Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Jun 16, 2014 |
print number 9264a |
Jun 16, 2014 |
amend and recommit to ways and means |
May 28, 2014 |
reported referred to ways and means |
Apr 04, 2014 |
referred to health |
Assembly Bill A9264A
2013-2014 Legislative Session
Sponsored By
ROSENTHAL
Archive: Last Bill Status - In Assembly Committee
- Introduced
-
- In Committee Assembly
- In Committee Senate
-
- On Floor Calendar Assembly
- On Floor Calendar Senate
-
- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
Bill Amendments
co-Sponsors
Michael Simanowitz
Anthony Brindisi
James Skoufis
Steven Cymbrowitz
multi-Sponsors
Andrew Raia
Robert Sweeney
Raymond Walter
2013-A9264 - Details
2013-A9264 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 9264 I N A S S E M B L Y April 4, 2014 ___________ Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to pharmacy benefit managers THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The public health law is amended by adding a new section 280-a to read as follows: S 280-A. PHARMACY BENEFIT MANAGERS. 1. DEFINITIONS. AS USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS: (A) "PHARMACY BENEFIT MANAGER" MEANS AN ENTITY THAT ENTERS INTO CONTRACTS WITH PHARMACIES ON BEHALF OF A HEALTH PLAN, STATE AGENCY, INSURER, MANAGED CARE ORGANIZATION, OR OTHER THIRD PARTY PAYOR TO PROVIDE PHARMACY HEALTH BENEFIT SERVICES OR ADMINISTRATION. (B) "MAXIMUM ALLOWABLE COST PRICE" MEANS A MAXIMUM REIMBURSEMENT AMOUNT FOR A GROUP OF THERAPEUTICALLY EQUIVALENT MULTIPLE SOURCE GENERIC DRUGS. 2. A PHARMACY BENEFIT MANAGER MAY NOT PLACE A PRESCRIPTION DRUG ON A MAXIMUM ALLOWABLE COST PRICE LIST UNLESS: (A) THE DRUG HAS AT LEAST THREE NATIONALLY AVAILABLE, THERAPEUTICALLY EQUIVALENT MULTIPLE SOURCE DRUGS WITH A SIGNIFICANT COST DIFFERENCE; (B) THE DRUG IS LISTED AS THERAPEUTICALLY EQUIVALENT AND PHARMACEUTI- CALLY EQUIVALENT OR "A" RATED IN THE UNITED STATES FOOD AND DRUG ADMIN- ISTRATION'S MOST RECENT VERSION OF THE "ORANGE BOOK"; (C) THE DRUG IS AVAILABLE FOR PURCHASE WITHOUT LIMITATIONS BY ALL PHARMACIES IN THE STATE FROM NATIONAL OR REGIONAL WHOLESALERS OPERATING IN NEW YORK AND IS NOT OBSOLETE OR TEMPORARILY UNAVAILABLE; AND (D) THE DRUG IS AVAILABLE FOR PURCHASE AT OR BELOW THE MAXIMUM ALLOW- ABLE COST WITHOUT LIMITATIONS TO PHARMACIES OPERATING IN NEW YORK. 3. A PHARMACY BENEFIT MANAGER SHALL MAKE AVAILABLE TO EACH NETWORK PHARMACY AT THE BEGINNING OF THE TERM OF THE CONTRACT, THE SOURCES UTILIZED TO DETERMINE THE MAXIMUM ALLOWABLE COST PRICING. 4. A PHARMACY BENEFIT MANAGER SHALL UPDATE THE MAXIMUM ALLOWABLE COST ON A TIMELY BASIS, BUT IN NO EVENT LONGER THAN SEVEN CALENDAR DAYS FROM EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
co-Sponsors
Michael Simanowitz
Anthony Brindisi
James Skoufis
Steven Cymbrowitz
multi-Sponsors
Andrew Raia
Robert Sweeney
Raymond Walter
2013-A9264A (ACTIVE) - Details
2013-A9264A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 9264--A I N A S S E M B L Y April 4, 2014 ___________ Introduced by M. of A. ROSENTHAL, SIMANOWITZ, BRINDISI, SKOUFIS, CYMBROWITZ, McDONALD -- Multi-Sponsored by -- M. of A. RAIA, SWEENEY, WALTER -- read once and referred to the Committee on Health -- reported and referred to the Committee on Ways and Means -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to pharmacy benefit managers THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The public health law is amended by adding a new section 280-a to read as follows: S 280-A. PHARMACY BENEFIT MANAGERS. 1. DEFINITIONS. AS USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS: (A) "PHARMACY BENEFIT MANAGER" MEANS AN ENTITY THAT ENTERS INTO CONTRACTS WITH PHARMACIES ON BEHALF OF A HEALTH PLAN, STATE AGENCY, INSURER, MANAGED CARE ORGANIZATION, OR OTHER THIRD PARTY PAYOR TO PROVIDE PHARMACY HEALTH BENEFIT SERVICES OR ADMINISTRATION. (B) "MAXIMUM ALLOWABLE COST PRICE" MEANS A MAXIMUM REIMBURSEMENT AMOUNT SET BY THE PHARMACY BENEFIT MANAGER FOR THERAPEUTICALLY EQUIV- ALENT MULTIPLE SOURCE GENERIC DRUGS. 2. ALL CONTRACTS BETWEEN A PHARMACY BENEFIT MANAGER AND A CONTRACTED PHARMACY SHALL INCLUDE A REASONABLE PROCESS TO APPEAL, INVESTIGATE AND RESOLVE DISPUTES REGARDING MULTI-SOURCE GENERIC DRUG PRICING. THE APPEALS PROCESS SHALL INCLUDE THE FOLLOWING PROVISIONS: (A) THE RIGHT TO APPEAL SHALL BE LIMITED TO SIXTY DAYS FOLLOWING THE INITIAL CLAIM SUBMITTED FOR PAYMENT; (B) A TELEPHONE NUMBER THROUGH WHICH A NETWORK PHARMACY MAY CONTACT THE PHARMACY BENEFIT MANAGER AND SPEAK WITH AN INDIVIDUAL WHO IS RESPON- SIBLE FOR PROCESSING APPEALS; (C) A PHARMACY BENEFIT MANAGER SHALL RESPOND IN WRITING TO THE CHAL- LENGE WITHIN SEVEN BUSINESS DAYS AFTER RECEIPT OF THE CHALLENGE; (D) IF AN UPDATE TO THE MAXIMUM ALLOWABLE COST IS WARRANTED, THE PHAR- MACY BENEFIT MANAGER SHALL MAKE THE CHANGE RETROACTIVE TO THE DATE ON EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
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