N.Y. Comp. Codes R. & Regs. tit. 14 § 635-11.6

Current through Register Vol. 46, No. 25, June 18, 2024

Section 635-11.6 - Other responsibilities and rights of agencies and sponsoring agencies regarding PDP enrollment and reviews

(a) No CEO, officer, designee or employee of an agency or sponsoring agency shall solicit, accept or receive from a PDP, pharmacy or contractor of a PDP or pharmacy, for personal use or benefit (other than for the personal use or benefit of the person being enrolled), any payment, discount or other remuneration in consideration of, or as a result of, enrolling the person in a PDP.

(b) No CEO, officer, designee or employee of an agency or sponsoring agency shall charge, accept or receive payment from the person, family or anyone else for enrolling the person in a PDP, for providing advice and assistance in choosing a PDP or for acting for the person in the Part D review process.

(c) When a CEO or designee is authorized to act by this section or appointed to act in the Part D review process for a person, the CEO or designee may appoint a party outside of the agency to act in the Part D review process for the person.

(d) When a CEO or designee enrolls a person he or she shall choose a PDP based on the best interests of the person.

(e) Nothing in this Subpart shall be deemed to diminish or remove the authority of a physician to request a coverage determination or an expedited redetermination on behalf of a beneficiary.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 635-11.6

Amended New York State Register June 26, 2019/Volume XLI, Issue 26, eff. 6/26/2019