Assembly Bill A2969

Vetoed By Governor
2019-2020 Legislative Session

Relates to prescription drug formulary changes during a contract year

download bill text pdf

Sponsored By

Archive: Last Bill Status - Vetoed by Governor


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

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Bill Amendments

co-Sponsors

multi-Sponsors

2019-A2969 - Details

See Senate Version of this Bill:
S2849
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
2017-2018: A2317, S5022

2019-A2969 - Summary

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

2019-A2969 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2969
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 28, 2019
                                ___________
 
 Introduced  by  M.  of  A.  PEOPLES-STOKES, BARRETT, NIOU, ORTIZ, GALEF,
   ABINANTI,  LAVINE,  COLTON,  JEAN-PIERRE,   TAYLOR,   BYRNE,   WEPRIN,
   SEAWRIGHT,  BARRON,  MOSLEY, LUPARDO -- Multi-Sponsored by -- M. of A.
   ENGLEBRIGHT, HEVESI, RA, THIELE --  read  once  and  referred  to  the
   Committee on Insurance

 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 OR INTERCHANGEABLE BIOLOGICAL
 PRODUCT FOR SUCH PRESCRIPTION DRUG IS ADDED TO THE FORMULARY AT THE SAME
 TIME.
 
              

co-Sponsors

multi-Sponsors

2019-A2969A (ACTIVE) - Details

See Senate Version of this Bill:
S2849
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
2017-2018: A2317, S5022

2019-A2969A (ACTIVE) - Summary

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

2019-A2969A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2969--A
                                                             R. R. 69
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 28, 2019
                                ___________
 
 Introduced  by  M.  of  A.  PEOPLES-STOKES, BARRETT, NIOU, ORTIZ, GALEF,
   ABINANTI,  LAVINE,  COLTON,  JEAN-PIERRE,   TAYLOR,   BYRNE,   WEPRIN,
   SEAWRIGHT, BARRON, MOSLEY, LUPARDO, ASHBY, REYES, L. ROSENTHAL, VANEL,
   STIRPE,  D. ROSENTHAL,  GRIFFIN,  JAFFEE, BUCHWALD, GOTTFRIED, D'URSO,
   MAGNARELLI, STERN, HUNTER, JACOBSON, LiPETRI, HEVESI,  OTIS,  CARROLL,
   STECK, SIMON, MIKULIN, PICHARDO, EPSTEIN, ROZIC, WALLACE, MALLIOTAKIS,
   BUTTENSCHON,  SCHMITT  --  Multi-Sponsored by -- M. of A. ENGLEBRIGHT,
   RA, THIELE -- read once and referred to the Committee on Insurance  --
   reported  and  referred  to  the  Committee  on  Codes -- reported and
   referred to the Committee on Rules -- amended on the special order  of
   third  reading,  ordered  reprinted as amended, retaining its place on
   the special 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
              

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