NY A10327

Defines "pharmacy acquisition cost rate" as the cost paid by in-network pharmacies to acquire generic, brand name drugs, or biologic products from manufacturers or wholesalers based on cost invoices.

Defines "national average drug acquisition cost" (NADAC) as the monthly federal survey conducted by the Centers for Medicare and Medicaid Services to determine average acquisition costs for Medicaid-covered outpatient drugs.

Requires pharmacy benefit managers to pay in-network pharmacies at minimum the NADAC rate or the pharmacy acquisition cost rate if greater, whichever applies, plus a professional dispensing fee at minimum equal to the state medical assistance program rate.

Mandates additional professional dispensing fees for brand name medications and biologic products requiring special packaging, shipping, or other dispensing costs that exceed the standard state medical assistance program fee.

Expands pharmacy benefit manager appeals processes to include disputes regarding pricing of multi-source generic drugs, brand name drugs, and biologic products.