§ 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.
§ 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.
§ 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.
