70.000 DRUG DISPENSING

70.919             Allowing Timely Access to Pain Medications in Discharged Hospital and Ambulatory Surgery Patients

The Medical Society of the State of New York shall advocate for legislation and/or regulation prohibiting health insurers in New York from requiring preauthorization for prescribed opioid pain medicine for post-surgery and post-hospital discharged patients for an initial 7-day supply, and the Medical Society of the State of New York shall submit a similar resolution to the American Medical Association regarding ERISA, and Medicare Advantage plans. (HOD 2025-164)

70.920             Requiring Insurances to Apply Discounts

That the Medical Society of the State of New York advocate for legislation or other appropriate means to ensure that all payments made by patients for prescription medications outside of their insurance coverage (such as pharmaceutical discount programs) count towards that patient’s annual deductible and out of pocket maximum, and the New York delegation to the American Medical Association advance this resolution for consideration at the next Annual AMA Meeting. (HOD 2025-50)

70.921             Addressing Problems in Retail Pharmacies

The Medical Society of the State of New York (MSSNY) collaborate with organizations representing independent pharmacies to advise state policymakers on the wide range of pharmacy problems including correcting pharmacy routines and systems that create inefficiency, confusion, unfairness and barriers to patient access. (HOD 2024-103, referred to Council; substitute adopted 11/21/24)

70.922             Transparency at the pharmacy counter – Let patients own their prescriptions.

The Medical Society of the State of New York (MSSNY) supports legislation and/or regulation that enhances transparency in pharmacy drug costs, and availability, as well as alteration of the physician’s original prescription.

MSSNY supports legislation and/or regulation to establish a mechanism for prescribers and patients to easily view the out-of-pocket insurance cost of drugs and price comparisons and availability between local pharmacies at the point of prescribing.

MSSNY urges lawmakers and regulatory bodies to collaborate with relevant stakeholders, including prescribers, pharmacists, and patient advocacy groups, to develop and implement policies that ensure the availability of accurate, real-time informational tools on drug prices for patients.

MSSNY will advocate legislation that would mandate that pharmacies, whether physical or mail-order, must inform the patient about the actual dose, duration, and number of units prescribed (number of pills, days of treatment, grams of cream, etc); inform patients about the option of purchasing the prescribed medications out-of-pocket and to provide the associated out-of-pocket costs when insurance does not cover or covers only part of the prescribed regimen; provide a reason for dispensing deviation from the prescribed dose, duration and number of units; whenever relevant pharmacy must include reference to insurance imposed limits or pharmacy impose limits. (HOD 2024 – 105 and 107)

70.923             Retire Current NYS I-STOP Prescription Drug Monitoring Program and Transition to the Multistate PMP System

The Medical Society of the State of New York will advocate to the New York State Department of Health for full integration access to multistate database in New York State Prescription Monitoring Program (PMP).

MSSNY will also advocate for integration of the state PMP into the electronic medical records of all prescribers, as required under the law, and that this integration be of no cost to the prescribers. (HOD 2023-156)

70.924             Methadone as Medication for Opioid Use Disorder in Community Settings

MSSNY will support pilot projects on expansion of office-based methadone treatment for OUD outside OTPs when prescribed by addiction specialists and dispensed at local pharmacies with appropriate training and safeguards in place. (HOD 2023-155)

70.925             Mandating Child-proof Packaging on Marijuana Products Sold Legally in New York State

The Medical Society of the State of New York will advocate for legislation or regulation mandating all cannabinoid products sold legally by licensed marijuana dispensaries in the State of New York to be sold to consumers in child-resistant packaging. (HOD 2023-154)

(See also Children and Youth, 30.000)

70.926             Ninety Day Refills and Care Gap Failures

MSSNY will advocate to ensure that physicians are not financially penalized by health insurers for patients’ refusal to obtain medications recommended by their physicians and that health insurers cover, and pharmacies dispense prescription medications in quantities recommended by the patients’ physicians. (HOD 2022-257)

70.927             Require Methadone Dispenser to Report to I-STOP-PMP

The Medical Society of the State of New York will seek legislative or other regulatory interventions to require the reporting of methadone into the State’s Prescription Monitoring Program (PMP) and will support requiring interconnectivity between the State PMP and methadone clinics. (HOD 2021-153)

70.928             Fifteen Month Prescribing

The Medical Society of the State of New York will advocate for changes to New York State insurance and Medicaid laws that would allow physicians, at their discretion and based on patient compliance, to prescribe non-controlled substances for 15 months. (HDO 2021-152)

70.929             Automated Pharmacy Refills without Patient Authorization

The Medical Society of the State of New York (MSSNY) will support legislation and/or regulation that would limit automated medication refills by requiring that the patient request the medication prior to transmittal of the request to the prescribing providers electronic system. MSSNY will advocate pharmacists be required to review the appropriateness and validity of medication refill requests prior to transmitting the refill request to the prescribing providers electronic system.

MSSNY will support legislation to reduce unnecessary and redundant pharmacy refill requests and provide payment to the physician for pharmacy generated refill requests that occur outside the time of a patient encounter. (HOD 2020-107 and 2020-114, referred to Council, adopted 6/3/21)

70.930        Ensuring Correct Drug Dispensing

The Medical Society of the State of New York will request that the New York State Education Department work with the pharmaceutical and pharmacy industries to facilitate the ability of pharmacies to ensure that when a prescription is dispensed, a color photo of the prescribed medication and its dosage is attached to the receipt, ensuring that the drug dispensed is that which has been prescribed.  MSSNY will forward a similar resolution to AMA to request similar action by the FDA.  (HOD-Late A, referred to and adopted by Council, 3/1/21)

70.931             Pharmacy Benefit Managers and Drug Shortages

The Medical Society of the State of New York will seek an investigation by the New York State Legislature, Department of Health and regulators into the role of pharmacy benefit managers in drug shortages.  This will be sent to AMA for investigation as well. (HOD 2020-109) 

70.932             Access to Medications

MSSNY will seek regulations that prohibit pharmacy benefit plans from limiting patient access to medications based on a prescription placed initially by mail order and additionally that pharmacies be required to offer patients access to their prescribed medications without undue delay.  This resolution will be sent to AMA for national support. (HOD 2020-108; referred to Council, adopted 9/17/20))

70.933             Payment for Brand Medication When the Generic Medication is Recalled

MSSNY will seek passage of state regulation and/or legislation that mandates that third party payers as well as Centers for Medicare and Medicaid Services allow reimbursement for brand medications at the lowest copayment tier so that patients can be effectively be treated until the medication manufacturing crisis is resolved.  MSSNY will send a resolution requesting the AMA petition CMS as well as third party payers to allow reimbursement for brand medications at the lowest copayment tier so that patients can be effectively treated until the medication manufacturing crisis is resolved.  (HOD 2019-263)

70.934             Restricting FAXes from Pharmacy Benefit Managers

The Medical Society of the State of New York will ask the American Medical Association to support limitations on the use of faxes sent to physicians by Pharmacy Benefit Managers (PBMs) and large pharmacy systems (such as Express Scripts, OptumRx, Humana).  MSSNY is committed to the goal of finding cost effective strategies for physicians and will suggest that the AMA work with MSSNY to convene a work group of stakeholders (physicians, health plan associations, health insurers, large pharmacy systems and their pharmaceutical benefit managers) to develop cost effective alternatives for contacting physicians for prescriptions and requests for prior authorization electronically (rather than by FAX) whenever possible.  (HOD 2018-106) 

70.935             Covered Drugs during Insurance Enrollment Year

The Medical Society of the State of New York will urge the American Medical Association to seek federal legislation or regulation which would prevent Medicare and HMO plans from changing covered drugs during the enrollment year.  MSSNY will seek legislation or regulation preventing Pharmacy Benefit Mangers (PBMs) and large pharmacy systems from asking prescribers to change prescriptions during the year unless there was medical evidence that the change would benefit the patient and further that no changes could be imposed on prescribers during the enrollment year (such as a change from brand to generic or from one brand to another). (HOD 2018-104)

70.936             High Drug Prices and Pharmacy Parity

The Medical Society of the State of New York will urge legislation prohibiting pharmacies from charging higher prices (from pharmacy benefit managers or insurance plans) than the actual pharmacy price of the medication.  MSSNY will further advocate for patients to have a choice of receiving maintenance prescriptions from either a mail order pharmacy or a brick-and-mortar pharmacy without any financial penalty.  (HOD 2018-102 and 105)

70.938             Changes in Insurance Accepted by Pharmacies

The Medical Society of the State of New York will seek legislation that will require pharmacies to contact all physicians and patients affected by the pharmacy’s cessation of participation in a specific health insurance plan and also require the transfer, with notice to the patient, of all new and pending prescription refills to a pharmacy that accepts the patients’ insurance.  MSSNY will seek through regulation or legislation the creation of a prescription clearing house that would reduce the existing hassles of the current system for patients, pharmacies and physicians.  (HOD 2017-263)

70.939             Partial Fill of Schedule II Controlled Substances

The Medical Society of the State of New York supports legislation/regulations allowing partial fill of Schedule II controlled substance medications similar to partial prescription fills permitted under regulations for Schedule III and IV medications.  (Adopted Council, June 2, 2016)

70.940             Medications Return Program

The Medical Society of State of New York (MSSNY) supports medication disposal which provides daily access to safe, convenient, and environmentally sound medication return for unwanted prescription medications and that such a medication disposal program should be fully funded by the pharmaceutical manufacturers, including costs for collection, transport and disposal of these materials as hazardous waste.

MSSNY supports change in New York State law or regulation that would allow a program for medication recycling and disposal to occur. 

The New York Delegation to the American Medical Association will encourage the AMA to pursue the same efforts. (HOD 2016-157; Reaffirmed HOD 2018 in lieu of 162)

70.941             Resolving E-Prescribing Problem

The Medical Society of the State of New York (MSSNY) will urge the New York State Health Department’s Bureau of Narcotic Enforcement (BNE) to issue rules permitting physicians to prescribe via paper/fax/phone in situations where the patient needs to comparison shop among pharmacies and to make regulatory changes to enable pharmacies that do not have a particular medication in stock the ability to transmit the prescription to another pharmacy that has the needed medication in stock.

The Medical Society of the State of New York (MSSNY) will urge the AMA to work with the DEA and other appropriate federal agencies to enable the use of tokens in multiple care settings.

MSSNY will encourage member physicians to record incidents in which a patient is harmed by the law’s ban on prescribing via paper/phone/fax and provide that data showing evidence of patient harm which has occurred as a result of e-prescribing to MSSNY for its ongoing dialogue with the New York State Health Department’s Bureau of Narcotic Enforcement (BNE) and the New York State Legislature on e-prescribing issues.

MSSNY will support legislation which (1) removes the requirement that all paper/fax/phone prescriptions be reported to the BNE, allowing instead that the prescription be recorded in the patient’s medical record and (2) ensures that a physician not be subjected to criminal charges, or other ramifications from the Department of Health or the Department of Education for having written a medically appropriate paper prescription.

The NYS DOH BNE shall provide prescribers and patients with educational materials that satisfy the HIPAA requirement of knowing where electronic data goes, who can access it and why, and how it is used. (HOD 2016-115)

70.942             Require Alternative Medication List after Denial

The Medical Society of the State of New York will advocate for ensurance that health insurers provide physicians an alternative list of medications when coverage for such medication is denied, instead of directing them to their website; and that health insurers create interfaces between physician e-prescribing systems and the insurer’s prescription formulary. (HOD 2016-68)

70.943             Regulation of Pharmacy Benefit Management Companies

The Medical Society of the State of New York will continue to advocate for legislation which will regulate the practices of Pharmaceutical Benefits Managers (PBMs); and for legislation which ensures that physicians have the final say in choosing which medications his or her patients should receive, and which would limit the ability of PBMs to interfere with the treatment recommendations of a physician prescribing medications for their patient. (HOD 2016-67)

70.944             E-Prescribing

The Medical Society of the State of New York will press for legislation or regulation that would allow patients’ requests for paper prescription and pharmacy choice to be honored and permit any patient to request opting out of electronic prescribing by requesting same in writing to a physician, who will then be permitted to issue a paper prescription in person or by fax. (Council 1/21/2016) 

70.945             Federal Agency Compliance with State Laws on Controlled Substances Databases

In order to better coordinate controlled substance prescribing with other physicians, the Medical Society of the State of New York, working with the AMA, will request that the Veterans Administration and other federal health programs comply with applicable State laws which require checking databases of controlled substance prescriptions and that they additionally comply with state laws with regard to respective requirements for entering data on prescription fills into controlled substance tracking databases.

MSSNY will work with the NYS Department of Health to address any technological obstacles that exist to impede the transfer of data from VA practitioners and other federal health programs to the NYS Prescription Monitoring Program.  (HOD 2015-100; Reaffirmed HOD 2025)

70.946             Generic Drug Pricing

The Medical Society of the State of New York (MSSNY) recognizes that generic drugs are not identical to their brand name precursors.  MSSNY will advocate to ensure that a patient’s physician has final decision-making authority regarding which prescription medications are necessary for that patient’s well-being and it will further advocate to ensure the availability of affordable prescription medications for patients, including opposition to sudden unjustified price increases in prescription medications.

The Medical Society will continue to work with the Department of Financial Services, Department of Health and Attorney General’s office to expedite reviews of situations where insurers and their agents improperly delay responding to requests for pre-authorization of needed medications and further, MSSNY will advocate for sufficient fines to be imposed on insurers who fail to respond to pre-authorization requests in a timely manner. (HOD 2015-52; Reaffirmed HOD 2019 in lieu of res 53)

70.947             Physical Appearance of Generic Drugs

SUNSET HOD 2025

70.948             Point of Care Dispensing

The Medical Society of the State of New York will seek legislation that permits in-office physician dispensing of prescription medication to the patients. (HOD 2014-113; Reaffirmed HOD 2024) 

70.949:            Insurance Coverage For A 90 Day Supply Of Maintenance Medications

Insurance plans should be required to fill prescriptions as written up to a 90 day supply for all maintenance medications at a pharmacy or by mail order. (HOD 2013-155; Reaffirmed HOD 2023)

70.950:            E-Prescribing for Controlled Substances: SUNSET HOD 2023

MSSNY supports use of e-prescribing for controlled substances with the ability to screen for multiple prescribers of controlled substances.  (HOD 2013-107)

70.951:            Electronic Prescription for Controlled Substances: SUNSET HOD 2023

MSSNY supports use of electronic prescriptions for controlled substances and termination of the requirement for “hard copy” prescriptions, unless an exception to the e-prescribing mandate applies.  (HOD 2013-106)

70.952             E-Prescribing of Class III-Narcotics and Other Controlled Substances: SUNSET HOD 2022

70.953             Inappropriate Export of Pharmaceutical Services: 

MSSNY will work with the pharmacists of New York and their Professional Organizations to maintain the option of patients to have their prescriptions dispensed at a local pharmacy and be counseled face-to-face by their pharmacist.  (HOD 2011-211; Reaffirmed HOD 2021)

70.954             Electronic Submission of All Prescriptions:  SUNSET HOD 2021

70.955             Unused Prescription Drug Drop-off Programs: SUNSET HOD 2021

70.956             Return of Unused Medications in Long Term Care Facilities: 

MSSNY adopted as policy the existing AMA Policy H-280.959, “Recycling of Nursing Home Drugs.” Recycling of Nursing Home Drugs Our AMA supports the return and reuse of medications to the dispensing pharmacy to reduce waste associated with unused medications in long-term care facilities (LTCFs) and to offer substantial savings to the health care system, provided the following conditions are satisfied:  (1) The returned medications are not controlled substances.  (2) The medications are dispensed in tamper-evident packaging and returned with packaging intact (e.g., unit dose, unused injectable vials and ampules).  (3) In the professional judgment of the pharmacist, the medications meet all federal and state standards for product integrity.  (4) Policies and procedures are followed for the appropriate storage and handling of medications at the LTCF and for the transfer, receipt, and security of medications returned to the dispensing pharmacy.  (5) A system is in place to track re-stocking and reuse to allow medications to be recalled if required.  (6) A mechanism (reasonable for both the payer and the dispensing LTC pharmacy) is in place for billing only the number of doses used or crediting the number of doses returned, regardless of payer source.

Also, MSSNY is to communicate this policy to appropriate Federal and State governmental agencies to urge its immediate adoption.  (HOD 2010-250; Reaffirmed HOD 2020)

70.957             List of Patients’ Medications Provided by Pharmacists:

MSSNY will encourage all pharmacies licensed in New York State to provide individuals with a complete listing of all their medications each time a prescription is filled.  This list of medications provided by the pharmacist to a patient would include the name of the drug (brand and generic, if appropriate), dosage and any other identifying information which will assist the individual in recognizing and understanding the medications they are taking.  (HOD 2010-103; Reaffirmed HOD 2020)

70.959             Pharmacy Benefit Managers’ or Payors’ Interference with the Course of Good Treatment and Requiring the Provision of Dangerous Quantities of Medicine:

MSSNY is to:

a)  seek legislation and/or regulation prohibiting a payor or Pharmacy Benefit Manager (PBM) from either requiring a prescription to be filled with a quantity greater than that which is prescribed by a patient’s treating physician, or imposing significant additional cost-sharing responsibilities on patients for filling prescriptions with smaller quantities;

b)       work with the State Insurance, Health and Education Departments to assure that patients can obtain prescription drugs consistent with the dosage, frequency and duration as prescribed by the physician;

c)       continue to seek legislation and/or regulation that permits a patient to obtain a denied prescription drug pending an internal or external appeal of a denial by a health insurance company at the insurer’s expense; continue to advocate for legislation that would prevent insurance companies from coercing patients through financial disincentives to change a medication upon which a patient is stabilized, simply due to a change in formulary, change in plan or change in insurer.  (HOD 2010-61; Reaffirmed HOD in lieu of 2017-103)

70.960             Cancellation or Rescission of Renewals after the Prescriptions Have Been Delivered to the Pharmacy:

MSSNY will seek appropriate measures including, if necessary, legislation to assure the ability of a physician to cancel or rescind a prescription for a patient if deemed warranted by the patient’s treating physician.  (HOD 2010-60, Reaffirmed HOD 2020)

70.961             NYS Prescription Pads:

MSSNY opposes any effort present or future to require physicians to pay a fee for the official prescription forms supplied by the state; and work to assure that an adequate supply of prescription forms are provided to each physician or licensed allied medical practitioner.  (HOD 2005-97; Reaffirmed HOD 2015; Reaffirmed HOD 2025)

70.962             Two-Part Official Prescriptions: SUNSET HOD 2015

70.963             Electronic Prescription System:  SUNSET HOD 2014

70.964             Pharmacies Should Be Required to Accept Faxed Prescriptions for Non-controlled Substances: SUNSET HOD 2023

70.965             Coverage for Brand Name Medications as Prescribed by Physicians:

MSSNY must aggressively pursue enactment of MSSNY Policies 70.974 (Restrictive Formulary Medication Benefit Plans); 70.976 (Continued Coverage for Prescription Medications from Health Plan Drug Formularies); 70.977 (Restrictive Formulary Drug Prescription Sanction Through Managed Care); and 165.941 (Coordination of Pharmacy Benefit Into Existing Health Plans).

Enactment of the aforementioned MSSNY Policies should become a top priority during the upcoming legislative session in Albany.

Legislation will be sought to ensure that patients are not financially penalized for the prescription of a “non-preferred” drug by either: (a) seeking legislation to mandate that any “non-preferred” agent for which no bio-equivalent “preferred” agent exists in that plan be covered as a “preferred” agent; or (b) seeking legislation to mandate that the insurer provide a credit towards the cost of the “non-preferred” agent in the amount equal to that which would have been paid had a similar “preferred” agent been prescribed.  (HOD 2002-57; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

70.966             Mandatory Acceptance of the Currently Utilized Physician Prescription Form by Pharmacy Benefit Plan Administration: SUNSET HOD 2013

70.967             Public Notification of Expired Pharmaceuticals:

MSSNY will aggressively pursue legislation which would mandate the placement of expiration dates on prescription drug labels as stipulated in Resolution 95-62, 96-60, reaffirmed in Resolution 99-63.

MSSNY will remind all physicians through their usual publications that all prescribed medications are to be utilized within a reasonable period of time so as to avoid the possibility of patients having unsafe or ineffective medications.

MSSNY will call upon the American Medical Association to encourage the Food and Drug Administration and/or other appropriate agencies to undertake a comprehensive study to determine how certain factors, including but not limited to time, storage and handling will affect the efficacy and safety of prescription drugs.  (HOD 2002-53; Reaffirmed HOD 2013; Modified and Reaffirmed HOD 2023)

70.968             Single Dose Labeling of Medication in a School Setting by Registered Professional School Nurses: Sunset HOD 2011

70.969             Removing DEA Documentation from Uncontrolled Prescription Pad:

MSSNY adopted as policy the existing AMA Policy H-100.972 “Misuse of the DEA License Number.”
Misuse of the DEA License Number
MSSNY affirms its opposition to use of the Drug Enforcement Administration (DEA) license number for any purpose other than for verification to the dispenser that the prescriber is authorized by federal law to prescribe the substance; and will explore measures to discourage or eliminate the use of physicians’  DEA license numbers as numerical identifiers in insurance processing and other data bases, either through legislation, regulation or accommodation with organizations which currently insist on collection of this sensitive data.

MSSNY will seek through legislation or regulation limitation of the use of DEA numbers to those federal and state entities that use the number to oversee and enforce the law regarding the manufacture, distribution, and dispensing of controlled substances.

MSSNY will advocate for adoption of the AMA’s Medical Education number as the unique identifier for physicians.  (HOD 2001-154; Reaffirmed HOD 2011; Reaffirmed HOD 2021)

70.970             Drugs with Narrow Therapeutic Index:

MSSNY supports the passage of State legislation requiring third party carriers to cover patient’s costs for brand name drugs contained on the list of narrow therapeutic index drugs at the same cost as if generic substitution were permitted.  (HOD 2001-56; Reaffirmed HOD 2011; Reaffirmed HOD 2021)

70.971             Administration of Prescription Drug Programs Insuring Patient Access to Necessary Medication:

MSSNY will:

1. express its concern to the New York Department of Health and the Department of Health and Human Services that the programs concerning prescription drugs be administered in such a way that patients will not be denied access to necessary medication; and
2. oppose any third party payer reducing reimbursement beyond or below a physician’s and/or other health care practitioner’s cost; and
3. support activity to ensure that all fair administrative costs be considered for reimbursement; and
4. coordinate with the Pharmacists Society of the State of New York in a concerted effort to insure proper access to pharmaceutical drugs for all patients in New York State. (Council 1/25/01; Reaffirmed Council 1/22/04)
5. vigorously advocate for fair and reasonable reimbursement for chemotherapy and other vaccines. (Council 1/22/04 addition) Policy 70.971 Reaffirmed HOD 2014; Reaffirmed HOD 2024)

70.972             Require Pharmacies to Print the Expiration Dates of Medications On All Prescription Labels: SUNSET HOD 2024

70.973             Insurance Companies, Pharmacies and Pharmaceutical Benefits Management Companies (PBMs) Should Not Require a Diagnosis in Order for the Patients Prescription to be Filled:

MSSNY will advocate for legislative/regulatory relief, requiring pharmacies, any health plan and pharmaceutical benefits managers to fill prescriptions even if their patient’s diagnosis is not divulged to them.  (HOD 2000-83; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

70.974             Restrictive Formulary Medication Benefits Plans:

MSSNY supports enactment in the State of New York of a pharmacy benefits management law that will regulate managed pharmacy benefit plans to prohibit interference in the doctor-patient relationship, to prevent interruption of ongoing medical care treatment and to promote access to medication that is consistent with accepted standards of appropriate medical care and treatment, to provide patients with advance notice of benefit limits and the right to pursue external review of medications denied due to formulary restrictions.

MSSNY supports legislation that requires that where a prescription is denied due to formulary restrictions the prescription drug must be dispensed to the patient for the pendency of the internal or external appeal process.

MSSNY will educate physicians and patients regarding the right to pursue external review when patients are denied or provided unequal access to medications because of formulary restrictions.  (HOD 00-78; Reaffirmed HOD 2001-53; Reaffirmed HOD 2011; Reaffirmed HOD 2016-67)

70.975             Continued Coverage for Prescription Medications From Health Plan Drug Formularies:

MSSNY will seek appropriate legislation that would allow a patient suffering from a chronic condition to continue to be reimbursed for medically necessary prescription drugs subsequently removed at the discretion of a health plan from its drug formularies provided that the patient’s physician believes that there is no appropriate alternate drug on the formulary.  (HOD 1998-74; Reaffirmed HOD 2001-53; Reaffirmed HOD 2011; Reaffirm HOD 2021)

70.976             Restrictive Formulary Drug Prescription Sanction Through Managed Care:

MSSNY will develop and propose legislation or regulation requiring (a) pharmacists to contact the prescribing physician if a prescription written by the physician violates the managed care formulary under which the patient is covered, so that the physician has an opportunity to prescribe an alternative drug, which may be on the formulary; (b) which prohibits managed care entities, and other insurers, from disciplining, or withholding payment from physicians because they have prescribed drugs to patients which are not on the insurer’s formulary or have appealed a plan’s denial of coverage for the prescribed drug; (c) which ensures that all pharmacy benefit management companies and insurers which use restrictive drug formularies be required to impanel an independent group of physicians to determine the composition of the drug formulary; (d) will request the American Medical Association to examine the feasibility of establishing a standardized process for formulary development applicable to all managed care plans.  (HOD 1998-55; Reaffirmed HOD 2001-53; Reaffirmed HOD 2011; Reaffirmed HOD 2021)

70.977             Sanctioning More Than One Non-Controlled Substance To Be Prescribed On The Same Prescription Blank: SUNSET HOD 2014

70.978             Contact Lens Prescription, Expiration Date for:

MSSNY has adopted the position that there is danger to the public health and safety by allowing prescriptions for contact lenses to be filled without time limitation and without any requirement for proper ophthalmic follow-up care and that the same strict standards that regulate the dispensing of oral and topical medications, medical devices and appliances also apply to the dispensing of contact lenses to the residents of New York, and that contact lens prescriptions have an expiration date of one year after the date they are written.    (HOD 1996-180; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

70.979             Expiration Date on Medicine Containers:   SUNSET HOD 2014 See 90.972

70.980             Generic Drug, Use of ‘A’ Rated:  SUNSET HOD 2014

70.981             Generic Substitutions:

MSSNY will seek legislation to provide that where there is generic substitution because the physician has not designated “DAW” the pharmacist filling the prescription include on the label the words “Substituted for (brand name).”    (HOD 1994-152; Reaffirmed 2010-97; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

70.982             Optometrists Prescribing Drugs: SUNSET HOD 2024

70.983             Triplicate Prescription Program:  SUNSET HOD 2014

70.984             Expiration Date and Control Number on Prescription Drugs: SUNSET HOD 2014  see 90.972

70.985             Opposition to Legalization of Non-Prescriptive Drugs Such as Heroin and Cocaine: SUNSET HOD 2024

70.986             New Medications – Testing:  SUNSET HOD 2014

70.987             Generic Drug Prescription:   SUNSET HOD 2014

70.988             Opposition to Legalization of Drugs for Non-Medically Indicated Uses: SUNSET HOD 2024

70.989             FDA ‘A’ Generic Drug Prescribing:  SUNSET HOD 2013

70.990             Political Pressure and Release of New Medications:  SUNSET HOD 2013

70.991             Physician’s Right to Dispense Drugs and Devices: 

MSSNY supports the position taken by the AMA House of Delegates in June, 1986 to support the physician’s right to dispense drugs and devices when it is in the best interest of the patient and consistent with the AMA’s Ethical Guidelines.  (Council 4/23/87; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

70.992             Marijuana:  SUNSET HOD 2013

70.993             “Look-Alike” Drugs: 

MSSNY encourages federal legislation prohibiting the manufacture, sale, distribution or gift of substances which look like controlled substances (“Look-alikes”). MSSNY supports stricter legislation controlling the advertising and sale of “Look-Alike” medications.  (Council 12/13/84; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

70.994             Qualitative Labeling of All Drugs:

MSSNY strongly supports efforts to promote qualitative drug labeling of all drugs, requiring the active and inactive ingredients of all drugs (over-the-counter as well as prescription) to be listed on the label or package insert for the drug.  (Council 12/13/84; Reaffirmed HOD 2013; Reaffirmed HOD 2023; Reaffirmed HOD 2024)

70.995             Generic Drug Labeling:

All generic medications should have an identifying number or symbol.  (Council 12/13/84; Reaffirmed HOD 2013; Reaffirmed HOD 2023; Reaffirmed HOD 2024)

70.996             Heroin for Pain Relief:

MSSNY opposes the use of heroin for pain relief in patients because there are sufficient pain medications available for treatment.    (Council 6/21/79; Reaffirmed HOD 1984-57; Modified and Reaffirmed HOD 2013; reaffirmed HOD 2023)

70.997             Generic Drug Substitution Statement on “Physician” Prescription Blanks: 

MSSNY supports the position that Doctors of Medicine and Doctors of Osteopathy be permitted to use the word “Physician” on their own personal prescription blanks and that those with D.D.S. degrees be permitted to use the word “Dentist,” those with D.V.M. degrees use the word “Veterinarian,” etc.  (HOD 1983-8; Reaffirmed HOD 2015; Reaffirmed HOD 2025)

70.998             Generic Drug Substitution: 

The members of the Medical Society of the State of New York are as interested as any other group of citizens in the State, if not more so, in eliminating unnecessary costs in the delivery of health care and are actively engaged in developing measures that will lead to the most effective use of the dollars expended on health care, provided that none of these measures results in a lowering of the quality of medical care available to and afforded the public.  Two measures that could lead to a wider use of generic drugs should be considered:

(1) The first is to conduct controlled, scientifically valid studies to conclusively establish that generic drug substitutes are equivalent in bio-availability and therapeutic equivalence.  Disturbing reports have appeared in scientific medical literature that seriously question whether generic drugs approved by the FDA do, in fact, satisfy these criteria.  In the face of such doubts, it is understandable that physicians will be reluctant to authorize drug substitutes for medications with which they are familiar by experience.  The necessary studies do entail expenditure of money and delays, but these are small prices to pay when one is primarily concerned with providing the very best available drug to an ill patient.

(2) A second major deterrent to physicians readily agreeing to generic drug substitution is the question of their liability if a substitute, of which they have insufficient knowledge and no control in choice, should prove to be ineffective for the purpose intended and the patient suffers thereby.  Our Society has had correspondence with both the State and Federal governments to determine the limitations of a physician’s liability and the responses have been equivocal.  It is our interpretation, as the Law now stands, that the physician may still be liable.  An unequivocal statement of acceptance, of complete liability, by either the Federal or State government, in the event of untoward effects developing solely from the use of a generic drug substitute such as was promulgated for the swine flu immunization program, would remove this anxiety from the physician’s mind and encourage wider use of generic substitution.

There is a basic principle to be stressed in the consideration of this subject, namely, that no law should curb the professional judgment of a physician in the treatment of his patient.  Years of intensive schooling and training mark the education of a physician and his licensure.  It is such training that establishes the physician as the one best able to determine the most effective means of therapy for the individual problems of a particular patient.  It is most earnestly hoped that no inadequate substitute for this professional judgment, based solely on cost, will ever be enacted.  (HOD 1983 Reaffirmed HOD 2013)

70.999             Generic Drug Prescription Forms: 

MSSNY is in favor, whenever possible, of reducing the cost of care to the patient.  Understanding that the freedom of the physician to specify a brand name remains inviolable and accepting the value of the freedom from liability incorporated in a 1982 generic drug substitution legislative proposal, The MSSNY adopted the position of not opposing a bill so long as the method of specifying brand name drugs on prescription forms remains simple, such as D.A.W. (in place of “Dispense as Written”) or checking one of two boxes.  (HOD 1982; Reaffirmed HOD 2013)