Senate Bill S4620

2021-2022 Legislative Session

Enacts the "patient Rx information and choice expansion act"

download bill text pdf

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Archive: Last Bill Status - Passed Senate & Assembly


  • 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

2021-S4620 - Details

Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

2021-S4620 - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

2021-S4620 - Sponsor Memo

2021-S4620 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4620
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 8, 2021
                                ___________
 
 Introduced  by  Sen. BRESLIN -- 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 enacting the  "patient
   Rx information and choice expansion act"
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   § 2. The insurance law is amended by adding a  new  section  341-a  to
 read as follows:
   §  341-A.  PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.  DEFINITIONS.
 AS USED IN THIS SECTION:
   (A) "HEALTH PLAN" MEANS BENEFITS PROVIDED BY ANY ENTITY DELIVERING  OR
 ISSUING  FOR DELIVERY A POLICY OF ACCIDENT AND HEALTH INSURANCE PURSUANT
 TO SECTION THREE THOUSAND TWO HUNDRED SIXTEEN, OR  A  GROUP  OR  BLANKET
 ACCIDENT  AND HEALTH INSURANCE POLICY PURSUANT TO SECTION THREE THOUSAND
 TWO HUNDRED TWENTY-ONE, OR PROVIDING BENEFITS PURSUANT TO  SECTION  FOUR
 THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   (B)  "COST-SHARING  INFORMATION"  MEANS  THE  AMOUNT  AN  ENROLLEE  IS
 REQUIRED TO PAY IN ORDER TO RECEIVE A DRUG THAT  IS  COVERED  UNDER  THE
 ENROLLEE'S HEALTH PLAN.
   (C)  "COVERED/COVERAGE"  MEANS  THOSE HEALTH CARE SERVICES TO WHICH AN
 ENROLLEE IS ENTITLED UNDER THE TERMS OF THE HEALTH PLAN.
   (D) "ENROLLEE" MEANS THE COVERED INDIVIDUAL, POLICYHOLDER, SUBSCRIBER,
 THE INSURED, OR PERSON WHO HAS AUTHORITY UNDER APPLICABLE LAW TO ACT  ON
 BEHALF  OF  AN  ENROLLEE  IN  MAKING DECISIONS RELATED TO HEALTH CARE, A
 HEALTH PLAN, OR PHARMACY BENEFIT MANAGER, OR ITS AFFILIATES OR ENTITIES.
   (E) "INTEROPERABILITY ELEMENT" MEANS  HARDWARE,  SOFTWARE,  INTEGRATED
 TECHNOLOGIES  OR  RELATED  LICENSES,  TECHNICAL INFORMATION, PRIVILEGES,
 RIGHTS, INTELLECTUAL PROPERTY, UPGRADES, OR SERVICES THAT MAY BE  NECES-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08942-01-1
              

2021-S4620A - Details

Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

2021-S4620A - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

2021-S4620A - Sponsor Memo

2021-S4620A - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4620--A
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 8, 2021
                                ___________
 
 Introduced  by  Sen. BRESLIN -- 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, in relation to enacting the "patient
   Rx information and choice expansion act"

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   §  2.  The  insurance  law is amended by adding a new section 341-a to
 read as follows:
   § 341-A. PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.    DEFINITIONS.
 AS USED IN THIS SECTION:
   (A)  "HEALTH PLAN" MEANS BENEFITS PROVIDED BY ANY ENTITY DELIVERING OR
 ISSUING FOR DELIVERY A POLICY OF ACCIDENT AND HEALTH INSURANCE  PURSUANT
 TO  SECTION  THREE  THOUSAND  TWO HUNDRED SIXTEEN, OR A GROUP OR BLANKET
 ACCIDENT AND HEALTH INSURANCE POLICY PURSUANT TO SECTION THREE  THOUSAND
 TWO  HUNDRED  TWENTY-ONE, OR PROVIDING BENEFITS PURSUANT TO SECTION FOUR
 THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   (B)  "COST-SHARING  INFORMATION"  MEANS  THE  AMOUNT  AN  ENROLLEE  IS
 REQUIRED  TO  PAY  IN  ORDER TO RECEIVE A DRUG THAT IS COVERED UNDER THE
 ENROLLEE'S HEALTH PLAN.
   (C) "COVERED/COVERAGE" MEANS THOSE HEALTH CARE SERVICES  TO  WHICH  AN
 ENROLLEE IS ENTITLED UNDER THE TERMS OF THE HEALTH PLAN.
   (D) "ENROLLEE" MEANS THE COVERED INDIVIDUAL, POLICYHOLDER, SUBSCRIBER,
 THE  INSURED, OR PERSON WHO HAS AUTHORITY UNDER APPLICABLE LAW TO ACT ON
 BEHALF OF AN ENROLLEE IN MAKING DECISIONS  RELATED  TO  HEALTH  CARE,  A
 HEALTH PLAN, OR PHARMACY BENEFIT MANAGER, OR ITS AFFILIATES OR ENTITIES.
   (E)  "INTEROPERABILITY  ELEMENT"  MEANS HARDWARE, SOFTWARE, INTEGRATED
 TECHNOLOGIES OR RELATED  LICENSES,  TECHNICAL  INFORMATION,  PRIVILEGES,
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

2021-S4620B - Details

Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

2021-S4620B - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

2021-S4620B - Sponsor Memo

2021-S4620B - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4620--B
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 8, 2021
                                ___________
 
 Introduced  by  Sen. BRESLIN -- 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 commit-
   tee
 
 AN ACT to amend the insurance law, in relation to enacting the  "patient
   Rx information and choice expansion act"
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   § 2. The insurance law is amended by adding a  new  section  341-a  to
 read as follows:
   §  341-A.  PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.  DEFINITIONS.
 AS USED IN THIS SECTION:
   (A) "HEALTH PLAN" MEANS BENEFITS PROVIDED BY ANY ENTITY DELIVERING  OR
 ISSUING  FOR DELIVERY A POLICY OF ACCIDENT AND HEALTH INSURANCE PURSUANT
 TO SECTION THREE THOUSAND TWO HUNDRED SIXTEEN, OR  A  GROUP  OR  BLANKET
 ACCIDENT  AND HEALTH INSURANCE POLICY PURSUANT TO SECTION THREE THOUSAND
 TWO HUNDRED TWENTY-ONE, OR PROVIDING BENEFITS PURSUANT TO  SECTION  FOUR
 THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
   (B)  "COST-SHARING  INFORMATION"  MEANS  THE  AMOUNT  AN  ENROLLEE  IS
 REQUIRED TO PAY IN ORDER TO RECEIVE A DRUG THAT  IS  COVERED  UNDER  THE
 ENROLLEE'S HEALTH PLAN.
   (C)  "COVERED/COVERAGE"  MEANS  THOSE HEALTH CARE SERVICES TO WHICH AN
 ENROLLEE IS ENTITLED UNDER THE TERMS OF THE HEALTH PLAN.
   (D) "ENROLLEE" MEANS THE COVERED INDIVIDUAL, POLICYHOLDER, SUBSCRIBER,
 THE INSURED, OR PERSON WHO HAS AUTHORITY UNDER APPLICABLE LAW TO ACT  ON

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08942-07-2
 S. 4620--B                          2
              

2021-S4620C (ACTIVE) - Details

Law Section:
Insurance Law
Laws Affected:
Add §341-a, Ins L

2021-S4620C (ACTIVE) - Summary

Requires health plans operating in the state to furnish the cost, benefit, and coverage data as required to the enrollee, his or her health care provider, or the third-party of his or her choosing.

2021-S4620C (ACTIVE) - Sponsor Memo

2021-S4620C (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4620--C
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 8, 2021
                                ___________
 
 Introduced  by  Sen. BRESLIN -- 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 commit-
   tee --  committee  discharged,  bill  amended,  ordered  reprinted  as
   amended and recommitted to said committee
 
 AN  ACT to amend the insurance law, in relation to enacting the "patient
   Rx information and choice expansion act"
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be cited as the "patient Rx
 information and choice expansion act" or the "PRICE act".
   §  2.  The  insurance  law is amended by adding a new section 341-a to
 read as follows:
   § 341-A. PATIENT PRESCRIPTION PRICING TRANSPARENCY. 1.    DEFINITIONS.
 AS USED IN THIS SECTION:
   (A) THE TERMS "COVERED INDIVIDUAL", "HEALTH PLAN", AND "PHARMACY BENE-
 FIT  MANAGER"  SHALL  HAVE  THE  SAME MEANINGS AS DEFINED BY SECTION TWO
 HUNDRED EIGHTY-A  OF  THE  PUBLIC  HEALTH  LAW.  THE  SUPERINTENDENT  IS
 EXPRESSLY AUTHORIZED TO INTERPRET THESE TERMS AS IF THE DEFINITIONS WERE
 STATED WITHIN THIS ARTICLE.
   (B)  "COST-SHARING  INFORMATION" MEANS THE AMOUNT A COVERED INDIVIDUAL
 IS REQUIRED TO PAY TO RECEIVE A DRUG THAT IS COVERED UNDER  THE  COVERED
 INDIVIDUAL'S HEALTH PLAN.
   (C)  "COVERED/COVERAGE"  MEANS  THOSE  HEALTH CARE SERVICES TO WHICH A
 COVERED INDIVIDUAL IS ENTITLED UNDER THE TERMS OF THE HEALTH PLAN.
   (D) "INTEROPERABILITY ELEMENT" MEANS  HARDWARE,  SOFTWARE,  INTEGRATED
 TECHNOLOGIES  OR  RELATED  LICENSES,  TECHNICAL INFORMATION, PRIVILEGES,
 RIGHTS, INTELLECTUAL PROPERTY, UPGRADES, OR SERVICES THAT MAY BE  NECES-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08942-12-2
              

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