senate Bill S1768

2021-2022 Legislative Session

Relates to reducing pharmacy benefit manager costs

download bill text pdf

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 15, 2021 referred to insurance

Co-Sponsors

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S1768 (ACTIVE) - Details

See Assembly Version of this Bill:
A291
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Add §3114, Ins L
Versions Introduced in 2019-2020 Legislative Session:
S6297, A8165

S1768 (ACTIVE) - Summary

Relates to reducing pharmacy benefit manager costs; defines "pharmacy benefit manager".

S1768 (ACTIVE) - Sponsor Memo

S1768 (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1768
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             January 15, 2021
                                ___________
 
 Introduced by Sens. SKOUFIS, ADDABBO, HOYLMAN, MAY, RIVERA -- read twice
   and ordered printed, and when printed to be committed to the Committee
   on Insurance
 
 AN  ACT  to  amend  the  insurance law, in relation to reducing pharmacy
   benefit manager costs
 
   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 3114
 to read as follows:
   § 3114. PHARMACY BENEFIT MANAGEMENT  SERVICES.  (A)  ANY  CONTRACT  OR
 OTHER  ARRANGEMENT  ENTERED  INTO  BY  A  HEALTH INSURER OFFERING HEALTH
 INSURANCE UNDER ARTICLE THIRTY-TWO OR FORTY-THREE OF  THIS  CHAPTER  FOR
 THE PROVISION AND ADMINISTRATION OF PHARMACY BENEFIT MANAGEMENT SERVICES
 SHALL BE BASED ON A PASS-THROUGH PRICING MODEL AND INCLUDE THE FOLLOWING
 REQUIREMENTS:
   (1)  PAYMENT  TO  THE  PHARMACY  BENEFIT  MANAGER FOR PHARMACY BENEFIT
 MANAGEMENT SERVICES SHALL BE LIMITED TO  THE  ACTUAL  INGREDIENT  COSTS,
 DISPENSING  FEES  PAID  TO  PHARMACIES,  AND  AN ADMINISTRATIVE FEE THAT
 COVERS THE COST OF PROVIDING PHARMACY BENEFIT MANAGEMENT SERVICES PURSU-
 ANT TO A CONTRACT DESCRIBED  IN  THIS  SUBSECTION.  THE  DEPARTMENT  MAY
 ESTABLISH A MAXIMUM ADMINISTRATIVE FEE;
   (2)  THE  PHARMACY  BENEFIT  MANAGER  SHALL  IDENTIFY  ALL SOURCES AND
 AMOUNTS OF INCOME, PAYMENTS, AND  FINANCIAL  BENEFITS  TO  THE  PHARMACY
 BENEFIT  MANAGER RELATED TO THE PROVISION AND ADMINISTRATION OF PHARMACY
 BENEFIT MANAGEMENT SERVICES ON BEHALF OF THE HEALTH CARE  PLAN,  INCLUD-
 ING,  BUT  NOT  LIMITED  TO, ANY PRICING DISCOUNTS, REBATES OF ANY KIND,
 INFLATIONARY PAYMENTS, CREDITS, CLAWBACKS,  FEES,  GRANTS,  CHARGEBACKS,
 REIMBURSEMENTS,  OR  OTHER BENEFITS AND SHALL ENSURE THAT ANY PORTION OF
 SUCH INCOME, PAYMENTS, AND FINANCIAL BENEFITS IS PASSED THROUGH  TO  THE
 HEALTH CARE PLAN IN FULL TO REDUCE THE REPORTABLE INGREDIENT COST;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01685-01-1

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