Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|
---|---|
Apr 17, 2018 |
print number 5022c |
Apr 17, 2018 |
amend and recommit to insurance |
Jan 18, 2018 |
print number 5022b |
Jan 18, 2018 |
amend and recommit to insurance |
Jan 03, 2018 |
referred to insurance |
Jun 14, 2017 |
print number 5022a |
Jun 14, 2017 |
amend (t) and recommit to insurance |
Mar 06, 2017 |
referred to insurance |
Senate Bill S5022C
2017-2018 Legislative Session
Sponsored By
(R, C, IP) Senate District
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
Actions
Bill Amendments
co-Sponsors
(R) Senate District
(R, C) 53rd Senate District
(D) Senate District
(R, C, G, IP, SC) Senate District
2017-S5022 - Details
2017-S5022 - Sponsor Memo
BILL NUMBER: S5022 TITLE OF BILL : An act to amend the insurance law, in relation to prescription drug formulary changes during a contract year PURPOSE : To clarify that health insurance consumers covered by plans that are required to offer essential health benefits under the affordable care act are protected from adverse effects of mid-year formulary changes. SUMMARY OF PROVISIONS : Section 1 creates a new section 4909 of the Insurance Law to state that a health care plan which provides essential health benefits under the federal affordable care act may not remove a prescription drug from a formulary during the enrollment year. If the plan's drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the enrollment year. The plan may also not add new or additional formulary restrictions during the enrollment year. A health care plan may move a prescription drug to a tier with a larger copayment, coinsurance and different deductible if an AB-rated generic equivalent drug is added to the formulary at the same time.
2017-S5022 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5022 2017-2018 Regular Sessions I N S E N A T E March 6, 2017 ___________ Introduced by Sens. SERINO, MURPHY -- 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 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
(D) Senate District
(R) Senate District
(R, C, IP) Senate District
(R, C) 53rd Senate District
2017-S5022A - Details
2017-S5022A - Sponsor Memo
BILL NUMBER: S5022A TITLE OF BILL : An act to amend the insurance law and the public health law, in relation to prescription drug formulary changes during a contract year PURPOSE : To clarify that health insurance consumers are protected from adverse effects of mid-year formulary changes. SUMMARY OF PROVISIONS : Section 1 creates a new section 4909 of the Insurance Law to add restrictions to drug formulary changes. If the plan's drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the enrollment year. Additionally, the plan may not add new utilization management restrictions to a formulary drug, unless such changes occur at the time of enrollment or issuance of coverage. A health care plan may move a prescription drug to a tier with a larger copayment, coinsurance and different deductible if an AB-rated generic equivalent drug is added to the formulary at the same time or if the federal Food and Drug Administration determines that such drug should be removed from the market, including new utilization management restrictions arising from
2017-S5022A - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5022--A 2017-2018 Regular Sessions I N S E N A T E March 6, 2017 ___________ Introduced by Sens. SERINO, CROCI, GRIFFO, LATIMER, MURPHY, SANDERS, SAVINO, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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. LBD05529-05-7
co-Sponsors
(D) Senate District
(D) Senate District
(D, WF) 46th Senate District
(D) Senate District
2017-S5022B - Details
2017-S5022B - Sponsor Memo
BILL NUMBER: S5022B SPONSOR: SERINO TITLE OF BILL: An act to amend the insurance law and the public health law, in relation to prescription drug formulary changes during a contract year PURPOSE: To clarify that health insurance consumers are protected from adverse effects of mid-year formulary changes. SUMMARY OF PROVISIONS: Section 1 creates a new section 4909 of the Insurance Law to add restrictions to drug formulary changes. If the plan's drug formulary has two or more tiers of drug benefits with different deductibles, copay- ments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the enrollment year. Additionally, the plan may not add new utilization management restrictions to a formulary drug,
2017-S5022B - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5022--B 2017-2018 Regular Sessions I N S E N A T E March 6, 2017 ___________ Introduced by Sens. SERINO, AVELLA, CROCI, GOLDEN, GRIFFO, KAMINSKY, KRUEGER, MURPHY, SANDERS, SAVINO, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Insur- ance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Insurance in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
co-Sponsors
(D) 15th Senate District
(R, C, IP, RFM) Senate District
(D) Senate District
(D) Senate District
2017-S5022C (ACTIVE) - Details
2017-S5022C (ACTIVE) - Sponsor Memo
BILL NUMBER: S5022C SPONSOR: SERINO TITLE OF BILL: An act to amend the insurance law and the public health law, in relation to prescription drug formulary changes during a contract year PURPOSE: To clarify that health insurance consumers are protected from adverse effects of mid-year formulary changes. SUMMARY OF PROVISIONS: Section 1 creates a new section 4909 of the Insurance Law to add restrictions to drug formulary changes. If the plan's drug formulary has two or more tiers of drug benefits with different deductibles, copay- ments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the enrollment year. Additionally, the plan may not add new utilization management restrictions to a formulary drug, unless such changes occur at the time of enrollment or issuance of
2017-S5022C (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5022--C 2017-2018 Regular Sessions I N S E N A T E March 6, 2017 ___________ Introduced by Sens. SERINO, ALCANTARA, AVELLA, BRESLIN, CARLUCCI, CROCI, GOLDEN, GRIFFO, HAMILTON, HANNON, HELMING, KAMINSKY, KENNEDY, KRUEGER, MARCHIONE, MURPHY, ORTT, RITCHIE, SANDERS, SAVINO, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Insurance in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said commit- tee 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. LBD05529-10-8
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