Bill Text: NY S06489 | 2019-2020 | General Assembly | Introduced


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 1-0)

Status: (Introduced) 2019-06-13 - REFERRED TO RULES [S06489 Detail]

Download: New_York-2019-S06489-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                          6489

                               2019-2020 Regular Sessions

                    IN SENATE

                                      June 13, 2019
                                       ___________

        Introduced  by  Sen. JACKSON -- read twice and ordered printed, and when
          printed to be committed to the Committee on Rules

        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

        S. 6489                             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.
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