Senate Bill S2393B

2023-2024 Legislative Session

Relates to requiring certain health insurance issuers to certify that at least a majority of prescription drug rebates are provided to patients at the point of sale

download bill text pdf

Sponsored By

Current Bill Status - In Senate Committee Finance 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

2023-S2393 - Details

See Assembly Version of this Bill:
A1962
Current Committee:
Senate Finance
Law Section:
Insurance Law
Laws Affected:
Add §§3246 & 4331, Ins L; add §4417, Pub Health L
Versions Introduced in Other Legislative Sessions:
2019-2020: S6489, A8310
2021-2022: S2006, A5218

2023-S2393 - Summary

Requires certain health insurance issuers to certify that at least a majority of prescription drug rebates are provided to patients at the point of sale.

2023-S2393 - Sponsor Memo

2023-S2393 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2393
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 20, 2023
                                ___________
 
 Introduced  by  Sen. JACKSON -- 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  requiring  individual
   and  small group insurance carriers and group and blanket accident and
   health carriers to certify that at least a  majority  of  prescription
   drug rebates are provided to patients at the point of sale
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph 1 of subsection (e) of section 3231 of the insur-
 ance law, as added by chapter 501 of the laws of  1992,  is  amended  by
 adding a new subparagraph (C) to read as follows:
   (C)  AN  INSURER SHALL ANNUALLY CERTIFY TO THE DEPARTMENT THAT, DURING
 THE PRIOR BENEFIT YEAR, THE INSURER MADE AVAILABLE TO ENROLLEES  AT  THE
 POINT  OF SALE AT LEAST A MAJORITY (I.E., GREATER THAN FIFTY PERCENT) OF
 THE REBATES RECEIVED BY SUCH INSURER OR ANY  THIRD  PARTY  ADMINISTERING
 PRESCRIPTION DRUG BENEFITS ON BEHALF OF SUCH INSURER.
   (I) FOR PURPOSES OF THIS PARAGRAPH, "REBATE" MEANS:
   (1)  NEGOTIATED  PRICE  CONCESSIONS  INCLUDING BUT NOT LIMITED TO BASE
 REBATES AND REASONABLE ESTIMATES OF ANY  PRICE  PROTECTION  REBATES  AND
 PERFORMANCE-BASED  REBATES THAT MAY ACCRUE DIRECTLY OR INDIRECTLY TO THE
 ISSUER DURING THE COVERAGE YEAR FROM A MANUFACTURER, DISPENSING  PHARMA-
 CY, OR OTHER PARTY TO THE TRANSACTION, AND
   (2)  REASONABLE  ESTIMATES  OF ANY FEES AND OTHER ADMINISTRATIVE COSTS
 THAT ARE PASSED THROUGH TO THE ISSUER AND SERVE TO REDUCE  THE  ISSUER'S
 PRESCRIPTION DRUG LIABILITIES FOR THE COVERAGE YEAR.
   (II)  IN PROVIDING THE CERTIFICATION REQUIRED UNDER THIS SUBPARAGRAPH,
 AN ISSUER SHALL SHARE INFORMATION REGARDING THE ACTUAL AMOUNT OF REBATES
 THE ISSUER RECEIVED ON A PRODUCT-,  MANUFACTURER-  OR  PHARMACY-SPECIFIC
 BASIS  WITH  THE  DEPARTMENT  AND  THE AMOUNT THAT WAS PASSED THROUGH TO
 CONSUMERS. ANY INFORMATION  SHARED  UNDER  THIS  SUBPARAGRAPH  SHALL  BE
 CONFIDENTIAL AND NOT SUBJECT TO DISCLOSURE BY THE DEPARTMENT.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05427-01-3
              

co-Sponsors

2023-S2393A - Details

See Assembly Version of this Bill:
A1962
Current Committee:
Senate Finance
Law Section:
Insurance Law
Laws Affected:
Add §§3246 & 4331, Ins L; add §4417, Pub Health L
Versions Introduced in Other Legislative Sessions:
2019-2020: S6489, A8310
2021-2022: S2006, A5218

2023-S2393A - Summary

Requires certain health insurance issuers to certify that at least a majority of prescription drug rebates are provided to patients at the point of sale.

2023-S2393A - Sponsor Memo

2023-S2393A - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2393--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 20, 2023
                                ___________
 
 Introduced  by  Sens.  JACKSON,  HOYLMAN-SIGAL -- 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
 
 AN ACT to amend the insurance law, in relation to  requiring  individual
   and  small group insurance carriers and group and blanket accident and
   health carriers to certify that at least a  majority  of  prescription
   drug rebates are provided to patients at the point of sale
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph 1 of subsection (e) of section 3231 of the insur-
 ance law is amended by adding a new subparagraph (C) to read as follows:
   (C) AN INSURER SHALL ANNUALLY CERTIFY TO THE DEPARTMENT  THAT,  DURING
 THE  PRIOR  BENEFIT YEAR, THE INSURER MADE AVAILABLE TO ENROLLEES AT THE
 POINT OF SALE AT LEAST A MAJORITY (I.E., GREATER THAN FIFTY PERCENT)  OF
 THE  REBATES  RECEIVED  BY SUCH INSURER OR ANY THIRD PARTY ADMINISTERING
 PRESCRIPTION DRUG BENEFITS ON BEHALF OF SUCH INSURER.
   (I) FOR PURPOSES OF THIS PARAGRAPH, "REBATE" MEANS:
   (1) NEGOTIATED PRICE CONCESSIONS INCLUDING BUT  NOT  LIMITED  TO  BASE
 REBATES  AND  REASONABLE  ESTIMATES  OF ANY PRICE PROTECTION REBATES AND
 PERFORMANCE-BASED REBATES THAT MAY ACCRUE DIRECTLY OR INDIRECTLY TO  THE
 ISSUER  DURING THE COVERAGE YEAR FROM A MANUFACTURER, DISPENSING PHARMA-
 CY, OR OTHER PARTY TO THE TRANSACTION, AND
   (2) REASONABLE ESTIMATES OF ANY FEES AND  OTHER  ADMINISTRATIVE  COSTS
 THAT  ARE  PASSED THROUGH TO THE ISSUER AND SERVE TO REDUCE THE ISSUER'S
 PRESCRIPTION DRUG LIABILITIES FOR THE COVERAGE YEAR.
   (II) IN PROVIDING THE CERTIFICATION REQUIRED UNDER THIS  SUBPARAGRAPH,
 AN  ISSUER  SHALL  NOT PUBLISH OR OTHERWISE REVEAL INFORMATION REGARDING
 THE ACTUAL AMOUNT OF REBATES THE ISSUER RECEIVED ON A PRODUCT-, MANUFAC-
 TURER- OR PHARMACY-SPECIFIC BASIS. SUCH INFORMATION IS  PROTECTED  AS  A
 TRADE  SECRET,  IS NOT A PUBLIC RECORD AS DEFINED IN THE PUBLIC OFFICERS
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05427-03-3
              

co-Sponsors

2023-S2393B (ACTIVE) - Details

See Assembly Version of this Bill:
A1962
Current Committee:
Senate Finance
Law Section:
Insurance Law
Laws Affected:
Add §§3246 & 4331, Ins L; add §4417, Pub Health L
Versions Introduced in Other Legislative Sessions:
2019-2020: S6489, A8310
2021-2022: S2006, A5218

2023-S2393B (ACTIVE) - Summary

Requires certain health insurance issuers to certify that at least a majority of prescription drug rebates are provided to patients at the point of sale.

2023-S2393B (ACTIVE) - Sponsor Memo

2023-S2393B (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2393--B
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 20, 2023
                                ___________
 
 Introduced  by  Sens.  JACKSON,  HOYLMAN-SIGAL -- 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  --  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 requiring certain health insurance issuers to certify that at least
   a majority of prescription drug rebates are provided  to  patients  at
   the point of sale
 
   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  3246
 to read as follows:
   § 3246. ENSURING FAIRNESS IN CERTAIN COST SHARING. (A) AS USED IN THIS
 SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
   (1)  "DEFINED  COST SHARING" MEANS A DEDUCTIBLE PAYMENT OR COINSURANCE
 AMOUNT IMPOSED ON AN ENROLLEE FOR A COVERED PRESCRIPTION DRUG UNDER  THE
 ENROLLEE'S HEALTH PLAN.
   (2)  "INSURER"  MEANS  ANY  HEALTH INSURANCE ISSUER THAT IS SUBJECT TO
 STATE LAW REGULATING INSURANCE AND OFFERS HEALTH INSURANCE COVERAGE,  AS
 DEFINED  IN  42  U.S.C.  §  300GG-91, OR ANY STATE OR LOCAL GOVERNMENTAL
 EMPLOYER PLAN.
   (3) "PRICE PROTECTION REBATE" MEANS A NEGOTIATED PRICE CONCESSION THAT
 ACCRUES DIRECTLY OR INDIRECTLY TO THE INSURER, OR OTHER PARTY ON  BEHALF
 OF THE INSURER, IN THE EVENT OF AN INCREASE IN THE WHOLESALE ACQUISITION
 COST OF A DRUG ABOVE A SPECIFIED THRESHOLD.
   (4) "REBATE" MEANS:
   (A)  NEGOTIATED  PRICE  CONCESSIONS  INCLUDING BUT NOT LIMITED TO BASE
 PRICE CONCESSIONS, WHETHER DESCRIBED  AS  A  REBATE  OR  OTHERWISE,  AND
 REASONABLE  ESTIMATES  OF  ANY PRICE PROTECTION REBATES AND PERFORMANCE-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05427-04-3
              

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