Bill Text: NY S07768 | 2023-2024 | General Assembly | Introduced

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Bill Title: Relates to prescription drug formulary coverage for interchangeable biologics and biosimilars.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-01-03 - REFERRED TO INSURANCE [S07768 Detail]

Download: New_York-2023-S07768-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7768

                               2023-2024 Regular Sessions

                    IN SENATE

                                    November 27, 2023
                                       ___________

        Introduced  by  Sen. HINCHEY -- 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  prescription  drug
          formulary coverage for interchangeable biologics and biosimilars

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

     1    Section 1.  Paragraph 4 of subsection (c-1) of  section  4903  of  the
     2  insurance  law,  as added by chapter 512 of the laws of 2016, is amended
     3  to read as follows:
     4    (4) The insured is stable on a prescription drug or drugs selected  by
     5  their health care professional for the medical condition under consider-
     6  ation,  provided  that this shall not prevent a utilization review agent
     7  from requiring an insured to try  an  AB-rated  generic  equivalent,  an
     8  interchangeable  biological  product  , or biosimilar prior to providing
     9  coverage for the equivalent brand name prescription drug or drugs; or
    10    § 2. Subparagraph (A) of paragraph 3 of subsection (c) of section 3242
    11  of the insurance law, as added by chapter 99 of the  laws  of  2022,  is
    12  amended to read as follows:
    13    (A)  An  insurer  with  a formulary that includes two or more tiers of
    14  benefits providing for different deductibles, copayments or  coinsurance
    15  applicable  to  prescription  drugs in each tier may move a prescription
    16  drug to a tier with a larger deductible, copayment or coinsurance if  an
    17  AB-rated generic equivalent [or], an interchangeable biological product,
    18  or  biosimilar  for  such prescription drug is added to the formulary at
    19  the same time.
    20    § 3.  Subparagraph (A) of paragraph 3 of  subsection  (c)  of  section
    21  4329  of  the insurance law, as added by chapter 99 of the laws of 2022,
    22  is amended to read as follows:
    23    (A) A corporation with a formulary that includes two or more tiers  of
    24  benefits  providing for different deductibles, copayments or coinsurance
    25  applicable to prescription drugs in each tier may  move  a  prescription

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11861-01-3
        S. 7768                             2

     1  drug  to a tier with a larger deductible, copayment or coinsurance if an
     2  AB-rated generic equivalent [or], an interchangeable biological product,
     3  or biosimilar for such prescription drug is added to  the  formulary  at
     4  the same time.
     5    § 4.  This act shall take effect immediately.