Bill Text: NY A08310 | 2019-2020 | General Assembly | Introduced

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Bill Title: Requires individual and small group insurance carriers and group and blanket accident and health carriers to certify that at least a majority of prescription drug rebates are provided to patients at the point of sale.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2020-01-08 - referred to insurance [A08310 Detail]

Download: New_York-2019-A08310-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          8310

                               2019-2020 Regular Sessions

                   IN ASSEMBLY

                                      June 13, 2019
                                       ___________

        Introduced by M. of A. WALKER -- read once and referred to the Committee
          on Insurance

        AN  ACT  to amend the insurance law, in relation to requiring individual
          and small group insurance carriers and group and blanket accident  and
          health  carriers  to  certify that at least a majority of prescription
          drug rebates are provided to patients at the point of sale

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Paragraph  1  of  subdivision  (e) of section 3231 of the
     2  insurance law is amended by adding a new subparagraph  (C)  to  read  as
     3  follows:
     4    (C)  an  insurer shall annually certify to the department that, during
     5  the prior benefit year, the insurer made available to enrollees  at  the
     6  point  of sale at least a majority (i.e., greater than fifty percent) of
     7  the rebates received by such insurer or any  third  party  administering
     8  prescription drug benefits on behalf of such insurer.
     9    (i) For purposes of this paragraph, "rebate" means:
    10    (1)  negotiated  price  concessions  including but not limited to base
    11  rebates and reasonable estimates of any  price  protection  rebates  and
    12  performance-based  rebates that may accrue directly or indirectly to the
    13  issuer during the coverage year from a manufacturer, dispensing  pharma-
    14  cy, or other party to the transaction, and
    15    (2)  reasonable  estimates  of any fees and other administrative costs
    16  that are passed through to the issuer and serve to reduce  the  issuer's
    17  prescription drug liabilities for the coverage year.
    18    (ii)  In providing the certification required under this subparagraph,
    19  an issuer shall not publish or otherwise  reveal  information  regarding
    20  the actual amount of rebates the issuer received on a product-, manufac-
    21  turer-  or  pharmacy-specific  basis. Such information is protected as a
    22  trade secret, is not a public record as defined in the  public  officers
    23  law  and shall not be disclosed directly or indirectly. An insurer shall

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13316-01-9
        A. 8310                             2

     1  impose the confidentiality protections of this subparagraph on any third
     2  parties or vendors with which it contracts  that  may  receive  or  have
     3  access to rebate information.
     4    §  2.  Subdivision (b) of section 3221 of the insurance law is amended
     5  to read as follows:
     6    (b) (1) No such policy shall be delivered or issued  for  delivery  in
     7  this  state  unless  a  schedule of the premium rates pertaining to such
     8  form shall have been filed with the superintendent.
     9    (2) An insurer shall annually certify to the department  that,  during
    10  the  prior  benefit year, the insurer made available to enrollees at the
    11  point of sale at least a majority (i.e., greater than fifty percent)  of
    12  the  rebates  received  by such insurer or any third party administering
    13  prescription drug benefits on behalf of such insurer.
    14    (A) For purposes of this paragraph, "rebate" means:
    15    (i) negotiated price concessions including but  not  limited  to  base
    16  rebates  and  reasonable  estimates  of any price protection rebates and
    17  performance-based rebates that may accrue directly or indirectly to  the
    18  issuer  during the coverage year from a manufacturer, dispensing pharma-
    19  cy, or other party to the transaction, and
    20    (ii) reasonable estimates of any fees and other  administrative  costs
    21  that  are  passed through to the issuer and serve to reduce the issuer's
    22  prescription drug liabilities for the coverage year.
    23    (B) In providing the certification required under this subdivision, an
    24  issuer shall not publish or otherwise reveal information  regarding  the
    25  actual  amount of rebates the issuer received on a product-, manufactur-
    26  er- or pharmacy-specific basis. Such information is protected as a trade
    27  secret, is not a public record as defined in the public officers law and
    28  shall not be disclosed directly or indirectly. An insurer  shall  impose
    29  the confidentiality protections of this subdivision on any third parties
    30  or  vendors  with  which it contracts that may receive or have access to
    31  rebate information.
    32    § 3. This act shall take effect immediately.