New York A 8136: Establishes the rural equity assistance program

Bill Text

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A08136 Summary:

BILL NOA08136 

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SAME ASSAME AS S07900

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SPONSORWeprin

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COSPNSR

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MLTSPNSR

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Amd §§3216, 3221 & 4303, Ins L; amd §4406-c, Pub Health L

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Authorizes insurance policies which provide coverage for prescription drugs where cost-sharing obligations are determined by category of prescription drugs to offer a program to insureds that utilizes rebates or discounts to lower an insured's cost-sharing for prescription drugs if the insured's cost-sharing under such program would be more favorable than the cost-sharing that would otherwise be applicable to the prescription drug.

Go to top A08136 Actions:

BILL NOA08136 

&nbsp

05/01/2025referred to insurance

01/07/2026referred to insurance

Go to topA08136 Committee&nbspVotes:

Go to topA08136 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA08136 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 8136

 2025-2026 Regular Sessions

 IN ASSEMBLY

 May 1, 2025
 ___________

 Introduced by M. of A. WEPRIN -- read once and referred to the Committee
 on Insurance

 AN ACT to amend the insurance law and the public health law, in relation
 to authorizing insurance policies which provide coverage for
 prescription drugs and involve cost-sharing obligations to offer a
 program to insureds utilizing rebates or discounts

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Paragraph 27 of subsection (i) of section 3216 of the
 2 insurance law, as added by chapter 536 of the laws of 2010, is amended
 3 to read as follows:
 4 (27) (A) No policy delivered or issued for delivery in this state
 5 which provides coverage for prescription drugs and for which cost-shar-
 6 ing, deductibles or co-insurance obligations are determined by category
 7 of prescription drugs shall impose cost-sharing, deductibles or co-insu-
 8 rance obligations for any prescription drug that exceeds the dollar
 9 amount of cost-sharing, deductibles or co-insurance obligations for
 10 non-preferred brand drugs or its equivalent (or brand drugs if there is
 11 no non-preferred brand drug category).
 12 (B) Notwithstanding the limitations prescribed in subparagraph (A) of
 13 this paragraph or any other provision of law, a policy delivered or
 14 issued for delivery in this state which provides coverage for
 15 prescription drugs where cost-sharing obligations are determined by
 16 category of prescription drugs may offer a program to insureds that
 17 utilizes rebates or discounts to lower an insured's cost-sharing for
 18 prescription drugs if the insured's cost-sharing under such program
 19 would be more favorable than the cost-sharing that would otherwise be
 20 applicable to the prescription drug. A program offered pursuant to this
 21 subparagraph shall not be deemed a separate tier of drug cost-sharing. A
 22 description of the program shall be set forth in the policy or contract,
 23 provided, however, such description may refer insureds to a website for

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD11644-01-5

 A. 8136 2

 1 additional information, including details regarding the insured's
 2 reduced cost-sharing.
 3 § 2. Paragraph 16 of subsection (a) of section 3221 of the insurance
 4 law, as added by chapter 536 of the laws of 2010, is amended to read as
 5 follows:
 6 (16) (A) No policy delivered or issued for delivery in this state
 7 which provides coverage for prescription drugs and for which cost-shar-
 8 ing, deductibles or co-insurance obligations are determined by category
 9 of prescription drugs shall impose cost-sharing, deductibles or co-insu-
 10 rance obligations for any prescription drug that exceeds the dollar
 11 amount of cost-sharing, deductibles or co-insurance obligations for
 12 non-preferred brand drugs or its equivalent (or brand drugs if there is
 13 no non-preferred brand drug category).
 14 (B) Notwithstanding the limitations prescribed in subparagraph (A) of
 15 this paragraph or any other provision of law, a policy delivered or
 16 issued for delivery in this state which provides coverage for
 17 prescription drugs where cost-sharing obligati