Bill Text: NY S05299 | 2021-2022 | General Assembly | Introduced

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

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Bill Title: Requires any third-party payments, financial assistance, discount, voucher or other price reduction instrument for out-of-pocket expenses made on behalf of an insured individual for the cost of prescription drugs to be applied to the insured's deductible, copayment, coinsurance, out-of-pocket maximum, or any other cost-sharing requirement when calculating such insured individual's overall contribution to any out-of-pocket maximum or any cost-sharing requirement.

Spectrum: Strong Partisan Bill (Democrat 14-1)

Status: (Engrossed - Dead) 2022-05-24 - SUBSTITUTED BY A1741A [S05299 Detail]

Download: New_York-2021-S05299-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          5299

                               2021-2022 Regular Sessions

                    IN SENATE

                                      March 1, 2021
                                       ___________

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

        AN ACT to amend the insurance law, in relation to calculating an insured
          individual's overall contribution to any out-of-pocket maximum or  any
          cost-sharing requirement

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

     1    Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
     2  amended by adding a new paragraph 36 to read as follows:
     3    (36)  Any  policy  that provides coverage for prescription drugs shall
     4  apply any third-party payments, financial assistance, discount,  voucher
     5  or  other  price reduction instrument for out-of-pocket expenses made on
     6  behalf of an insured individual for the cost of  prescription  drugs  to
     7  the insured's deductible, copayment, coinsurance, out-of-pocket maximum,
     8  or  any  other  cost-sharing  requirement  when calculating such insured
     9  individual's overall contribution to any out-of-pocket  maximum  or  any
    10  cost-sharing requirement.
    11    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    12  adding a new paragraph 21 to read as follows:
    13    (21) Every group or blanket policy delivered or issued for delivery in
    14  this state that provides coverage for prescription drugs shall apply any
    15  third-party  payments,  financial assistance, discount, voucher or other
    16  price reduction instrument for out-of-pocket expenses made on behalf  of
    17  an  insured  individual  for  the  cost  of  prescription  drugs  to the
    18  insured's deductible, copayment, coinsurance, out-of-pocket maximum,  or
    19  any  other  cost-sharing requirement when calculating such insured indi-
    20  vidual's overall contribution to any out-of-pocket maximum or any  cost-
    21  sharing requirement.
    22    §  3.  Section  4303  of  the insurance law is amended by adding a new
    23  subsection (ss) to read as follows:

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00472-01-1
        S. 5299                             2

     1    (ss) Every contract issued by a medical expense indemnity corporation,
     2  hospital  service  corporation,  or  health  service  corporation   that
     3  provides  coverage  for  prescription  drugs shall apply any third-party
     4  payments,  financial  assistance,  discount,  voucher  or  other   price
     5  reduction  instrument  for  out-of-pocket  expenses made on behalf of an
     6  insured individual for the cost of prescription drugs to  the  insured's
     7  deductible,  copayment, coinsurance, out-of-pocket maximum, or any other
     8  cost-sharing requirement  when  calculating  such  insured  individual's
     9  overall  contribution  to  any out-of-pocket maximum or any cost-sharing
    10  requirement.
    11    § 4. This act shall take effect on the first of January next  succeed-
    12  ing  the date on which it shall have become a law and shall apply to all
    13  policies and contracts issued, renewed, modified, altered or amended  on
    14  or after such date.