Bill Text: NY A10575 | 2023-2024 | General Assembly | Introduced

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Bill Title: Requires state contracts for the services of pharmacy benefit managers under health insurance plans for state officers and employees to be procured pursuant to a reverse auction process.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-06-20 - referred to governmental operations [A10575 Detail]

Download: New_York-2023-A10575-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          10575

                   IN ASSEMBLY

                                      June 20, 2024
                                       ___________

        Introduced by COMMITTEE ON RULES -- (at request of M. of A. Rajkumar) --
          read once and referred to the Committee on Governmental Operations

        AN  ACT  to  amend the civil service law, in relation to state contracts
          for the services of pharmacy benefit managers under  health  insurance
          plans for state officers and employees

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

     1    Section 1. The civil service law is amended by adding  a  new  section
     2  162-a to read as follows:
     3    §   162-a.  Procurement  of  pharmacy  benefit  manager  services.  1.
     4  Notwithstanding the provisions of this article or article eleven of  the
     5  state  finance  law,  if  the state enters into a private contract for a
     6  pharmacy benefits manager, the president shall procure and enter into  a
     7  contract  for  the services of a pharmacy benefits manager in connection
     8  with health insurance benefits under this article in accordance  with  a
     9  reverse auction process as provided for in this section, and pursuant to
    10  rules  and  regulations to be promulgated by the president, in consulta-
    11  tion with the state comptroller.
    12    2. In consultation with the technology platform vendor selected  under
    13  subdivision  six  of this section, the president shall specify the terms
    14  of a participant bidding agreement that all bidders  must  accept  as  a
    15  prerequisite  for  participation in the reverse auction process, includ-
    16  ing:
    17    (a) common definitions;
    18    (b) prescription drug classifications;
    19    (c) retail pricing rules, including maximum allowable cost price lists
    20  and dispensing fees; and
    21    (d) any other contract terms the president deems necessary to  further
    22  the purpose of this section.
    23    3.  A  pharmacy  benefit  manager who submits a bid under this section
    24  shall provide the president access  to  complete  pharmacy  claims  data
    25  necessary  for the president to conduct the reverse auction and to carry
    26  out administrative and management duties.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13942-02-4
        A. 10575                            2

     1    4. The terms of a contract entered into under this section  shall  not
     2  be  modified by the pharmacy benefit manager except with the approval of
     3  the president.
     4    5. The president may structure the contract awarded under this section
     5  to  pay  the  cost of the technology platform and the associated profes-
     6  sional services contracted for under this section by assessing a fee per
     7  prescription to be paid directly by the pharmacy benefit manager to  the
     8  technology platform vendor.
     9    6.  At least three months before the reverse auction process is sched-
    10  uled to be completed, the president shall procure through a  competitive
    11  bidding  process  a  contract  with a professional services vendor for a
    12  technology platform and any associated professional  services  necessary
    13  to  operate  the  platform to evaluate the qualifications of prospective
    14  pharmacy benefit  manager  bidders  for  the  pharmacy  benefit  manager
    15  procurement  and host and conduct an online automated reverse auction as
    16  required by this section.
    17    7. For the purposes of this section:
    18    (a) "Pharmacy benefit manager" shall have  the  same  meaning  as  set
    19  forth in section two hundred eighty-a of the public health law; and
    20    (b)  "Reverse  auction"  means  an automated bidding process conducted
    21  online that starts with an opening price and allows qualified bidders to
    22  counteroffer a lower price for multiple rounds of bidding.
    23    § 2. This act shall take effect immediately.