N.Y. Elder Law § 241: Definitions

§ 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, 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 commissioner 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.

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, a non-resident establishment registered pursuant to

section sixty-eight hundred eight-b 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.

8. "Medicare part D excluded drug classes" shall mean any drugs or

classes of drugs, or their medical uses, which are described in section

1927(d)(2) or 1927(d)(3) of the federal social security act, with the

exception of smoking cessation agents.