Bill Text: NY A01962 | 2023-2024 | General Assembly | Introduced

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

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Bill Title: Requires certain health insurance issuers to certify that at least a majority of prescription drug rebates are provided to patients at the point of sale.

Spectrum: Partisan Bill (Democrat 18-0)

Status: (Introduced) 2024-02-06 - print number 1962a [A01962 Detail]

Download: New_York-2023-A01962-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          1962

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                    January 23, 2023
                                       ___________

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

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05427-02-3
        A. 1962                             2

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