NY A01722

Requires health insurers to use pass-through pricing models in contracts with pharmacy benefit managers (PBMs), limiting payments to actual ingredient costs, dispensing fees, and an administrative fee

Prohibits PBMs from using "spread pricing" (charging health plans more than what is paid to pharmacies) and requires any excess amounts to be remitted quarterly to the health plan

Mandates PBMs fully disclose all sources of income including rebates, discounts, clawbacks, fees, and other financial benefits to both the health plan and the Department of Insurance

Requires all rebates and financial benefits received by PBMs to be passed through in full to health plans to reduce ingredient costs

Authorizes the Department of Insurance to establish maximum administrative fees and approve any premium changes resulting from PBM contracts