Bill Text: NY A00663 | 2021-2022 | General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Requires certain manufacturers of prescription drugs to notify the drug utilization review board of the proposed increase of the wholesale acquisition cost of such prescription drugs.

Spectrum: Strong Partisan Bill (Democrat 12-1)

Status: (Introduced - Dead) 2022-05-19 - print number 663b [A00663 Detail]

Download: New_York-2021-A00663-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         663--A

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                       (Prefiled)

                                     January 6, 2021
                                       ___________

        Introduced   by  M.  of  A.  D. ROSENTHAL,  DICKENS,  COLTON,  WILLIAMS,
          SEAWRIGHT, COOK, O'DONNELL,  SIMON,  ABINANTI,  JACOBSON,  GRIFFIN  --
          Multi-Sponsored  by -- M. of A. GALEF, SALKA -- read once and referred
          to the Committee on Health -- recommitted to the Committee  on  Health
          in  accordance  with  Assembly Rule 3, sec. 2 -- committee discharged,
          bill amended, ordered reprinted as amended  and  recommitted  to  said
          committee

        AN  ACT  to  amend  the  insurance law, in relation to requiring certain
          manufacturers of prescription drugs to notify  the  superintendant  of
          any  proposed  increase  of  the  wholesale  acquisition  cost of such
          prescription drugs

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

     1    Section  1. The insurance law is amended by adding a new section 111-a
     2  to read as follows:
     3    § 111-a. Notification of prescription drug price increases by manufac-
     4  turers. (a) This section shall apply to a manufacturer of a prescription
     5  drug that is purchased or reimbursed in this state by any of the follow-
     6  ing:
     7    (1) An insurance company authorized in this state  to  write  accident
     8  and  health  insurance,  a  company organized pursuant to article forty-
     9  three of this chapter,  a  municipal  cooperative  health  benefit  plan
    10  established  pursuant  to article forty-seven of this chapter, an organ-
    11  ization certified pursuant to article forty-four of  the  public  health
    12  law,  an  institution  of higher education certified pursuant to section
    13  one thousand one hundred twenty-four of this chapter, or  the  New  York
    14  state  health  insurance  plan established pursuant to article eleven of
    15  the civil service law; or
    16    (2) A pharmacy benefit manager, including an entity that  directly  or
    17  through an intermediary, manages the prescription drug coverage provided

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05130-03-2
        A. 663--A                           2

     1  by  a  health insurer under a contract or policy delivered or issued for
     2  delivery in this state or a health plan subject to section three hundred
     3  sixty-four-j of the social services law, including  the  processing  and
     4  payment of claims for prescription drugs, the performance of drug utili-
     5  zation  review, the processing of drug prior authorization requests, the
     6  adjudication of appeals  or  grievances  related  to  prescription  drug
     7  coverage,  contracting with network pharmacies, and controlling the cost
     8  of covered prescription drugs.
     9    (b) (1) A manufacturer of a prescription drug with a wholesale  acqui-
    10  sition  cost  of  more  than forty dollars for a course of therapy shall
    11  notify the superintendent, his or her deputy or other officer designated
    12  by the superintendent, if the increase in the wholesale acquisition cost
    13  of such prescription drug  is  more  than  ten  percent,  including  the
    14  proposed  increase and the cumulative increases that occurred within the
    15  previous twelve months prior to the current year. For purposes  of  this
    16  section, a "course of therapy" is defined as either of the following:
    17    (i) the recommended daily dosage units of a prescription drug pursuant
    18  to its prescribing label as approved by the federal Food and Drug Admin-
    19  istration for thirty days; or
    20    (ii)  the recommended daily dosage units of a prescription drug pursu-
    21  ant to its prescribing label as approved by the federal  Food  and  Drug
    22  Administration for a normal course of treatment that is less than thirty
    23  days.
    24    (2)  (i) The notice required by paragraph (1) of this subsection shall
    25  be provided in writing to the superintendent at least sixty  days  prior
    26  to the planned effective date of the increase.
    27    (ii) The superintendent shall forthwith publish the notice required by
    28  paragraph  (a)  of  this  subdivision  on  the  department  of financial
    29  services website within five days of its receipt.
    30    (3) (i) The notice required by paragraph (1) of this subsection  shall
    31  include the date of the increase, the current wholesale acquisition cost
    32  of  the  prescription drug, and the dollar amount of the future increase
    33  in the wholesale acquisition cost of the prescription drug.
    34    (ii) The notice required by paragraph (1)  of  this  subsection  shall
    35  include  a  statement  regarding  whether a change or improvement in the
    36  drug necessitates the price increase.  If  so,  the  manufacturer  shall
    37  describe the change or improvement.
    38    (4)  The  superintendent  shall  determine  the confidentiality of any
    39  supporting documentation a manufacturer designates as a trade secret and
    40  that such manufacturer may submit with the required notice. Should  such
    41  supporting  documentation  be deemed confidential by the superintendent,
    42  the supporting documentation shall not be subject to  disclosure  except
    43  where  and  as  the  superintendent determines that disclosure is in the
    44  public interest.
    45    (5) In the event that a manufacturer of a prescription drug subject to
    46  this section does not report the information required in  paragraph  (1)
    47  of  this  subsection,  the  superintendent  is  authorized to impose any
    48  penalty or remedy authorized by this chapter, after notice and  a  hear-
    49  ing, against such manufacturer of up to ten thousand dollars per day for
    50  every  day after the reporting period described in this section that the
    51  required information is not reported.
    52    § 2. This act shall take effect immediately.