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 - Dead) 2020-01-08 - REFERRED TO INSURANCE [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. LBD13316-01-9S. 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.
