senate Bill S5299A

2021-2022 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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Sponsored By

Current Bill Status Via A1741 - 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 (19)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
May 24, 2022 returned to assembly
passed senate
3rd reading cal.762
substituted for s5299a
May 24, 2022 substituted by a1741a
May 05, 2022 amended on third reading 5299a
Apr 27, 2022 advanced to third reading
Apr 26, 2022 2nd report cal.
Apr 25, 2022 1st report cal.762
Jan 05, 2022 referred to insurance
returned to senate
died in assembly
May 12, 2021 referred to insurance
delivered to assembly
passed senate
Mar 18, 2021 advanced to third reading
Mar 17, 2021 2nd report cal.
Mar 16, 2021 1st report cal.576
Mar 01, 2021 referred to insurance

Votes

view votes

Apr 25, 2022 - Insurance committee Vote

S5299
10
0
committee
10
Aye
0
Nay
1
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show committee vote details

Committee Vote: Apr 25, 2022

aye wr (1)

Mar 16, 2021 - Insurance committee Vote

S5299
9
0
committee
9
Aye
0
Nay
2
Aye with Reservations
0
Absent
0
Excused
0
Abstained
show committee vote details

Committee Vote: Mar 16, 2021

aye wr (2)

Co-Sponsors

view additional co-sponsors

S5299 - Details

See Assembly Version of this Bill:
A1741
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2019-2020 Legislative Session:
S6303, A8246

S5299 - 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.

S5299 - Sponsor Memo

S5299 - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5299
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                               March 1, 2021
                                ___________
 
 Introduced  by  Sen.  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 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.
                                                            LBD00472-01-1

Co-Sponsors

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S5299A (ACTIVE) - Details

See Assembly Version of this Bill:
A1741
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2019-2020 Legislative Session:
S6303, A8246

S5299A (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.

S5299A (ACTIVE) - Sponsor Memo

S5299A (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  5299--A
     Cal. No. 762
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                               March 1, 2021
                                ___________
 
 Introduced  by  Sens.  RIVERA, ADDABBO, AKSHAR, BROOKS, COONEY, HOYLMAN,
   JACKSON, KENNEDY, KRUEGER, SALAZAR, SKOUFIS -- read twice and  ordered
   printed,  and  when printed to be committed to the Committee on Insur-
   ance -- recommitted to the Committee on Insurance in  accordance  with
   Senate  Rule  6,  sec.  8  --  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, 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 37 to read as follows:
   (37)  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.    IF  UNDER FEDERAL LAW, APPLICATION OF THIS
 REQUIREMENT WOULD RESULT IN HEALTH SAVINGS ACCOUNT  INELIGIBILITY  UNDER
 26 USC 223, THIS REQUIREMENT SHALL APPLY FOR HEALTH SAVINGS ACCOUNT-QUA-
 LIFIED  HIGH  DEDUCTIBLE  HEALTH PLANS WITH RESPECT TO THE DEDUCTIBLE OF
 SUCH A PLAN AFTER THE ENROLLEE  HAS  SATISFIED  THE  MINIMUM  DEDUCTIBLE
 UNDER  26 USC 223, EXCEPT FOR WITH RESPECT TO ITEMS OR SERVICES THAT ARE
 PREVENTIVE CARE PURSUANT TO 26  USC  223(C)(2)(C),  IN  WHICH  CASE  THE
 REQUIREMENTS  OF  THIS  PARAGRAPH  SHALL APPLY REGARDLESS OF WHETHER THE
 MINIMUM DEDUCTIBLE UNDER 26 USC 223 HAS BEEN SATISFIED.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

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