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NY S07767
Bill
Status
2/24/2022
Primary Sponsor
Neil Breslin
Click for details
AI Summary
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Repeals Section 4909 of both the Insurance Law and Public Health Law that were added in 2021 regarding prescription drug formulary changes during contract years.
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Prohibits insurers and health insurance corporations from removing drugs from formularies, moving drugs to higher cost-sharing tiers, or adding utilization management restrictions during a plan year (applies only at enrollment, issuance, or renewal).
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Creates exceptions allowing insurers to move drugs to higher cost-sharing tiers if an AB-rated generic equivalent or interchangeable biological product is added simultaneously, and to remove drugs if the FDA determines they should be removed from the market.
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Permits insurers to move drugs to higher copayment tiers during a plan year only for new patients, excluding those already receiving the drug or diagnosed with conditions treated by the drug as of the plan year start date.
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Requires insurers to provide 90 days' notice before plan year start of formulary changes and cost-sharing adjustments, with notices posted online and in prescription drug finder systems; effective date January 1, 2023.
Legislative Description
Prohibits health care plans that provide essential benefits under the Affordable Care Act from removing a prescription drug from a formulary or adding new or additional formulary restrictions from a formulary during a plan year; requires notice to policy holders of intent to remove a drug from a formulary; relates to the effectiveness of certain provisions of law relating thereto.
Last Action
SIGNED CHAP.99
2/24/2022