NY State Assembly Bill A2317C

Archive: Last Bill Status - Passed Assembly

Introduced
In Committee
On Floor Calendar
- Passed Senate
- Passed Assembly
Delivered to Governor
Signed/Vetoed by Governor

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Actions

view actions (21)

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Apr 30, 2018	recommitted to insurance returned to senate repassed assembly
Apr 17, 2018	amended on third reading 2317c
Apr 17, 2018	vote reconsidered - restored to third reading returned to assembly recalled from senate
Feb 06, 2018	referred to insurance delivered to senate passed assembly
Jan 23, 2018	amended on third reading 2317b
Jan 03, 2018	ordered to third reading cal.171 returned to assembly died in senate
Jun 20, 2017	referred to rules delivered to senate passed assembly
Jun 14, 2017	amended on third reading (t) 2317a
May 18, 2017	advanced to third reading cal.390
May 16, 2017	reported
Jan 17, 2017	referred to insurance

Bill Amendments

Original

C (Active)

Original

C (Active)

Co-Sponsors

Multi-Sponsors

A2317 - Details

See Senate Version of this Bill:: S5022
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: A7707, S5382
2019-2020: A2969, S2849

A2317 - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317 - Bill Text download pdf


                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2317

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by M. of A. PEOPLES-STOKES, HARRIS -- read once and referred
  to the Committee on Insurance

AN ACT to amend the insurance law,  in  relation  to  prescription  drug
  formulary changes during a contract year

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new  section  4909
to read as follows:
  §  4909.  PRESCRIPTION  DRUG FORMULARY CHANGES. (A) A HEALTH CARE PLAN
REQUIRED TO PROVIDE ESSENTIAL  HEALTH  BENEFITS  SHALL  NOT,  EXCEPT  AS
OTHERWISE   PROVIDED  IN  SUBSECTION  (B)  OF  THIS  SECTION,  REMOVE  A
PRESCRIPTION DRUG FROM A FORMULARY:
  (I) IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF BENEFITS  PROVIDING
FOR  DIFFERENT  DEDUCTIBLES, COPAYMENTS OR COINSURANCE APPLICABLE TO THE
PRESCRIPTION DRUGS IN EACH TIER, MOVE A DRUG TO A  TIER  WITH  A  LARGER
DEDUCTIBLE, COPAYMENT OR COINSURANCE, OR
  (II)  ADD  UTILIZATION  MANAGEMENT  RESTRICTIONS  TO A FORMULARY DRUG,
UNLESS SUCH CHANGES OCCUR AT THE  TIME  OF  ENROLLMENT  OR  ISSUANCE  OF
COVERAGE.    SUCH PROHIBITION SHALL APPLY BEGINNING ON THE DATE ON WHICH
OPEN ENROLLMENT BEGINS FOR A PLAN YEAR AND THROUGH THE END OF  THE  PLAN
YEAR TO WHICH SUCH OPEN ENROLLMENT PERIOD APPLIES.
  (B)  (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR MORE
TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCTIBLES,  COPAYMENTS  OR
COINSURANCE  APPLICABLE  TO  PRESCRIPTION  DRUGS IN EACH TIER MAY MOVE A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCIBLE, COPAYMENT OR  COIN-
SURANCE  IF AN AB-RATED GENERIC DRUG FOR SUCH PRESCRIPTION DRUG IS ADDED
TO THE FORMULARY AT THE SAME TIME.
  (II) A HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM  A  FORMU-
LARY  IF  THE  FEDERAL FOOD AND DRUG ADMINISTRATION DETERMINES THAT SUCH
DRUG SHOULD BE REMOVED FROM THE MARKET.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05529-01-7

A. 2317                             2

  § 2. This act shall take effect on the sixtieth  day  after  it  shall
have  become  a  law; provided, however, that effective immediately, the
addition, amendment and/or repeal of any rule  or  regulation  necessary
for  the implementation of this act on its effective date are authorized
to  be made and completed by the superintendent of financial services on
or before such date.

Co-Sponsors

Multi-Sponsors

A2317A - Details

See Senate Version of this Bill:: S5022
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: A7707, S5382
2019-2020: A2969, S2849

A2317A - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317A - Bill Text download pdf


                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2317--A
                                                        Cal. No. 390

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by  M. of A. PEOPLES-STOKES, HARRIS, SKOUFIS, BARRETT, NIOU,
  ORTIZ -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT -- read  once  and
  referred  to  the  Committee  on Insurance -- reported from committee,
  advanced to a third reading, amended and ordered reprinted,  retaining
  its place on the order of third reading

AN ACT to amend the insurance law and the public health law, in relation
  to prescription drug formulary changes during a contract year

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new  section  4909
to read as follows:
  §  4909.  PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT AS OTHERWISE
PROVIDED IN SUBSECTION (C) OF THIS SECTION, A  HEALTH  CARE  PLAN  SHALL
NOT:
  (I)  REMOVE  A  PRESCRIPTION  DRUG  FROM  A FORMULARY IF THE FORMULARY
INCLUDES TWO OR MORE TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCT-
IBLES, COPAYMENTS OR COINSURANCE APPLICABLE TO THE PRESCRIPTION DRUGS IN
EACH  TIER, MOVE A DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR
COINSURANCE; OR
  (II) ADD UTILIZATION MANAGEMENT  RESTRICTIONS  TO  A  FORMULARY  DRUG,
UNLESS  SUCH  CHANGES  OCCUR  AT  THE  TIME OF ENROLLMENT OR ISSUANCE OF
COVERAGE.
  (B) PROHIBITIONS PROVIDED IN SUBSECTION  (A)  OF  THIS  SECTION  SHALL
APPLY  BEGINNING  ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR A PLAN
YEAR AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN  ENROLLMENT
PERIOD APPLIES.
  (C)  (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR MORE
TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCTIBLES,  COPAYMENTS  OR
COINSURANCE  APPLICABLE  TO  PRESCRIPTION  DRUGS IN EACH TIER MAY MOVE A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCIBLE, COPAYMENT OR  COIN-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.

                                                           LBD05529-04-7

A. 2317--A                          2

SURANCE  IF AN AB-RATED GENERIC DRUG FOR SUCH PRESCRIPTION DRUG IS ADDED
TO THE FORMULARY AT THE SAME TIME.
  (II)  A  HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM A FORMU-
LARY IF THE FEDERAL FOOD AND DRUG ADMINISTRATION  DETERMINES  THAT  SUCH
DRUG  SHOULD  BE  REMOVED  FROM  THE  MARKET,  INCLUDING NEW UTILIZATION
MANAGEMENT RESTRICTIONS ISSUED PURSUANT TO FEDERAL FOOD AND DRUG  ADMIN-
ISTRATION SAFETY CONCERNS.
  §  2. The public health law is amended by adding a new section 4909 to
read as follows:
  § 4909. PRESCRIPTION DRUG FORMULARY CHANGES. 1.  EXCEPT  AS  OTHERWISE
PROVIDED  IN SUBDIVISION THREE OF THIS SECTION, A HEALTH CARE PLAN SHALL
NOT:
  (A) REMOVE A PRESCRIPTION DRUG  FROM  A  FORMULARY  IF  THE  FORMULARY
INCLUDES  TWO  OR MORE TIERS OF BENEFITS PROVIDING FOR DIFFERENT DEDUCT-
IBLES, COPAYMENTS OR COINSURANCE APPLICABLE TO THE PRESCRIPTION DRUGS IN
EACH TIER, MOVE A DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT  OR
COINSURANCE; OR
  (B)  ADD  UTILIZATION  MANAGEMENT  RESTRICTIONS  TO  A FORMULARY DRUG,
UNLESS SUCH CHANGES OCCUR AT THE  TIME  OF  ENROLLMENT  OR  ISSUANCE  OF
COVERAGE.
  2. PROHIBITION PROVIDED IN SUBDIVISION ONE OF THIS SECTION SHALL APPLY
BEGINNING  ON  THE  DATE ON WHICH OPEN ENROLLMENT BEGINS FOR A PLAN YEAR
AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN ENROLLMENT PERI-
OD APPLIES.
  3. (A) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO  OR  MORE
TIERS  OF  BENEFITS  PROVIDING  FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR
COINSURANCE APPLICABLE TO PRESCRIPTION DRUGS IN EACH  TIER  MAY  MOVE  A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR COIN-
SURANCE  IF AN AB-RATED GENERIC DRUG FOR SUCH PRESCRIPTION DRUG IS ADDED
TO THE FORMULARY AT THE SAME TIME.
  (B) A HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM A FORMULARY
IF THE FEDERAL FOOD AND DRUG ADMINISTRATION DETERMINES  THAT  SUCH  DRUG
SHOULD  BE REMOVED FROM THE MARKET, INCLUDING NEW UTILIZATION MANAGEMENT
RESTRICTIONS ISSUED PURSUANT TO FEDERAL  FOOD  AND  DRUG  ADMINISTRATION
SAFETY CONCERNS.
  §  3.  This  act  shall take effect on the sixtieth day after it shall
have become a law; provided, however, that  effective  immediately,  the
addition,  amendment  and/or  repeal of any rule or regulation necessary
for the implementation of this act on its effective date are  authorized
to  be made and completed by the superintendent of financial services on
or before such date.

Co-Sponsors

Multi-Sponsors

A2317B - Details

See Senate Version of this Bill:: S5022
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: A7707, S5382
2019-2020: A2969, S2849

A2317B - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317B - Bill Text download pdf


                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2317--B
                                                        Cal. No. 171

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by  M. of A. PEOPLES-STOKES, HARRIS, SKOUFIS, BARRETT, NIOU,
  ORTIZ, SEPULVEDA, GALEF, ABINANTI, LAVINE -- Multi-Sponsored by --  M.
  of  A.  ENGLEBRIGHT, HEVESI -- read once and referred to the Committee
  on Insurance -- reported from committee, advanced to a third  reading,
  amended  and  ordered  reprinted,  retaining its place on the order of
  third reading -- ordered to  a  third  reading,  amended  and  ordered
  reprinted, retaining its place on the order of third reading

AN ACT to amend the insurance law and the public health law, in relation
  to prescription drug formulary changes during a contract year

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new  section  4909
to read as follows:
  §  4909.  PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT AS OTHERWISE
PROVIDED IN SUBSECTION (C) OF THIS SECTION, A  HEALTH  CARE  PLAN  SHALL
NOT:
  (I) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
  (II)  MOVE  A  PRESCRIPTION  DRUG  TO A TIER WITH A LARGER DEDUCTIBLE,
COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
BENEFITS PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR  COINSURANCE
APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
  (III)  ADD  UTILIZATION MANAGEMENT RESTRICTIONS TO A PRESCRIPTION DRUG
ON A FORMULARY, UNLESS SUCH CHANGES OCCUR AT THE TIME OF  ENROLLMENT  OR
ISSUANCE OF COVERAGE.
  (B)  PROHIBITIONS  PROVIDED  IN  SUBSECTION  (A) OF THIS SECTION SHALL
APPLY BEGINNING ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR  A  PLAN
YEAR  AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN ENROLLMENT
PERIOD APPLIES.
  (C) (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR  MORE
TIERS  OF  BENEFITS  PROVIDING  FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR
COINSURANCE APPLICABLE TO PRESCRIPTION DRUGS IN EACH  TIER  MAY  MOVE  A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR COIN-
SURANCE  IF AN AB-RATED GENERIC EQUIVALENT FOR SUCH PRESCRIPTION DRUG IS

ADDED TO THE FORMULARY AT THE SAME TIME.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05529-08-8

A. 2317--B                          2

  (II) A HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM  A  FORMU-
LARY  IF  THE  FEDERAL FOOD AND DRUG ADMINISTRATION DETERMINES THAT SUCH
PRESCRIPTION DRUG SHOULD BE  REMOVED  FROM  THE  MARKET,  INCLUDING  NEW
UTILIZATION  MANAGEMENT RESTRICTIONS ISSUED PURSUANT TO FEDERAL FOOD AND
DRUG ADMINISTRATION SAFETY CONCERNS.
  (D)  A  HEALTH  CARE PLAN SHALL PROVIDE NOTICE TO POLICYHOLDERS OF THE
INTENT TO REMOVE A PRESCRIPTION DRUG FROM A FORMULARY OR  ALTER  DEDUCT-
IBLE,  COPAYMENT  OR COINSURANCE REQUIREMENTS IN THE UPCOMING PLAN YEAR,
THIRTY DAYS PRIOR TO THE OPEN ENROLLMENT PERIOD FOR THE CONSECUTIVE PLAN
YEAR. SUCH NOTICE OF IMPENDING FORMULARY AND  DEDUCTIBLE,  COPAYMENT  OR
COINSURANCE  CHANGES SHALL ALSO BE POSTED ON THE PLAN'S ONLINE FORMULARY
AND IN ANY PRESCRIPTION DRUG FINDER SYSTEM THAT THE PLAN PROVIDES TO THE
PUBLIC.
  § 2. The public health law is amended by adding a new section 4909  to
read as follows:
  §  4909.  PRESCRIPTION  DRUG FORMULARY CHANGES. 1. EXCEPT AS OTHERWISE
PROVIDED IN SUBDIVISION THREE OF THIS SECTION, A HEALTH CARE PLAN  SHALL
NOT:
  (A) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
  (B)  MOVE  A  PRESCRIPTION  DRUG  TO  A TIER WITH A LARGER DEDUCTIBLE,
COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
BENEFITS PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR  COINSURANCE
APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
  (C)  ADD UTILIZATION MANAGEMENT RESTRICTIONS TO A PRESCRIPTION DRUG ON
A FORMULARY, UNLESS SUCH CHANGES OCCUR AT  THE  TIME  OF  ENROLLMENT  OR
ISSUANCE OF COVERAGE.
  2.  PROHIBITIONS  PROVIDED  IN  SUBDIVISION  ONE OF THIS SECTION SHALL
APPLY BEGINNING ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR  A  PLAN
YEAR  AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN ENROLLMENT
PERIOD APPLIES.
  3. (A) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO  OR  MORE
TIERS  OF  BENEFITS  PROVIDING  FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR
COINSURANCE APPLICABLE TO PRESCRIPTION DRUGS IN EACH  TIER  MAY  MOVE  A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR COIN-
SURANCE  IF AN AB-RATED GENERIC EQUIVALENT FOR SUCH PRESCRIPTION DRUG IS
ADDED TO THE FORMULARY AT THE SAME TIME.
  (B) A HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM A FORMULARY
IF THE  FEDERAL  FOOD  AND  DRUG  ADMINISTRATION  DETERMINES  THAT  SUCH
PRESCRIPTION  DRUG  SHOULD  BE  REMOVED  FROM  THE MARKET, INCLUDING NEW
UTILIZATION MANAGEMENT RESTRICTIONS ISSUED PURSUANT TO FEDERAL FOOD  AND
DRUG ADMINISTRATION SAFETY CONCERNS.
  4.  A  HEALTH  CARE  PLAN SHALL PROVIDE NOTICE TO POLICYHOLDERS OF THE
INTENT TO REMOVE A PRESCRIPTION DRUG FROM A FORMULARY OR  ALTER  DEDUCT-
IBLE,  COPAYMENT  OR COINSURANCE REQUIREMENTS IN THE UPCOMING PLAN YEAR,
THIRTY DAYS PRIOR TO THE OPEN ENROLLMENT PERIOD FOR THE CONSECUTIVE PLAN
YEAR. SUCH NOTICE OF IMPENDING FORMULARY AND  DEDUCTIBLE,  COPAYMENT  OR
COINSURANCE  CHANGES SHALL ALSO BE POSTED ON THE PLAN'S ONLINE FORMULARY
AND IN ANY PRESCRIPTION DRUG FINDER SYSTEM THAT THE PLAN PROVIDES TO THE
PUBLIC.
  § 3. This act shall take effect on the sixtieth  day  after  it  shall
have  become  a  law; provided, however, that effective immediately, the
addition, amendment and/or repeal of any rule  or  regulation  necessary
for  the implementation of this act on its effective date are authorized
to be made and completed by the superintendent of financial services  on
or before such date.

Co-Sponsors

Multi-Sponsors

A2317C (ACTIVE) - Details

See Senate Version of this Bill:: S5022
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: A7707, S5382
2019-2020: A2969, S2849

A2317C (ACTIVE) - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317C (ACTIVE) - Bill Text download pdf


                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2317--C
                                                        Cal. No. 171

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by  M.  of A. PEOPLES-STOKES, SKOUFIS, BARRETT, NIOU, ORTIZ,
  SEPULVEDA,  GALEF,  ABINANTI,  LAVINE,  COLTON,  JEAN-PIERRE,  TAYLOR,
  BYRNE,  WEPRIN  -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT, HEVESI,
  RA -- read once and referred to the Committee on Insurance -- reported
  from committee, advanced to  a  third  reading,  amended  and  ordered
  reprinted,  retaining  its  place  on  the  order  of third reading --
  ordered to a third reading, amended and ordered  reprinted,  retaining
  its  place  on  the  order  of third reading -- passed by Assembly and
  delivered to the Senate, recalled from the Senate, vote  reconsidered,
  bill  amended,  ordered reprinted, retaining its place on the order of
  third reading

AN ACT to amend the insurance law and the public health law, in relation
  to prescription drug formulary changes during a contract year

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  The insurance law is amended by adding a new section 4909
to read as follows:
  § 4909. PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT  AS  OTHERWISE
PROVIDED  IN  SUBSECTION  (C)  OF THIS SECTION, A HEALTH CARE PLAN SHALL
NOT:
  (I) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
  (II) MOVE A PRESCRIPTION DRUG TO A  TIER  WITH  A  LARGER  DEDUCTIBLE,
COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
BENEFITS  PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR COINSURANCE
APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
  (III) ADD UTILIZATION MANAGEMENT RESTRICTIONS TO A  PRESCRIPTION  DRUG
ON  A  FORMULARY, UNLESS SUCH CHANGES OCCUR AT THE TIME OF ENROLLMENT OR
ISSUANCE OF COVERAGE.
  (B) PROHIBITIONS PROVIDED IN SUBSECTION  (A)  OF  THIS  SECTION  SHALL
APPLY  BEGINNING  ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR A PLAN

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.

                                                           LBD05529-11-8

A. 2317--C                          2

YEAR AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN  ENROLLMENT
PERIOD APPLIES.
  (C)  (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR MORE
TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCTIBLES,  COPAYMENTS  OR
COINSURANCE  APPLICABLE  TO  PRESCRIPTION  DRUGS IN EACH TIER MAY MOVE A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR COIN-
SURANCE IF AN AB-RATED GENERIC EQUIVALENT OR INTERCHANGEABLE  BIOLOGICAL
PRODUCT FOR SUCH PRESCRIPTION DRUG IS ADDED TO THE FORMULARY AT THE SAME
TIME.
  (II)  A  HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM A FORMU-
LARY IF THE FEDERAL FOOD AND DRUG ADMINISTRATION  DETERMINES  THAT  SUCH
PRESCRIPTION  DRUG  SHOULD  BE  REMOVED  FROM  THE MARKET, INCLUDING NEW
UTILIZATION MANAGEMENT RESTRICTIONS ISSUED PURSUANT TO FEDERAL FOOD  AND
DRUG ADMINISTRATION SAFETY CONCERNS.
  (D)  A  HEALTH  CARE PLAN SHALL PROVIDE NOTICE TO POLICYHOLDERS OF THE
INTENT TO REMOVE A PRESCRIPTION DRUG FROM A FORMULARY OR  ALTER  DEDUCT-
IBLE,  COPAYMENT  OR COINSURANCE REQUIREMENTS IN THE UPCOMING PLAN YEAR,
THIRTY DAYS PRIOR TO THE OPEN ENROLLMENT PERIOD FOR THE CONSECUTIVE PLAN
YEAR. SUCH NOTICE OF IMPENDING FORMULARY AND  DEDUCTIBLE,  COPAYMENT  OR
COINSURANCE  CHANGES SHALL ALSO BE POSTED ON THE PLAN'S ONLINE FORMULARY
AND IN ANY PRESCRIPTION DRUG FINDER SYSTEM THAT THE PLAN PROVIDES TO THE
PUBLIC.
  § 2. The public health law is amended by adding a new section 4909  to
read as follows:
  §  4909.  PRESCRIPTION  DRUG FORMULARY CHANGES. 1. EXCEPT AS OTHERWISE
PROVIDED IN SUBDIVISION THREE OF THIS SECTION, A HEALTH CARE PLAN  SHALL
NOT:
  (A) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
  (B)  MOVE  A  PRESCRIPTION  DRUG  TO  A TIER WITH A LARGER DEDUCTIBLE,
COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
BENEFITS PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR  COINSURANCE
APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
  (C)  ADD UTILIZATION MANAGEMENT RESTRICTIONS TO A PRESCRIPTION DRUG ON
A FORMULARY, UNLESS SUCH CHANGES OCCUR AT  THE  TIME  OF  ENROLLMENT  OR
ISSUANCE OF COVERAGE.
  2.  PROHIBITIONS  PROVIDED  IN  SUBDIVISION  ONE OF THIS SECTION SHALL
APPLY BEGINNING ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR  A  PLAN
YEAR  AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN ENROLLMENT
PERIOD APPLIES.
  3. (A) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO  OR  MORE
TIERS  OF  BENEFITS  PROVIDING  FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR
COINSURANCE APPLICABLE TO PRESCRIPTION DRUGS IN EACH  TIER  MAY  MOVE  A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR COIN-
SURANCE  IF AN AB-RATED GENERIC EQUIVALENT OR INTERCHANGEABLE BIOLOGICAL
PRODUCT FOR SUCH PRESCRIPTION DRUG IS ADDED TO THE FORMULARY AT THE SAME
TIME.
  (B) A HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM A FORMULARY
IF THE  FEDERAL  FOOD  AND  DRUG  ADMINISTRATION  DETERMINES  THAT  SUCH
PRESCRIPTION  DRUG  SHOULD  BE  REMOVED  FROM  THE MARKET, INCLUDING NEW
UTILIZATION MANAGEMENT RESTRICTIONS ISSUED PURSUANT TO FEDERAL FOOD  AND
DRUG ADMINISTRATION SAFETY CONCERNS.
  4.  A  HEALTH  CARE  PLAN SHALL PROVIDE NOTICE TO POLICYHOLDERS OF THE
INTENT TO REMOVE A PRESCRIPTION DRUG FROM A FORMULARY OR  ALTER  DEDUCT-
IBLE,  COPAYMENT  OR COINSURANCE REQUIREMENTS IN THE UPCOMING PLAN YEAR,
THIRTY DAYS PRIOR TO THE OPEN ENROLLMENT PERIOD FOR THE CONSECUTIVE PLAN
YEAR. SUCH NOTICE OF IMPENDING FORMULARY AND  DEDUCTIBLE,  COPAYMENT  OR

A. 2317--C                          3

COINSURANCE  CHANGES SHALL ALSO BE POSTED ON THE PLAN'S ONLINE FORMULARY
AND IN ANY PRESCRIPTION DRUG FINDER SYSTEM THAT THE PLAN PROVIDES TO THE
PUBLIC.
  §  3.  This  act  shall take effect on the sixtieth day after it shall
have become a law; provided, however, that  effective  immediately,  the
addition,  amendment  and/or  repeal of any rule or regulation necessary
for the implementation of this act on its effective date are  authorized
to  be made and completed by the superintendent of financial services on
or before such date.

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The New York State Senate

assembly Bill A2317C

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Archive: Last Bill Status - Passed Assembly

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A2317 - Details

A2317 - Summary

A2317 - Bill Text download pdf

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A2317A - Details

A2317A - Summary

A2317A - Bill Text download pdf

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A2317B - Details

A2317B - Summary

A2317B - Bill Text download pdf

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A2317C (ACTIVE) - Details

A2317C (ACTIVE) - Summary

A2317C (ACTIVE) - Bill Text download pdf

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assembly Bill A2317C

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PEOPLES-STOKES

Archive: Last Bill Status - Passed Assembly

Your Voice

Actions

Bill Amendments

Co-Sponsors

Pamela Harris

James Skoufis

Didi Barrett

Yuh-Line Niou

Felix Ortiz

Multi-Sponsors

Steven Englebright

A2317 - Details

A2317 - Summary

A2317 - Bill Text download pdf

Co-Sponsors

Pamela Harris

James Skoufis

Didi Barrett

Yuh-Line Niou

Felix Ortiz

Luis R. Sepúlveda

Sandy Galef

Thomas Abinanti

Charles Lavine

Multi-Sponsors

Steven Englebright

Andrew Hevesi

A2317A - Details

A2317A - Summary

A2317A - Bill Text download pdf

Co-Sponsors

James Skoufis

Didi Barrett

Yuh-Line Niou

Felix Ortiz

Luis R. Sepúlveda

Sandy Galef

Thomas Abinanti

Charles Lavine

William Colton

Kimberly Jean-Pierre

Al Taylor

Kevin M. Byrne

David Weprin

Multi-Sponsors

Steven Englebright

Andrew Hevesi

Edward Ra

A2317B - Details

A2317B - Summary

A2317B - Bill Text download pdf

Co-Sponsors

James Skoufis

Didi Barrett

Yuh-Line Niou

Felix Ortiz

Luis R. Sepúlveda

Sandy Galef

Thomas Abinanti

Charles Lavine

William Colton

Kimberly Jean-Pierre

Al Taylor

Kevin M. Byrne

David Weprin

Rebecca Seawright

Inez Barron

Walter T. Mosley

Donna Lupardo

Multi-Sponsors

Steven Englebright

Andrew Hevesi

Edward Ra

Fred Thiele

A2317C (ACTIVE) - Details