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NY S00355
Bill
Status
5/20/2025
Primary Sponsor
Gustavo Rivera
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AI Summary
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Expands eligibility for New York's Elderly Pharmaceutical Insurance Coverage (EPIC) program to include individuals enrolled in public or private drug plans that meet or exceed Medicare Part D coverage standards, not just Medicare Part D itself
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Requires the Department of Health to assess health plans submitted by insurers to determine whether their prescription drug coverage meets or exceeds the actuarial value of Medicare Part D standard coverage
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Allows individuals enrolled in health plans with prescription drug coverage to request the Department of Health evaluate whether their plan qualifies as comparable to Medicare Part D for EPIC eligibility purposes
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Mandates the Department of Health maintain and publish an online list of health plans that qualify as meeting or exceeding Medicare Part D standards, with ongoing monitoring for continued compliance
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Takes effect on the first of April following enactment, with the Department of Health required to notify all insurers providing prescription drug coverage in New York about the new provisions and EPIC eligibility criteria
Legislative Description
Relates to program eligibility for plans comparable to Medicare part D; provides for analysis of health plans by the department of health to determine whether such health plans meet or exceed the Medicare part D standard; requires the department of health, in consultation with the department of financial services, to notify prescription drug insurers of the provisions of this act.
Last Action
REPORTED AND COMMITTED TO FINANCE
2/4/2026