senate Bill S2849A

2019-2020 Legislative Session

Relates to prescription drug formulary changes during a contract year

download bill text pdf

Sponsored By

Current Bill Status Via A2969 - Passed Senate & 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 (10)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
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

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

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.

Co-Sponsors

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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

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

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