Assembly Bill A3554

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3554
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 28, 2025
                                ___________
 
 Introduced by M. of A. RAJKUMAR -- read once and referred to the Commit-
   tee on Governmental Operations
 
 AN  ACT  to  amend the civil service law, in relation to state contracts
   for the services of pharmacy benefit managers under  health  insurance
   plans for state officers and employees

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The civil service law is amended by adding  a  new  section
 162-a to read as follows:
   §   162-A.  PROCUREMENT  OF  PHARMACY  BENEFIT  MANAGER  SERVICES.  1.
 NOTWITHSTANDING THE PROVISIONS OF THIS ARTICLE OR ARTICLE ELEVEN OF  THE
 STATE  FINANCE  LAW,  IF  THE STATE ENTERS INTO A PRIVATE CONTRACT FOR A
 PHARMACY BENEFITS MANAGER, THE PRESIDENT SHALL PROCURE AND ENTER INTO  A
 CONTRACT  FOR  THE SERVICES OF A PHARMACY BENEFITS MANAGER IN CONNECTION
 WITH HEALTH INSURANCE BENEFITS UNDER THIS ARTICLE IN ACCORDANCE  WITH  A
 REVERSE AUCTION PROCESS AS PROVIDED FOR IN THIS SECTION, AND PURSUANT TO
 RULES  AND  REGULATIONS TO BE PROMULGATED BY THE PRESIDENT, IN CONSULTA-
 TION WITH THE STATE COMPTROLLER.
   2. IN CONSULTATION WITH THE TECHNOLOGY PLATFORM VENDOR SELECTED  UNDER
 SUBDIVISION  SIX  OF THIS SECTION, THE PRESIDENT SHALL SPECIFY THE TERMS
 OF A PARTICIPANT BIDDING AGREEMENT THAT ALL BIDDERS  MUST  ACCEPT  AS  A
 PREREQUISITE  FOR  PARTICIPATION IN THE REVERSE AUCTION PROCESS, INCLUD-
 ING:
   (A) COMMON DEFINITIONS;
   (B) PRESCRIPTION DRUG CLASSIFICATIONS;
   (C) RETAIL PRICING RULES, INCLUDING MAXIMUM ALLOWABLE COST PRICE LISTS
 AND DISPENSING FEES; AND
   (D) ANY OTHER CONTRACT TERMS THE PRESIDENT DEEMS NECESSARY TO  FURTHER
 THE PURPOSE OF THIS SECTION.
   3.  A  PHARMACY  BENEFIT  MANAGER WHO SUBMITS A BID UNDER THIS SECTION
 SHALL PROVIDE THE PRESIDENT ACCESS  TO  COMPLETE  PHARMACY  CLAIMS  DATA
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07473-01-5
              

 A. 3554                             2
 
 NECESSARY  FOR THE PRESIDENT TO CONDUCT THE REVERSE AUCTION AND TO CARRY
 OUT ADMINISTRATIVE AND MANAGEMENT DUTIES.
   4.  THE  TERMS OF A CONTRACT ENTERED INTO UNDER THIS SECTION SHALL NOT
 BE MODIFIED BY THE PHARMACY BENEFIT MANAGER EXCEPT WITH THE APPROVAL  OF
 THE PRESIDENT.
   5. THE PRESIDENT MAY STRUCTURE THE CONTRACT AWARDED UNDER THIS SECTION
 TO  PAY  THE  COST OF THE TECHNOLOGY PLATFORM AND THE ASSOCIATED PROFES-
 SIONAL SERVICES CONTRACTED FOR UNDER THIS SECTION BY ASSESSING A FEE PER
 PRESCRIPTION TO BE PAID DIRECTLY BY THE PHARMACY BENEFIT MANAGER TO  THE
 TECHNOLOGY PLATFORM VENDOR.
   6.  AT LEAST THREE MONTHS BEFORE THE REVERSE AUCTION PROCESS IS SCHED-
 ULED TO BE COMPLETED, THE PRESIDENT SHALL PROCURE THROUGH A  COMPETITIVE
 BIDDING  PROCESS  A  CONTRACT  WITH A PROFESSIONAL SERVICES VENDOR FOR A
 TECHNOLOGY PLATFORM AND ANY ASSOCIATED PROFESSIONAL  SERVICES  NECESSARY
 TO  OPERATE  THE  PLATFORM TO EVALUATE THE QUALIFICATIONS OF PROSPECTIVE
 PHARMACY BENEFIT  MANAGER  BIDDERS  FOR  THE  PHARMACY  BENEFIT  MANAGER
 PROCUREMENT  AND HOST AND CONDUCT AN ONLINE AUTOMATED REVERSE AUCTION AS
 REQUIRED BY THIS SECTION.
   7. FOR THE PURPOSES OF THIS SECTION:
   (A) "PHARMACY BENEFIT MANAGER" SHALL HAVE  THE  SAME  MEANING  AS  SET
 FORTH IN SECTION TWO HUNDRED EIGHTY-A OF THE PUBLIC HEALTH LAW; AND
   (B)  "REVERSE  AUCTION"  MEANS  AN AUTOMATED BIDDING PROCESS CONDUCTED
 ONLINE THAT STARTS WITH AN OPENING PRICE AND ALLOWS QUALIFIED BIDDERS TO
 COUNTEROFFER A LOWER PRICE FOR MULTIPLE ROUNDS OF BIDDING.
   § 2. This act shall take effect immediately.