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Assembly Bill A8246

2019-2020 Legislative Session

Relates to calculating an insured individual's overall contribution to any out-of-pocket maximum or any cost-sharing requirement

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Archive: Last Bill Status - In Assembly Committee

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2019-A8246 (ACTIVE) - Details

See Senate Version of this Bill:
S6303
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2021-2022 Legislative Session:
A1741, S5299

2019-A8246 (ACTIVE) - Summary

Requires any third-party payments, financial assistance, discount, voucher or other price reduction instrument for out-of-pocket expenses made on behalf of an insured individual for the cost of prescription drugs to be applied to the insured's deductible, copayment, coinsurance, out-of-pocket maximum, or any other cost-sharing requirement when calculating such insured individual's overall contribution to any out-of-pocket maximum or any cost-sharing requirement.

2019-A8246 (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8246
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               June 10, 2019
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to calculating an insured
   individual's overall contribution to any out-of-pocket maximum or  any
   cost-sharing requirement
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
 amended by adding a new paragraph 36 to read as follows:
   (36)  ANY  POLICY  THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
 APPLY ANY THIRD-PARTY PAYMENTS, FINANCIAL ASSISTANCE, DISCOUNT,  VOUCHER
 OR  OTHER  PRICE REDUCTION INSTRUMENT FOR OUT-OF-POCKET EXPENSES MADE ON
 BEHALF OF AN INSURED INDIVIDUAL FOR THE COST OF  PRESCRIPTION  DRUGS  TO
 THE INSURED'S DEDUCTIBLE, COPAYMENT, COINSURANCE, OUT-OF-POCKET MAXIMUM,
 OR  ANY  OTHER  COST-SHARING  REQUIREMENT  WHEN CALCULATING SUCH INSURED
 INDIVIDUAL'S OVERALL CONTRIBUTION TO ANY OUT-OF-POCKET  MAXIMUM  OR  ANY
 COST-SHARING REQUIREMENT.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 21 to read as follows:
   (21) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
 THIS STATE THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL APPLY ANY
 THIRD-PARTY  PAYMENTS,  FINANCIAL ASSISTANCE, DISCOUNT, VOUCHER OR OTHER
 PRICE REDUCTION INSTRUMENT FOR OUT-OF-POCKET EXPENSES MADE ON BEHALF  OF
 AN  INSURED  INDIVIDUAL  FOR  THE  COST  OF  PRESCRIPTION  DRUGS  TO THE
 INSURED'S DEDUCTIBLE, COPAYMENT, COINSURANCE, OUT-OF-POCKET MAXIMUM,  OR
 ANY  OTHER  COST-SHARING REQUIREMENT WHEN CALCULATING SUCH INSURED INDI-
 VIDUAL'S OVERALL CONTRIBUTION TO ANY OUT-OF-POCKET MAXIMUM OR ANY  COST-
 SHARING REQUIREMENT.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (ss) to read as follows:

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13146-01-9

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