senate Bill S7191A

2017-2018 Legislative Session

Relates to enhancing pharmaceutical transparency and consumer protection

download bill text pdf

Sponsored By

Current Bill Status - In Senate Health Committee


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

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Actions

view actions (3)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Feb 08, 2018 print number 7191a
Feb 08, 2018 amend and recommit to health
Jan 03, 2018 referred to health

S7191 - Details

See Assembly Version of this Bill:
A9893
Law Section:
Public Health Law
Laws Affected:
Add §280-c, Pub Health L; amd §§3217-b & 4325, Ins L

S7191 - Summary

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

S7191 - Sponsor Memo

S7191 - Bill Text download pdf

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

                                  7191

                            I N  S E N A T E

                               (PREFILED)

                             January 3, 2018
                               ___________

Introduced  by  Sen.  GRIFFO -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

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:
  S 280-C. CONTRACTS BETWEEN PHARMACIES AND PHARMACY  BENEFIT  MANAGERS.
1.  ON  AND  AFTER JANUARY FIRST, TWO THOUSAND EIGHTEEN, 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 EIGHTEEN, 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

S7191A (ACTIVE) - Details

See Assembly Version of this Bill:
A9893
Law Section:
Public Health Law
Laws Affected:
Add §280-c, Pub Health L; amd §§3217-b & 4325, Ins L

S7191A (ACTIVE) - Summary

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

S7191A (ACTIVE) - Sponsor Memo

S7191A (ACTIVE) - Bill Text download pdf

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

                                 7191--A

                            I N  S E N A T E

                               (PREFILED)

                             January 3, 2018
                               ___________

Introduced  by  Sen.  GRIFFO -- read twice and ordered printed, and when
  printed to be committed  to  the  Committee  on  Health  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

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:
  S  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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

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