New York S 5464: Allows the thruway authority to offer a discounted toll rate to residents of Rockland and Westchester counties for Tappan Zee bridge crossings

Bill Text

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S05464 Summary:

BILL NOS05464 

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SAME ASNo Same As

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SPONSORCOMRIE

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COSPNSR

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MLTSPNSR

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Amd §280-a, Pub Health L

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Amends provisions governing reimbursement practices of pharmacy benefit managers to ensure that pharmacies are not reimbursed an amount less than the cost of procuring the drugs.

Go to top S05464 Actions:

BILL NOS05464 

&nbsp

02/21/2025REFERRED TO HEALTH

01/07/2026REFERRED TO HEALTH

Go to topS05464 Committee&nbspVotes:

Go to topS05464 Floor&nbspVotes:

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

Go to topS05464 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 5464

 2025-2026 Regular Sessions

 IN SENATE

 February 21, 2025
 ___________

 Introduced by Sen. COMRIE -- read twice and ordered printed, and when
 printed to be committed to the Committee on Health

 AN ACT to amend the public health law, in relation to pharmacy benefit
 managers

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

 1 Section 1. Section 280-a of the public health law, as added by chapter
 2 828 of the laws of 2021, subdivisions 1, 2 and 3 as amended by chapter
 3 128 of the laws of 2022 and subdivision 5 as amended by chapter 396 of
 4 the laws of 2024, is amended to read as follows:
 5 § 280-a. Pharmacy benefit managers. 1. Definitions. As used in this
 6 section, the following terms shall have the following meanings:
 7 (a) "Health plan" means an entity for which a pharmacy benefit manager
 8 provides pharmacy benefit management services and that is a health bene-
 9 fit plan or other entity that approves, provides, arranges for, or pays
 10 or reimburses in whole or in part for health care items or services, to
 11 include at least prescription drugs, for a substantial number of benefi-
 12 ciaries who work or reside in this state. The superintendent shall
 13 determine, in [his or her] their sole discretion, by regulation how the
 14 phrase "a substantial number of beneficiaries who work or reside in this
 15 state" shall be interpreted.
 16 (b) "Pharmacy benefit management services" means the management or
 17 administration of prescription drug benefits for a health plan, directly
 18 or through another entity, and regardless of whether the pharmacy bene-
 19 fit manager and the health plan are related, or associated by ownership,
 20 common ownership, organization or otherwise; including the procurement
 21 of prescription drugs to be dispensed to patients, or the administration
 22 or management of prescription drug benefits, including but not limited
 23 to, any of the following:
 24 (i) mail service pharmacy;

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD09728-01-5

 S. 5464 2

 1 (ii) claims processing, retail network management, or payment of
 2 claims to pharmacies for dispensing prescription drugs;
 3 (iii) clinical or other formulary or preferred drug list development
 4 or management;
 5 (iv) negotiation or administration of rebates, discounts, payment
 6 differentials, or other incentives, for the inclusion of particular
 7 prescription drugs in a particular category or to promote the purchase
 8 of particular prescription drugs;
 9 (v) patient compliance, therapeutic intervention, or generic substi-
 10 tution programs;
 11 (vi) disease management;
 12 (vii) drug utilization review or prior authorization;
 13 (viii) adjudication of appeals or grievances related to prescription
 14 drug coverage;
 15 (ix) contracting with network pharmacies; and
 16 (x) controlling the cost of covered prescription drugs.
 17 (c) "Pharmacy benefit manager" means any entity that performs pharmacy
 18 benefit management services for a health plan.
 19 (d) "Maximum allowable cost price" means a maximum reimbursement
 20 amount set by the pharmacy benefit manager for therapeutically equiv-
 21 alent multiple source generic drugs.
 22 (e) "Controlling person" means any person or other entity who or which
 23 directly or indirectly has the power to direct or cause to be directed
 24 the management, control or activities of a pharmacy benefit manager.
 25 (f) "Covered individual" means a member, participant, enrollee,
 26 contract holder or policy hol