New York S 6161: Relates to the protection of the health, safety and employment rights of persons suffering employment loss from the closure of nuclear electric plants and to the Indian Point Nuclear Power Plant

Bill Text

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S06161 Summary:

BILL NOS06161 

&nbsp

SAME ASSAME AS A01722

&nbsp

SPONSORSKOUFIS

&nbsp

COSPNSRADDABBO, HOYLMAN-SIGAL, MAY, RIVERA

&nbsp

MLTSPNSR

&nbsp

Add §3115, Ins L

&nbsp

Relates to reducing pharmacy benefit manager costs; defines "pharmacy benefit manager".

Go to top S06161 Actions:

BILL NOS06161 

&nbsp

03/06/2025REFERRED TO INSURANCE

01/07/2026REFERRED TO INSURANCE

Go to topS06161 Committee&nbspVotes:

Go to topS06161 Floor&nbspVotes:

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

Go to topS06161 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6161

 2025-2026 Regular Sessions

 IN SENATE

 March 6, 2025
 ___________

 Introduced by Sens. SKOUFIS, ADDABBO, HOYLMAN-SIGAL, MAY, RIVERA -- 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 reducing pharmacy
 benefit manager costs

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

 1 Section 1. The insurance law is amended by adding a new section 3115
 2 to read as follows:
 3 § 3115. Pharmacy benefit management services. (a) Any contract or
 4 other arrangement entered into by a health insurer offering health
 5 insurance under article thirty-two or forty-three of this chapter for
 6 the provision and administration of pharmacy benefit management services
 7 shall be based on a pass-through pricing model and include the following
 8 requirements:
 9 (1) Payment to the pharmacy benefit manager for pharmacy benefit
 10 management services shall be limited to the actual ingredient costs,
 11 dispensing fees paid to pharmacies, and an administrative fee that
 12 covers the cost of providing pharmacy benefit management services pursu-
 13 ant to a contract described in this subsection. The department may
 14 establish a maximum administrative fee;
 15 (2) The pharmacy benefit manager shall identify all sources and
 16 amounts of income, payments, and financial benefits to the pharmacy
 17 benefit manager related to the provision and administration of pharmacy
 18 benefit management services on behalf of the health care plan, includ-
 19 ing, but not limited to, any pricing discounts, rebates of any kind,
 20 inflationary payments, credits, clawbacks, fees, grants, chargebacks,
 21 reimbursements, or other benefits and shall ensure that any portion of
 22 such income, payments, and financial benefits is passed through to the
 23 health care plan in full to reduce the reportable ingredient cost;

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD03803-01-5

 S. 6161 2

 1 (3) The pharmacy benefit manager shall fully disclose to the depart-
 2 ment and to the health care plan the sources and amounts of all income,
 3 payments, and financial benefits referred to in paragraph two of this
 4 subsection received by the pharmacy benefit manager;
 5 (4) The pharmacy benefit manager shall identify all ingredient costs
 6 and dispensing fees or similar payments made by the pharmacy benefit
 7 manager to any pharmacy in connection with the contract or other
 8 arrangement;
 9 (5) The pharmacy benefit manager shall not utilize any form of spread
 10 pricing in any contract or other arrangement with health care plans. For
 11 purposes of this subsection "spread pricing" means any amount charged or
 12 claimed by the pharmacy benefit manager in excess of the amount paid to
 13 pharmacies on behalf of the health care plan less an administrative fee
 14 as described in this subsection. Any such excess amount shall be remit-
 15 ted to the health care plan on a quarterly basis;
 16 (6) Pharmacy benefit managers shall make their payment model for
 17 administrative fees available to the health care plan and to the depart-
 18 ment. The health care plan shall, if so directed by the department,
 19 make changes to the payment model and resubmit an amended contract or
 20 contracts to the department for review and approval.
 21 (b) Any changes to premiums resulting from such contracts shall be
 22 subject to the approval of the department.
 23 (c) For the purposes of this section, the term "pharmacy benefit
 24 manager" means an entity that co