assembly Bill A9893

2017-2018 Legislative Session

Relates to enhancing pharmaceutical transparency and consumer protection

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Archive: Last Bill Status - In Assembly Committee


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Feb 20, 2018 referred to insurance

Co-Sponsors

A9893 (ACTIVE) - Details

See Senate Version of this Bill:
S7191
Current Committee:
Assembly Insurance
Law Section:
Public Health Law
Laws Affected:
Add §280-c, Pub Health L; amd §§3217-b & 4325, Ins L

A9893 (ACTIVE) - Summary

Relates to enhancing pharmaceutical transparency and consumer protection between pharmacies and pharmacy benefit managers.

A9893 (ACTIVE) - Bill Text download pdf


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

                                  9893

                          I N  A S S E M B L Y

                            February 20, 2018
                               ___________

Introduced by M. of A. BRINDISI -- read once and referred to the Commit-
  tee on Insurance

AN ACT to amend the public health law and the insurance law, in relation
  to contracts between pharmacies and 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-c to read as follows:
  §  280-C.  CONTRACTS BETWEEN PHARMACIES AND PHARMACY BENEFIT MANAGERS.
1. ON AND AFTER JANUARY FIRST, TWO THOUSAND NINETEEN,  NO  CONTRACT  FOR
PHARMACY  SERVICES  ENTERED INTO IN THE STATE BETWEEN A HEALTH INSURANCE
CARRIER OR A PHARMACY BENEFIT MANAGER, AS DEFINED IN SECTION TWO HUNDRED
EIGHTY-A OF THIS ARTICLE, AND A PHARMACY,  PHARMACIST  OR  A  PHARMACY'S
CONTRACTING  AGENT, SUCH AS A PHARMACY SERVICES ADMINISTRATIVE ORGANIZA-
TION, SHALL CONTAIN A PROVISION  PROHIBITING  OR  PENALIZING,  INCLUDING
THROUGH  INCREASED  UTILIZATION REVIEW, REDUCED PAYMENTS OR OTHER FINAN-
CIAL DISINCENTIVES, A PHARMACIST'S DISCLOSURE TO AN INDIVIDUAL  PURCHAS-
ING PRESCRIPTION MEDICATION OF INFORMATION REGARDING (A) THE COST OF THE
PRESCRIPTION  MEDICATION  TO  THE INDIVIDUAL, OR (B) THE AVAILABILITY OF
ANY THERAPEUTICALLY EQUIVALENT ALTERNATIVE  MEDICATIONS  OR  ALTERNATIVE
METHODS  OF  PURCHASING  THE PRESCRIPTION MEDICATION, INCLUDING, BUT NOT
LIMITED TO, PAYING A CASH PRICE, THAT ARE LESS EXPENSIVE THAN  THE  COST
OF THE PRESCRIPTION MEDICATION TO THE INDIVIDUAL.
  2. ON AND AFTER JANUARY FIRST, TWO THOUSAND NINETEEN, NO HEALTH INSUR-
ANCE  CARRIER OR PHARMACY BENEFIT MANAGER SHALL REQUIRE AN INDIVIDUAL TO
MAKE A PAYMENT AT THE POINT OF SALE FOR A COVERED  PRESCRIPTION  MEDICA-
TION  IN  AN AMOUNT GREATER THAN THE LESSER OF (A) THE APPLICABLE COPAY-
MENT FOR SUCH PRESCRIPTION MEDICATION, (B) THE  ALLOWABLE  CLAIM  AMOUNT
FOR  THE  PRESCRIPTION MEDICATION, OR (C) THE AMOUNT AN INDIVIDUAL WOULD
PAY FOR THE PRESCRIPTION MEDICATION  IF  THE  INDIVIDUAL  PURCHASED  THE
PRESCRIPTION MEDICATION WITHOUT USING A HEALTH BENEFIT PLAN OR ANY OTHER
SOURCE  OF  PRESCRIPTION  MEDICATION  BENEFITS  OR  DISCOUNTS.  FOR  THE
PURPOSES OF THIS SECTION, "ALLOWABLE CLAIM AMOUNT" MEANS THE AMOUNT  THE

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