
  twelve persons. Four members shall be appointed by the  governor,  three
  members shall be appointed by the temporary president of the senate, one
  member  shall  be  appointed by the minority leader of the senate, three
  members shall be appointed by the speaker of the assembly and one member
  shall be appointed by the minority leader of the assembly. The committee
  members   shall   be   representatives   of   consumers,    pharmacists,
  pharmaceutical  drug  manufacturers  and  pharmaceutical wholesalers. No
  less than fifty percent of the committee membership shall represent  the
  consumers.  The  executive director shall consult the advisory committee
  and consider its recommendations concerning the implementation  of  this
  program  and  the  policies  governing  the  continued operation of this
  program. Committee members  shall  receive  no  compensation  for  their
  services  but  shall  be  allowed  their  actual  and necessary expenses
  incurred in the performance of their duties.