Bill Text: NY S02541 | 2017-2018 | General Assembly | Introduced

New York Senate Bill 2541 (Prior Session Legislation)

Introduced

Bill Title: Prohibits the imposition of a charge for a prescription drug, upon a person having health insurance, which exceeds the negotiated reimbursement rate by the insurer or pharmacy benefit manager and paid to the drug company.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2018-01-03 - REFERRED TO HEALTH [S02541 Detail]

Download: New_York-2017-S02541-Introduced.html

                STATE OF NEW YORK
        ________________________________________________________________________
                                          2541
                               2017-2018 Regular Sessions
                    IN SENATE
                                    January 13, 2017
                                       ___________
        Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health
        AN ACT to amend the public health law and the insurance law, in relation
          to contracts between pharmacy benefit managers and health insurers  to
          protect consumers
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Section 280-a of the public health law is amended by adding
     2  a new subdivision 3 to read as follows:
     3    3. A pharmacy benefit manager shall, with respect to contracts between
     4  the pharmacy benefit manager and an insurer, ensure a prescription  drug
     5  consumer  is  not charged, through either a co-pay or deductible, a cost
     6  that is higher than the negotiated reimbursement rate for the drug, less
     7  any rebate collected.
     8    § 2. Section 4406-c of the public health law is amended  by  adding  a
     9  new subdivision 9 to read as follows:
    10     9.  No  health  maintenance organization shall require an enrollee to
    11  pay a cost higher than the health maintenance  organization's  or  their
    12  pharmacy   benefit   manager's   negotiated  reimbursement  rate  for  a
    13  prescription drug, less any rebates collected.   Any co-payment  charged
    14  under  the  contract  shall also be based upon the negotiated rate, less
    15  any rebate collected.
    16    § 3. Section 3217-b of the insurance law is amended by  adding  a  new
    17  subsection (k) to read as follows:
    18    (k)  No insurer shall require an insured to pay a cost higher than the
    19  insurer's or their pharmacy benefit manager's  negotiated  reimbursement
    20  rate for a prescription drug, less any rebates collected. Any co-payment
    21  charged  under  the policy shall also be based upon the negotiated rate,
    22  less any rebate collected.
    23    § 4. Section 4325 of the insurance law is  amended  by  adding  a  new
    24  subsection (1) to read as follows:
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD06850-02-7

        S. 2541                             2
     1    (1)  No  corporation  organized  under  this  article  shall require a
     2  covered person to pay a cost higher  than  the  corporation's  or  their
     3  pharmacy   benefit   manager's   negotiated  reimbursement  rate  for  a
     4  prescription drug, less any rebates collected.  Any  co-payment  charged
     5  under  the  contract  shall also be based upon the negotiated rate, less
     6  any rebate collected.
     7    § 5. This act shall take effect on the first of January next  succeed-
     8  ing the date on which it shall have become a law.