Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Health Care Access topic
No spam. Unsubscribe anytime.
Assembly requires insurers to pay pharmacists Medicaid‑rate administrative fee for dispensing hormonal contraception
Summary
The Assembly passed a bill requiring health insurers to pay pharmacists an administrative fee at least equal to the current Medicaid rate when pharmacists dispense self‑administered hormonal contraceptives; sponsors said Medicaid reimbursement is $48.20 for a new consult and $15.29 for follow‑ups; the bill passed 138–4 and takes effect immediately.
The Assembly passed a measure that would require health insurers to pay an administrative fee to pharmacists who dispense self‑administered hormonal contraceptives and provide the related services, at a minimum equal to the Medicaid reimbursement rate for those services.
Sponsor Assemblymember McDonald said pharmacists in New York have authority to dispense contraceptives under an existing standing order and that pharmacies already bill Medicaid for the service. He cited the Medicaid administrative fee of $48.20 for a first‑time consultation (which covers a 15–20 minute clinical history and assessment) and $15.29 for follow‑up consultations.
Members discussed a prior veto message that suggested insurers would need to change billing systems and that pharmacy benefit managers could pass costs to health plans; sponsors said the revised approach is sensitive to those concerns and ties the minimum reimbursement to Medicaid levels while permitting insurers to pay more if they choose. Members also emphasized the service is voluntary for pharmacists and said the measure could expand access to contraception where primary‑care providers are scarce.
The Assembly recorded 138 ayes and 4 noes and passed the bill; the clerk read that the section will take effect immediately.
