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NY A02200
Bill
Status
3/3/2023
Primary Sponsor
John McDonald
Click for details
AI Summary
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Repeals subsection 341-a of the insurance law related to the "patient Rx information and choice expansion act" enacted in 2022.
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Requires insurers, health plans, and pharmacy benefit managers to provide cost, benefit, and coverage data for prescribed drugs upon request by patients, healthcare providers, or authorized third parties within one business day of any changes.
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Mandates use of real-time benefit tools (RTBT) when healthcare providers request data and establishes industry standards for data transmission including ANSI-accredited standards and formats approved by federal agencies like CMS.
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Prohibits insurers and pharmacy benefit managers from interfering with data access, penalizing providers for disclosing cost information, or restricting providers from discussing lower-cost alternatives with patients.
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Exempts health plans serving exclusively Medicaid, Child Health Plus, Basic Health Program, or Medicare beneficiaries from these requirements.
Legislative Description
Provides for patient prescription pricing transparency; requires certain insurers or pharmacy benefit managers to furnish required cost, benefit and coverage data upon request of the insured, the insured's health care provider or an authorized third party.
Last Action
signed chap.63
3/3/2023