NY A07142

Requires health insurers to calculate enrollee cost sharing (deductibles and coinsurance) for prescription drugs at the point of sale using a price reduced by at least 85% of all rebates received or expected to be received

Defines "rebates" broadly to include negotiated price concessions, price protection rebates triggered by wholesale acquisition cost increases, performance-based concessions, and administrative fees passed through from manufacturers, pharmacies, or other parties

Mandates insurers submit annual certification to the superintendent by January 1st attesting compliance with the rebate pass-through requirements for the prior calendar year

Prohibits insurers and their agents from publicly disclosing actual rebate amounts by product, therapeutic class, manufacturer, or pharmacy, with such information exempt from Freedom of Information Law disclosure

Applies to insurers regulated under the insurance law, nonprofit health service corporations, and health maintenance organizations, with provisions taking effect for contracts issued, renewed, or amended on or after January 1, 2025