NY A05882

Requires pharmacy benefit managers (PBMs) to pay participating pharmacies at minimum the national average drug acquisition cost (NADAC) rate, or the pharmacy's actual acquisition cost if no NADAC rate exists, plus a professional dispensing fee at least equal to the Medicaid dispensing fee

Mandates additional professional dispensing fees for specialty medications (biologics, genetically-produced drugs) that require unique handling, special packaging, in-depth patient teaching, or enhanced monitoring to ensure pharmacies are not paid below their costs

Allows PBMs to require pharmacies to demonstrate their acquisition costs through invoices, but prohibits payment below the pharmacy's actual acquisition cost

Exempts collectively bargained health plans, union trust funds established under the Labor Management Relations Act, and multi-employer plans from these minimum payment requirements

Expands the existing appeals process for drug pricing disputes to include brand name drugs, biologic products, and drugs produced through genetic technology or biopharmaceutical processes, in addition to generic drugs

Takes effect January 1, 2026 and applies to all policies and contracts issued, renewed, modified, altered, or amended on or after that date