assembly Bill A5411D

Signed By Governor
2021-2022 Legislative Session

Enacts the "patient Rx information and choice expansion act"

download bill text pdf

Sponsored By

Archive: Last Bill Status Via S4620 - Signed by Governor


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

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Actions

view actions (18)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Dec 30, 2022 approval memo.104
signed chap.826
Dec 19, 2022 delivered to governor
May 31, 2022 returned to senate
passed assembly
ordered to third reading cal.594
substituted for a5411d
May 31, 2022 substituted by s4620c
May 17, 2022 amended on third reading 5411d
May 09, 2022 amended on third reading 5411c
May 05, 2022 advanced to third reading cal.594
May 04, 2022 reported
Jan 07, 2022 print number 5411b
Jan 07, 2022 amend and recommit to insurance
Jan 05, 2022 referred to insurance
Apr 23, 2021 print number 5411a
Apr 23, 2021 amend and recommit to insurance
Feb 16, 2021 referred to insurance

Co-Sponsors

view additional co-sponsors

A5411 - Details

See Senate Version of this Bill:
S4620
Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

A5411 - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

A5411 - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5411
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 16, 2021
                                ___________
 
 Introduced by M. of A. McDONALD -- read once and referred to the Commit-
   tee on Insurance
 
 AN  ACT to amend the insurance law, in relation to enacting the "patient
   Rx information and choice expansion act"
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   §  2.  The  insurance  law is amended by adding a new section 341-a to
 read as follows:
   § 341-A. PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.    DEFINITIONS.
 AS USED IN THIS SECTION:
   (A)  "HEALTH PLAN" MEANS BENEFITS PROVIDED BY ANY ENTITY DELIVERING OR
 ISSUING FOR DELIVERY A POLICY OF ACCIDENT AND HEALTH INSURANCE  PURSUANT
 TO  SECTION  THREE  THOUSAND  TWO HUNDRED SIXTEEN, OR A GROUP OR BLANKET
 ACCIDENT AND HEALTH INSURANCE POLICY PURSUANT TO SECTION THREE  THOUSAND
 TWO  HUNDRED  TWENTY-ONE, OR PROVIDING BENEFITS PURSUANT TO SECTION FOUR
 THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   (B)  "COST-SHARING  INFORMATION"  MEANS  THE  AMOUNT  AN  ENROLLEE  IS
 REQUIRED  TO  PAY  IN  ORDER TO RECEIVE A DRUG THAT IS COVERED UNDER THE
 ENROLLEE'S HEALTH PLAN.
   (C) "COVERED/COVERAGE" MEANS THOSE HEALTH CARE SERVICES  TO  WHICH  AN
 ENROLLEE IS ENTITLED UNDER THE TERMS OF THE HEALTH PLAN.
   (D) "ENROLLEE" MEANS THE COVERED INDIVIDUAL, POLICYHOLDER, SUBSCRIBER,
 THE  INSURED, OR PERSON WHO HAS AUTHORITY UNDER APPLICABLE LAW TO ACT ON
 BEHALF OF AN ENROLLEE IN MAKING DECISIONS  RELATED  TO  HEALTH  CARE,  A
 HEALTH PLAN, OR PHARMACY BENEFIT MANAGER, OR ITS AFFILIATES OR ENTITIES.
   (E)  "INTEROPERABILITY  ELEMENT"  MEANS HARDWARE, SOFTWARE, INTEGRATED
 TECHNOLOGIES OR RELATED  LICENSES,  TECHNICAL  INFORMATION,  PRIVILEGES,
 RIGHTS,  INTELLECTUAL PROPERTY, UPGRADES, OR SERVICES THAT MAY BE NECES-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08942-01-1

Co-Sponsors

view additional co-sponsors

A5411A - Details

See Senate Version of this Bill:
S4620
Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

A5411A - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

A5411A - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5411--A
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 16, 2021
                                ___________
 
 Introduced  by M. of A. McDONALD, THIELE, ENGLEBRIGHT, BURDICK, MONTESA-
   NO, SCHMITT, REILLY, LAWLER,  McDONOUGH,  BARRON,  LEMONDES,  DICKENS,
   SILLITTI,  CUSICK,  SIMON,  ANGELINO,  SALKA, DURSO, JACKSON, GUNTHER,
   GOTTFRIED -- read once and referred to the Committee on  Insurance  --
   committee  discharged,  bill amended, ordered reprinted as amended and
   recommitted to said committee
 
 AN ACT to amend the insurance law, in relation to enacting the  "patient
   Rx information and choice expansion act"
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   § 2. The insurance law is amended by adding a  new  section  341-a  to
 read as follows:
   §  341-A.  PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.  DEFINITIONS.
 AS USED IN THIS SECTION:
   (A) "HEALTH PLAN" MEANS BENEFITS PROVIDED BY ANY ENTITY DELIVERING  OR
 ISSUING  FOR DELIVERY A POLICY OF ACCIDENT AND HEALTH INSURANCE PURSUANT
 TO SECTION THREE THOUSAND TWO HUNDRED SIXTEEN, OR  A  GROUP  OR  BLANKET
 ACCIDENT  AND HEALTH INSURANCE POLICY PURSUANT TO SECTION THREE THOUSAND
 TWO HUNDRED TWENTY-ONE, OR PROVIDING BENEFITS PURSUANT TO  SECTION  FOUR
 THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   (B)  "COST-SHARING  INFORMATION"  MEANS  THE  AMOUNT  AN  ENROLLEE  IS
 REQUIRED TO PAY IN ORDER TO RECEIVE A DRUG THAT  IS  COVERED  UNDER  THE
 ENROLLEE'S HEALTH PLAN.
   (C)  "COVERED/COVERAGE"  MEANS  THOSE HEALTH CARE SERVICES TO WHICH AN
 ENROLLEE IS ENTITLED UNDER THE TERMS OF THE HEALTH PLAN.
   (D) "ENROLLEE" MEANS THE COVERED INDIVIDUAL, POLICYHOLDER, SUBSCRIBER,
 THE INSURED, OR PERSON WHO HAS AUTHORITY UNDER APPLICABLE LAW TO ACT  ON
 BEHALF  OF  AN  ENROLLEE  IN  MAKING DECISIONS RELATED TO HEALTH CARE, A
 HEALTH PLAN, OR PHARMACY BENEFIT MANAGER, OR ITS AFFILIATES OR ENTITIES.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

Co-Sponsors

view additional co-sponsors

A5411B - Details

See Senate Version of this Bill:
S4620
Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

A5411B - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

A5411B - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5411--B
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 16, 2021
                                ___________
 
 Introduced  by M. of A. McDONALD, THIELE, ENGLEBRIGHT, BURDICK, MONTESA-
   NO, SCHMITT, REILLY, LAWLER, McDONOUGH, LEMONDES,  DICKENS,  SILLITTI,
   CUSICK,  SIMON,  ANGELINO,  SALKA, DURSO, JACKSON, GUNTHER, GOTTFRIED,
   STECK, HAWLEY, FORREST -- read once and referred to the  Committee  on
   Insurance  -- committee discharged, bill amended, ordered reprinted as
   amended and recommitted  to  said  committee  --  recommitted  to  the
   Committee  on  Insurance in accordance with Assembly Rule 3, sec. 2 --
   committee discharged, bill amended, ordered reprinted as  amended  and
   recommitted to said committee
 
 AN  ACT to amend the insurance law, in relation to enacting the "patient
   Rx information and choice expansion act"
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   §  2.  The  insurance  law is amended by adding a new section 341-a to
 read as follows:
   § 341-A. PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.    DEFINITIONS.
 AS USED IN THIS SECTION:
   (A)  "HEALTH PLAN" MEANS BENEFITS PROVIDED BY ANY ENTITY DELIVERING OR
 ISSUING FOR DELIVERY A POLICY OF ACCIDENT AND HEALTH INSURANCE  PURSUANT
 TO  SECTION  THREE  THOUSAND  TWO HUNDRED SIXTEEN, OR A GROUP OR BLANKET
 ACCIDENT AND HEALTH INSURANCE POLICY PURSUANT TO SECTION THREE  THOUSAND
 TWO  HUNDRED  TWENTY-ONE, OR PROVIDING BENEFITS PURSUANT TO SECTION FOUR
 THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   (B)  "COST-SHARING  INFORMATION"  MEANS  THE  AMOUNT  AN  ENROLLEE  IS
 REQUIRED  TO  PAY  IN  ORDER TO RECEIVE A DRUG THAT IS COVERED UNDER THE
 ENROLLEE'S HEALTH PLAN.
   (C) "COVERED/COVERAGE" MEANS THOSE HEALTH CARE SERVICES  TO  WHICH  AN
 ENROLLEE IS ENTITLED UNDER THE TERMS OF THE HEALTH PLAN.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08942-04-1
 A. 5411--B                          2

Co-Sponsors

view additional co-sponsors

A5411C - Details

See Senate Version of this Bill:
S4620
Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

A5411C - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

A5411C - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5411--C
                                                         Cal. No. 594
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 16, 2021
                                ___________
 
 Introduced  by M. of A. McDONALD, THIELE, ENGLEBRIGHT, BURDICK, MONTESA-
   NO, SCHMITT, REILLY, LAWLER, McDONOUGH, LEMONDES,  DICKENS,  SILLITTI,
   CUSICK,  SIMON,  ANGELINO,  SALKA, DURSO, JACKSON, GUNTHER, GOTTFRIED,
   STECK, HAWLEY, FORREST -- read once and referred to the  Committee  on
   Insurance  -- committee discharged, bill amended, ordered reprinted as
   amended and recommitted  to  said  committee  --  recommitted  to  the
   Committee  on  Insurance in accordance with Assembly Rule 3, sec. 2 --
   committee discharged, bill amended, ordered reprinted as  amended  and
   recommitted  to said committee -- reported from committee, advanced to
   a third reading, amended and ordered reprinted, retaining its place on
   the order of third reading
 
 AN ACT to amend the insurance law, in relation to enacting the  "patient
   Rx information and choice expansion act"
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   § 2. The insurance law is amended by adding a  new  section  341-a  to
 read as follows:
   §  341-A.  PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.  DEFINITIONS.
 AS USED IN THIS SECTION:
   (A) "HEALTH PLAN" MEANS BENEFITS PROVIDED BY ANY ENTITY DELIVERING  OR
 ISSUING  FOR DELIVERY A POLICY OF ACCIDENT AND HEALTH INSURANCE PURSUANT
 TO SECTION THREE THOUSAND TWO HUNDRED SIXTEEN, OR  A  GROUP  OR  BLANKET
 ACCIDENT  AND HEALTH INSURANCE POLICY PURSUANT TO SECTION THREE THOUSAND
 TWO HUNDRED TWENTY-ONE, OR PROVIDING BENEFITS PURSUANT TO  SECTION  FOUR
 THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   (B)  "COST-SHARING  INFORMATION"  MEANS  THE  AMOUNT  AN  ENROLLEE  IS
 REQUIRED TO PAY IN ORDER TO RECEIVE A DRUG THAT  IS  COVERED  UNDER  THE
 ENROLLEE'S HEALTH PLAN.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08942-06-2

Co-Sponsors

view additional co-sponsors

A5411D (ACTIVE) - Details

See Senate Version of this Bill:
S4620
Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

A5411D (ACTIVE) - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

A5411D (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5411--D
                                                         Cal. No. 594
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 16, 2021
                                ___________
 
 Introduced  by M. of A. McDONALD, THIELE, ENGLEBRIGHT, BURDICK, MONTESA-
   NO, SCHMITT, REILLY, LAWLER, McDONOUGH, LEMONDES,  DICKENS,  SILLITTI,
   CUSICK,  SIMON,  ANGELINO,  SALKA, DURSO, JACKSON, GUNTHER, GOTTFRIED,
   STECK, HAWLEY, FORREST, CONRAD  --  read  once  and  referred  to  the
   Committee  on Insurance -- committee discharged, bill amended, ordered
   reprinted as amended and recommitted to said committee --  recommitted
   to the Committee on Insurance in accordance with Assembly Rule 3, sec.
   2  -- committee discharged, bill amended, ordered reprinted as amended
   and recommitted to said committee -- reported from committee, advanced
   to a third reading, amended and ordered reprinted, retaining its place
   on the order of third reading  --  again  amended  on  third  reading,
   ordered reprinted, retaining its place on the order of third reading
 
 AN  ACT to amend the insurance law, in relation to enacting the "patient
   Rx information and choice expansion act"
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   §  2.  The  insurance  law is amended by adding a new section 341-a to
 read as follows:
   § 341-A. PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.    DEFINITIONS.
 AS USED IN THIS SECTION:
   (A) THE TERMS "COVERED INDIVIDUAL", "HEALTH PLAN", AND "PHARMACY BENE-
 FIT  MANAGER"  SHALL  HAVE  THE  SAME MEANINGS AS DEFINED BY SECTION TWO
 HUNDRED EIGHTY-A  OF  THE  PUBLIC  HEALTH  LAW.  THE  SUPERINTENDENT  IS
 EXPRESSLY AUTHORIZED TO INTERPRET THESE TERMS AS IF THE DEFINITIONS WERE
 STATED WITHIN THIS ARTICLE.
   (B)  "COST-SHARING  INFORMATION" MEANS THE AMOUNT A COVERED INDIVIDUAL
 IS REQUIRED TO PAY TO RECEIVE A DRUG THAT IS COVERED UNDER  THE  COVERED
 INDIVIDUAL'S HEALTH PLAN.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08942-13-2