§ 241. Definitions. For purposes of this title, the terms:
* 1. "Covered drug" shall mean a drug dispensed subject to a legally
authorized prescription pursuant to section sixty-eight hundred ten of
the education law, and insulin, an insulin syringe, or an insulin
needle. Such term shall not include: (a) any drug determined by the
commissioner of the federal food and drug administration to be
ineffective or unsafe; (b) any drug dispensed in a package, or form of
dosage or administration, as to which the commissioner of health finally
determines in accordance with the provisions of section two hundred
fifty-two of this title that a less expensive package, or form of dosage
or administration, is available that is pharmaceutically equivalent and
equivalent in its therapeutic effect for the general health
characteristics of the eligible program participant population; (c) any
device for the aid or correction of vision; (d) any drug, including
vitamins, which is generally available without a physician's
prescription; and (e) drugs for the treatment of sexual or erectile
dysfunction, unless such drugs are used to treat a condition, other than
sexual or erectile dysfunction, for which the drugs have been approved
by the federal food and drug administration. Any of the drugs enumerated
in the preceding sentence shall be considered a covered drug or a
prescription drug for purposes of this article if it is added to the
preferred drug list under article two-A of the public health law. For
the purpose of this title, except as otherwise provided in this section,
a covered drug shall be dispensed in quantities no greater than a thirty
day supply or one hundred units, whichever is greater. In the case of a
drug dispensed in a form of administration other than a tablet or
capsule, the maximum allowed quantity shall be a thirty day supply; the
panel is authorized to approve exceptions to these limits for specific
products following consideration of recommendations from pharmaceutical
or medical experts regarding commonly packaged quantities, unusual forms
of administration, length of treatment or cost effectiveness. In the
case of a drug prescribed pursuant to section thirty-three hundred
thirty-two of the public health law to treat one of the conditions that
have been enumerated by the commissioner of health pursuant to
regulation as warranting the prescribing of greater than a thirty day
supply, such drug shall be dispensed in quantities not to exceed a three
month supply.
* NB Effective until June 15, 2012
* 1. "Covered drug" shall mean a drug dispensed subject to a legally
authorized prescription pursuant to section sixty-eight hundred ten of
the education law, and insulin, an insulin syringe, or an insulin
needle. Such term shall not include: (a) any drug determined by the
commissioner of the federal food and drug administration to be
ineffective or unsafe; (b) any drug dispensed in a package, or form of
dosage or administration, as to which the commissioner of health finally
determines in accordance with the provisions of section two hundred
fifty-two of this title that a less expensive package, or form of dosage
or administration, is available that is pharmaceutically equivalent and
equivalent in its therapeutic effect for the general health
characteristics of the eligible program participant population; (c) any
device for the aid or correction of vision, or any drug, including
vitamins, which is generally available without a physician's
prescription; and (d) drugs for the treatment of sexual or erectile
dysfunction, unless such drugs are used to treat a condition, other than
sexual or erectile dysfunction, for which the drugs have been approved
by the federal food and drug administration. For the purpose of this
title, except as otherwise provided in this section, a covered drug
shall be dispensed in quantities no greater than a thirty day supply or
one hundred units, whichever is greater. In the case of a drug dispensed
in a form of administration other than a tablet or capsule, the maximum
allowed quantity shall be a thirty day supply; the panel is authorized
to approve exceptions to these limits for specific products following
consideration of recommendations from pharmaceutical or medical experts
regarding commonly packaged quantities, unusual forms of administration,
length of treatment or cost effectiveness. In the case of a drug
prescribed pursuant to section thirty-three hundred thirty-two of the
public health law to treat one of the conditions that have been
enumerated by the commissioner of health pursuant to regulation as
warranting the prescribing of greater than a thirty day supply, such
drug shall be dispensed in quantities not to exceed a three month
supply.
* NB Effective June 15, 2012
2. "Provider pharmacy" shall mean a pharmacy registered in the state
of New York pursuant to section sixty-eight hundred eight of the
education law or a pharmacy registered in a state bordering the state of
New York when certified as necessary by the executive director pursuant
to section two hundred fifty-three of this title, for which an agreement
to provide pharmacy services for purposes of this program pursuant to
section two hundred forty-nine of this title is in effect.
3. "Income" shall mean "household gross income" as defined in the real
property tax circuit breaker credit program, pursuant to subparagraph
(C) of paragraph one of subsection (e) of section six hundred six of the
tax law, but only shall include the income of program applicants and
spouses and shall exclude the income of other members of the household.
4. "Contractor" shall mean a private not-for-profit or proprietary
corporation which has entered into a contractual arrangement with the
state to carry out the provisions of section two hundred forty-three of
this title.
5. "Resident" shall mean an individual legally domiciled within the
state.
6. "Annual coverage period" shall mean the period of twelve
consecutive calendar months for which an eligible program participant
has met the application fee or deductible requirements, as the case may
be, of sections two hundred forty-seven and two hundred forty-eight of
this title.
7. "Program year" shall mean a year beginning on October first and
ending the following September thirtieth.
Last modified: November 19, 2006