Assembly Bill A2317C

2017-2018 Legislative Session

Relates to prescription drug formulary changes during a contract year

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Archive: Last Bill Status - In Senate Committee Insurance Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Bill Amendments

co-Sponsors

multi-Sponsors

2017-A2317 - Details

See Senate Version of this Bill:
S5022
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:
2015-2016: A7707, S5382
2019-2020: A2969, S2849

2017-A2317 - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

2017-A2317 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2317
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2017
                                ___________
 
 Introduced  by M. of A. PEOPLES-STOKES, HARRIS -- read once and referred
   to the Committee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  prescription  drug
   formulary changes during a contract year
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. The insurance law is amended by adding a new  section  4909
 to read as follows:
   §  4909.  PRESCRIPTION  DRUG FORMULARY CHANGES. (A) A HEALTH CARE PLAN
 REQUIRED TO PROVIDE ESSENTIAL  HEALTH  BENEFITS  SHALL  NOT,  EXCEPT  AS
 OTHERWISE   PROVIDED  IN  SUBSECTION  (B)  OF  THIS  SECTION,  REMOVE  A
 PRESCRIPTION DRUG FROM A FORMULARY:
   (I) IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF BENEFITS  PROVIDING
 FOR  DIFFERENT  DEDUCTIBLES, COPAYMENTS OR COINSURANCE APPLICABLE TO THE
 PRESCRIPTION DRUGS IN EACH TIER, MOVE A DRUG TO A  TIER  WITH  A  LARGER
 DEDUCTIBLE, COPAYMENT OR COINSURANCE, OR
   (II)  ADD  UTILIZATION  MANAGEMENT  RESTRICTIONS  TO A FORMULARY DRUG,
 UNLESS SUCH CHANGES OCCUR AT THE  TIME  OF  ENROLLMENT  OR  ISSUANCE  OF
 COVERAGE.    SUCH PROHIBITION SHALL APPLY BEGINNING ON THE DATE ON WHICH
 OPEN ENROLLMENT BEGINS FOR A PLAN YEAR AND THROUGH THE END OF  THE  PLAN
 YEAR TO WHICH SUCH OPEN ENROLLMENT PERIOD APPLIES.
   (B)  (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR MORE
 TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCTIBLES,  COPAYMENTS  OR
 COINSURANCE  APPLICABLE  TO  PRESCRIPTION  DRUGS IN EACH TIER MAY MOVE A
 PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCIBLE, COPAYMENT OR  COIN-
 SURANCE  IF AN AB-RATED GENERIC DRUG FOR SUCH PRESCRIPTION DRUG IS ADDED
 TO THE FORMULARY AT THE SAME TIME.
   (II) A HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM  A  FORMU-
 LARY  IF  THE  FEDERAL FOOD AND DRUG ADMINISTRATION DETERMINES THAT SUCH
 DRUG SHOULD BE REMOVED FROM THE MARKET.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05529-01-7
              

co-Sponsors

multi-Sponsors

2017-A2317A - Details

See Senate Version of this Bill:
S5022
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:
2015-2016: A7707, S5382
2019-2020: A2969, S2849

2017-A2317A - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

2017-A2317A - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2317--A
                                                         Cal. No. 390
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2017
                                ___________
 
 Introduced  by  M. of A. PEOPLES-STOKES, HARRIS, SKOUFIS, BARRETT, NIOU,
   ORTIZ -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT -- read  once  and
   referred  to  the  Committee  on Insurance -- reported from committee,
   advanced to a third reading, amended and ordered reprinted,  retaining
   its place on the order of third reading
 
 AN ACT to amend the insurance law and the public health law, in relation
   to prescription drug formulary changes during a contract year
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The insurance law is amended by adding a new  section  4909
 to read as follows:
   §  4909.  PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT AS OTHERWISE
 PROVIDED IN SUBSECTION (C) OF THIS SECTION, A  HEALTH  CARE  PLAN  SHALL
 NOT:
   (I)  REMOVE  A  PRESCRIPTION  DRUG  FROM  A FORMULARY IF THE FORMULARY
 INCLUDES TWO OR MORE TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCT-
 IBLES, COPAYMENTS OR COINSURANCE APPLICABLE TO THE PRESCRIPTION DRUGS IN
 EACH  TIER, MOVE A DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR
 COINSURANCE; OR
   (II) ADD UTILIZATION MANAGEMENT  RESTRICTIONS  TO  A  FORMULARY  DRUG,
 UNLESS  SUCH  CHANGES  OCCUR  AT  THE  TIME OF ENROLLMENT OR ISSUANCE OF
 COVERAGE.
   (B) PROHIBITIONS PROVIDED IN SUBSECTION  (A)  OF  THIS  SECTION  SHALL
 APPLY  BEGINNING  ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR A PLAN
 YEAR AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN  ENROLLMENT
 PERIOD APPLIES.
   (C)  (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR MORE
 TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCTIBLES,  COPAYMENTS  OR
 COINSURANCE  APPLICABLE  TO  PRESCRIPTION  DRUGS IN EACH TIER MAY MOVE A
 PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCIBLE, COPAYMENT OR  COIN-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

co-Sponsors

multi-Sponsors

2017-A2317B - Details

See Senate Version of this Bill:
S5022
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:
2015-2016: A7707, S5382
2019-2020: A2969, S2849

2017-A2317B - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

2017-A2317B - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2317--B
                                                         Cal. No. 171
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2017
                                ___________
 
 Introduced  by  M. of A. PEOPLES-STOKES, HARRIS, SKOUFIS, BARRETT, NIOU,
   ORTIZ, SEPULVEDA, GALEF, ABINANTI, LAVINE -- Multi-Sponsored by --  M.
   of  A.  ENGLEBRIGHT, HEVESI -- read once and referred to the Committee
   on Insurance -- reported from committee, advanced to a third  reading,
   amended  and  ordered  reprinted,  retaining its place on the order of
   third reading -- ordered to  a  third  reading,  amended  and  ordered
   reprinted, retaining its place on the order of third reading
 
 AN ACT to amend the insurance law and the public health law, in relation
   to prescription drug formulary changes during a contract year
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The insurance law is amended by adding a new  section  4909
 to read as follows:
   §  4909.  PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT AS OTHERWISE
 PROVIDED IN SUBSECTION (C) OF THIS SECTION, A  HEALTH  CARE  PLAN  SHALL
 NOT:
   (I) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
   (II)  MOVE  A  PRESCRIPTION  DRUG  TO A TIER WITH A LARGER DEDUCTIBLE,
 COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
 BENEFITS PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR  COINSURANCE
 APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
   (III)  ADD  UTILIZATION MANAGEMENT RESTRICTIONS TO A PRESCRIPTION DRUG
 ON A FORMULARY, UNLESS SUCH CHANGES OCCUR AT THE TIME OF  ENROLLMENT  OR
 ISSUANCE OF COVERAGE.
   (B)  PROHIBITIONS  PROVIDED  IN  SUBSECTION  (A) OF THIS SECTION SHALL
 APPLY BEGINNING ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR  A  PLAN
 YEAR  AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN ENROLLMENT
 PERIOD APPLIES.
   (C) (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR  MORE
 TIERS  OF  BENEFITS  PROVIDING  FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR
 COINSURANCE APPLICABLE TO PRESCRIPTION DRUGS IN EACH  TIER  MAY  MOVE  A
 PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR COIN-
 SURANCE  IF AN AB-RATED GENERIC EQUIVALENT FOR SUCH PRESCRIPTION DRUG IS
              

co-Sponsors

multi-Sponsors

2017-A2317C (ACTIVE) - Details

See Senate Version of this Bill:
S5022
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in Other Legislative Sessions:
2015-2016: A7707, S5382
2019-2020: A2969, S2849

2017-A2317C (ACTIVE) - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

2017-A2317C (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2317--C
                                                         Cal. No. 171
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2017
                                ___________
 
 Introduced  by  M.  of A. PEOPLES-STOKES, SKOUFIS, BARRETT, NIOU, ORTIZ,
   SEPULVEDA,  GALEF,  ABINANTI,  LAVINE,  COLTON,  JEAN-PIERRE,  TAYLOR,
   BYRNE,  WEPRIN  -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT, HEVESI,
   RA -- read once and referred to the Committee on Insurance -- reported
   from committee, advanced to  a  third  reading,  amended  and  ordered
   reprinted,  retaining  its  place  on  the  order  of third reading --
   ordered to a third reading, amended and ordered  reprinted,  retaining
   its  place  on  the  order  of third reading -- passed by Assembly and
   delivered to the Senate, recalled from the Senate, vote  reconsidered,
   bill  amended,  ordered reprinted, retaining its place on the order of
   third reading
 
 AN ACT to amend the insurance law and the public health law, in relation
   to prescription drug formulary changes during a contract year
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The insurance law is amended by adding a new section 4909
 to read as follows:
   § 4909. PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT  AS  OTHERWISE
 PROVIDED  IN  SUBSECTION  (C)  OF THIS SECTION, A HEALTH CARE PLAN SHALL
 NOT:
   (I) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
   (II) MOVE A PRESCRIPTION DRUG TO A  TIER  WITH  A  LARGER  DEDUCTIBLE,
 COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
 BENEFITS  PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR COINSURANCE
 APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
   (III) ADD UTILIZATION MANAGEMENT RESTRICTIONS TO A  PRESCRIPTION  DRUG
 ON  A  FORMULARY, UNLESS SUCH CHANGES OCCUR AT THE TIME OF ENROLLMENT OR
 ISSUANCE OF COVERAGE.
   (B) PROHIBITIONS PROVIDED IN SUBSECTION  (A)  OF  THIS  SECTION  SHALL
 APPLY  BEGINNING  ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR A PLAN
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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