NY State Senate Bill S2849A

Archive: Last Bill Status Via A2969 - Vetoed by Governor

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

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Actions

view actions (13)

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Dec 23, 2019	tabled vetoed memo.245
Dec 17, 2019	delivered to governor
Jun 19, 2019	returned to assembly passed senate 3rd reading cal.462 substituted for s2849a
Jun 19, 2019	substituted by a2969a
Jun 11, 2019	amended on third reading 2849a
May 01, 2019	advanced to third reading
Apr 30, 2019	2nd report cal.
Apr 29, 2019	1st report cal.462
Jan 29, 2019	referred to insurance

Votes

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Jun 19, 2019 - floor Vote

A2969A

floor

Aye

Nay

Absent

Excused

Abstained

Apr 29, 2019 - Insurance committee Vote

S2849

committee

Aye

Nay

Aye with Reservations

Absent

Excused

Abstained

Bill Amendments

Original

A (Active)

Original

A (Active)

Co-Sponsors

view additional co-sponsors

S2849 - Details

See Assembly Version of this Bill:: A2969
Law Section:: Insurance Law
Laws Affected:: Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: S5382, A7707
2017-2018: S5022, A2317

S2849 - Summary

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

S2849 - Sponsor Memo

 
BILL NUMBER: S2849

SPONSOR: BRESLIN
 
TITLE OF BILL:

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

 
PURPOSE:

To clarify that health insurance consumers are protected from adverse
effects of mid-year formulary changes.

 
SUMMARY OF PROVISIONS:

Section 1 creates a new section 4909 of the Insurance Law to add
restrictions to drug formulary changes. If the plan's drug formulary has
two or more tiers of drug benefits with different deductibles, copay-
ments or coinsurance, the plan may not move a drug to a tier with higher
patient cost sharing during the enrollment year. Additionally, the plan
may not add new utilization management restrictions to a formulary drug,

unless such changes occur at the time of enrollment or issuance of
coverage, and must provide notice to policyholders of certain changes to
a formulary in an upcoming plan year. A health care plan may move a
prescription drug to a tier with a larger copayment, coinsurance and
different deductible if an AB-rated generic equivalent drug or inter
changeable biological equivalent is added to the formulary at the same-
time. A prescription drug may be removed 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 aris-
ing from safety concerns.

Section 2 adds a new section 4909 of the Public Health Law to add simi-
lar provisions as Section 1 of this act.

Section 3 provides that this act would take effect on the 60th day after
enactment, provided that effective immediately the superintendent of
insurance may make regulations and take other actions necessary to
implement the act.

 
JUSTIFICATION:

The purpose of the bill is to ensure that health insurance enrollees
have assurance that their health plan will maintain continuity in cover-
age for their prescription drugs during the course of the enrollment
year. Enrollees choose health exchange plans based on the formulary
status of a necessary therapy. Not only can these unexpected formulary
changes be extremely financially burdensome, a change in prescription
drug availability could result in serious medical problems for the
enrollee.

 
LEGISLATIVE HISTORY:

2018: S.5022c - Referred to Insurance
2016: S.5382a - Referred to Insurance

 
FISCAL IMPLICATIONS:

None.
 
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become a law. 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
on or before such effective date.

S2849 - Bill Text download pdf


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

                                  2849

                       2019-2020 Regular Sessions

                            I N  S E N A T E

                            January 29, 2019
                               ___________

Introduced  by Sens. BRESLIN, ADDABBO, AKSHAR, BROOKS, CARLUCCI, COMRIE,
  GRIFFO, HELMING, JACOBS, KAMINSKY, KENNEDY, KRUEGER,  LANZA,  LAVALLE,
  MAYER,   ORTT,  PARKER,  RITCHIE,  RIVERA,  ROBACH,  SANDERS,  SAVINO,
  SEPULVEDA, SERINO -- read twice and ordered printed, and when  printed
  to be committed to the Committee on Insurance

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 OR INTERCHANGEABLE BIOLOGICAL
PRODUCT 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.
                                                           LBD04720-01-9

S. 2849                             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 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
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.    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 on or before such effective date.

Co-Sponsors

view additional co-sponsors

S2849A (ACTIVE) - Details

See Assembly Version of this Bill:: A2969
Law Section:: Insurance Law
Laws Affected:: Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2015-2016: S5382, A7707
2017-2018: S5022, A2317

S2849A (ACTIVE) - Summary

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

S2849A (ACTIVE) - Sponsor Memo

 
BILL NUMBER: S2849A

SPONSOR: BRESLIN
 
TITLE OF BILL:  An act to amend the insurance law and the public
health law, in relation to prescription drug formulary changes during a
contract year

 
PURPOSE OR GENERAL IDEA OF BILL:

To clarify that health insurance consumers covered by plans that are
required to offer essential health benefits under the affordable care
act are protected from adverse effects of mid-year formulary changes,
and properly notified of formulary changes.

 
SUMMARY OF PROVISIONS:

Section 1 adds a new section 4909 to the Insurance Law to state that a
health care plan which provides essential health benefits under the
federal affordable care act may not remove a prescription drug from a
formulary during the enrollment year. If the plan's drug formulary has
two or more tiers of drug benefits with different deductibles, copay-

ments or coinsurance, the plan may not move a drug to a tier with higher
patient cost sharing during the enrollment year. The plan may also not
add new or additional formulary restrictions during the enrollment year.
A health care plan may move a prescription drug to a tier with a larger
copayment, coinsurance and different deductible if an AB-rated generic
equivalent drug or interchangeable biological product is added to the
formulary at the same time. In addition, provide notice to policyholders
of the intent to remove a prescription drugs from a formulary or alter
deductible, copayment or coinsurance requirements in the upcoming plan
year, thirty days prior to the open enrollment period for the consec-
utive plan year. This section also provides that terms of a collective
bargaining agreement shall not be superseded.

Section 2 adds a new section 4909 to the public health law to also state
that a health care plan which provides essential health benefits under
the federal affordable care act may not remove a prescription drug from
a formulary during the enrollment year. If the plan's drug formulary has
two or more tiers of drug benefits with different deductibles, copay-
ments or coinsurance, the plan may not move a drug to a tier with higher
patient cost sharing during the enrollment year. The plan may also not
add new or additional formulary restrictions during the enrollment year
A health care plan may move a prescription drug to a tier with a larger
copayment, coinsurance and different deductible if an AB-rated generic
equivalent drug or interchangeable biological product is added to the
formulary at the same time. In addition, provide notice to policyholders
of the intent to remove a prescription drugs from a formulary or alter
deductible, copayment or coinsurance requirements in the upcoming plan
year, thirty days prior to the open enrollment period for the consec-
utive plan year. This section also provides that terms of a collective
bargaining agreement shall not be superseded.

Section 3 provides that this act would take effect on the 60th day after
enactment, provided that effective immediately the superintendent of
insurance may make regulations and take other actions necessary to
implement the act.

 
DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE):

The amendments to this bill clarify that this act shall not supersede a
collective bargaining agreement or the rights of labor organizations to
collectively bargain changes to formularies.

 
JUSTIFICATION:

This bill ensures that enrollees who select a health exchange plan based
on their individual prescription drug needs have assurance that the
health plan will maintain continuity in coverage for those prescription
drugs during the course of the enrollment year, and be provided adequate
notice of the intent to remove a prescription on the upcoming plan year.
Enrollees choose health exchange plans based on the formulary status of
a necessary therapy.

A change in prescription drug availability could result in serious
medical problems for the enrollee. Also, these unexpected formulary
changes can be extremely financially burdensome and have negative health
outcomes.

 
PRIOR LEGISLATIVE HISTORY:

A.2317-C of 2017/2018;
A.7707A of 2015/2016
2018: S.5022c - Referred to Insurance
2016: S.5382a - Referred to Insurance

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None.

 
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become a law; provided, however, that effective immediately, the addi-
tion, 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.

S2849A (ACTIVE) - Bill Text download pdf


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

                                 2849--A
    Cal. No. 462

                       2019-2020 Regular Sessions

                            I N  S E N A T E

                            January 29, 2019
                               ___________

Introduced  by Sens. BRESLIN, ADDABBO, AKSHAR, BENJAMIN, BIAGGI, BROOKS,
  CARLUCCI, COMRIE, FUNKE, GALLIVAN, GAUGHRAN, GIANARIS,  GRIFFO,  HELM-
  ING,  HOYLMAN,  JACOBS,  JORDAN,  KAMINSKY,  KENNEDY,  KRUEGER, LANZA,
  LAVALLE, MAY, MAYER, ORTT, PARKER, RITCHIE, RIVERA,  ROBACH,  SALAZAR,
  SANDERS,  SAVINO,  SEPULVEDA, SERINO, SERRANO, SKOUFIS, THOMAS -- read
  twice and ordered printed, and when printed to  be  committed  to  the
  Committee  on  Insurance  --  reported  favorably from said committee,
  ordered to first and  second  report,  ordered  to  a  third  reading,
  amended  and  ordered  reprinted,  retaining its place in 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.

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

                      [ ] is old law to be omitted.
                                                           LBD04720-05-9

S. 2849--A                          2

  (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.
  (E)  THE PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A
COLLECTIVE BARGAINING AGREEMENT, OR THE RIGHTS OF  LABOR  REPRESENTATION
GROUPS TO COLLECTIVELY BARGAIN CHANGES TO THE FORMULARIES.
  §  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

S. 2849--A                          3

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.
  5.  THE  PROVISIONS OF THIS SECTION SHALL NOT SUPERSEDE THE TERMS OF A
COLLECTIVE BARGAINING AGREEMENT, OR THE RIGHTS OF  LABOR  REPRESENTATION
GROUPS TO COLLECTIVELY BARGAIN CHANGES TO THE FORMULARIES.
  §  3.  This  act  shall take effect on the sixtieth day after it shall
have become a law.    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 on or before such effective date.

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The New York State Senate

senate Bill S2849A

Sponsored By

Archive: Last Bill Status Via A2969 - Vetoed by Governor

Your Voice

Actions

Votes

Jun 19, 2019 - floor Vote

Floor Vote: Jun 19, 2019

Apr 29, 2019 - Insurance committee Vote

Committee Vote: Apr 29, 2019

Bill Amendments

Co-Sponsors

S2849 - Details

S2849 - Summary

S2849 - Sponsor Memo

S2849 - Bill Text download pdf

Co-Sponsors

S2849A (ACTIVE) - Details

S2849A (ACTIVE) - Summary

S2849A (ACTIVE) - Sponsor Memo

S2849A (ACTIVE) - Bill Text download pdf

Comments

senate Bill S2849A

Share this bill

Sponsored By

Archive: Last Bill Status Via A2969 - Vetoed by Governor

Your Voice

Actions

Votes

Jun 19, 2019 - floor Vote

Floor Vote: Jun 19, 2019

Apr 29, 2019 - Insurance committee Vote

Committee Vote: Apr 29, 2019

Bill Amendments

Co-Sponsors

S2849 - Details

S2849 - Summary

S2849 - Sponsor Memo

S2849 - Bill Text download pdf

Co-Sponsors

S2849A (ACTIVE) - Details

S2849A (ACTIVE) - Summary

S2849A (ACTIVE) - Sponsor Memo

S2849A (ACTIVE) - Bill Text download pdf

Comments