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HMO fined for policy on 90-day prescriptions


State Insurance Commissioner Steven B. Larson has fined an HMO $40,000 for not providing patients with a 90-day supply of drugs when prescribed by a physician.

The HMO, NYLCare Health Plans of the Mid-Atlantic Inc., believed that it was complying with state law when it offered 90-day mail-order prescriptions, said Walter Cherniak, a regional spokesman for Aetna U.S. Healthcare, NYLCare's parent. NYLCare will present its case at a hearing later this month, Cherniak said.

In an order issued Nov. 23, Larsen said his office had made it

clear that the state's requirement for providing a 90-day supply, contained in a 1997 law, extended to local pharmacies as well as to mail order. He also ruled that NYLCare's policy of providing 90-day supplies from local pharmacies only when the member requested it was not sufficient.

He imposed a fine of $5,000 for each of eight violations reported in complaints to his office. He also directed NYLCare to provide records on the number of patients who had been prescribed "maintenance" drugs, the number who had received 90-day supplies and the number who had complained.

Pub Date: 12/02/98

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