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NY S05000
Bill
Status
10/1/2010
Primary Sponsor
Martin Dilan
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AI Summary
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Prohibits health maintenance organizations, insurance policies, and health service corporations from imposing cost-sharing, deductibles, or co-insurance for any prescription drug that exceeds the amount required for non-preferred brand drugs or their equivalents.
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Applies to tiered prescription drug plans that categorize drugs (such as Tier IV or specialty tiers) used to treat cancer, multiple sclerosis, rheumatoid arthritis, hepatitis C, hemophilia, psoriasis, and similar serious conditions.
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Designates violations as unlawful discriminatory practices under Executive Law Section 296, with an exemption for self-insured employee welfare benefit plans under the Employee Retirement Income Security Act of 1974.
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Takes effect thirty days after becoming law.
Legislative Description
Provides that no health care plan or health insurance policy which provides coverage for prescription drugs and for which cost-sharing, deductibles or co-insurance obligations are determined by category of prescription drugs including, but not limited to, generic drugs, preferred brand drugs and non-preferred brand drugs, shall impose cost-sharing, deductibles or co-insurance obligations for any prescription drug that exceeds the dollar amount of cost-sharing, deductibles or co-insurance obligations for any other prescription drug provided under such coverage in the category of non-preferred brand drugs or their equivalents.
Last Action
SIGNED CHAP.536
10/1/2010