STATE OF NEW YORK
________________________________________________________________________
663--B
2021-2022 Regular Sessions
IN ASSEMBLY(Prefiled)
January 6, 2021
___________
Introduced by M. of A. D. ROSENTHAL, DICKENS, COLTON, WILLIAMS,
SEAWRIGHT, COOK, O'DONNELL, SIMON, ABINANTI, JACOBSON, GRIFFIN --
Multi-Sponsored by -- M. of A. GALEF, SALKA -- read once and referred
to the Committee on Health -- recommitted to the Committee on Health
in accordance with Assembly Rule 3, sec. 2 -- committee discharged,
bill amended, ordered reprinted as amended and recommitted to said
committee -- again reported from said committee with amendments,
ordered reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to requiring certain
manufacturers of prescription drugs to notify the superintendant of
any proposed increase of the wholesale acquisition cost of such
prescription drugs
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The insurance law is amended by adding a new section 111-a
2 to read as follows:
3 § 111-a. Notification of prescription drug price increases by manufac-
4 turers. (a) This section shall apply to a manufacturer of a prescription
5 drug that is purchased or reimbursed in this state by any of the follow-
6 ing:
7 (1) An insurance company authorized in this state to write accident
8 and health insurance, a company organized pursuant to article forty-
9 three of this chapter, a municipal cooperative health benefit plan
10 established pursuant to article forty-seven of this chapter, an organ-
11 ization certified pursuant to article forty-four of the public health
12 law, an institution of higher education certified pursuant to section
13 one thousand one hundred twenty-four of this chapter, or the New York
14 state health insurance plan established pursuant to article eleven of
15 the civil service law; or
16 (2) A pharmacy benefit manager, including an entity that directly or
17 through an intermediary, manages the prescription drug coverage provided
18 by a health insurer under a contract or policy delivered or issued for
19 delivery in this state or a health plan subject to section three hundred
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05130-05-2
A. 663--B 2
1 sixty-four-j of the social services law, including the processing and
2 payment of claims for prescription drugs, the performance of drug utili-
3 zation review, the processing of drug prior authorization requests, the
4 adjudication of appeals or grievances related to prescription drug
5 coverage, contracting with network pharmacies, and controlling the cost
6 of covered prescription drugs.
7 (b) (1) A manufacturer of a prescription drug with a wholesale acqui-
8 sition cost of more than forty dollars for a course of therapy shall
9 notify the superintendent, his or her deputy or other officer designated
10 by the superintendent, if the increase in the wholesale acquisition cost
11 of such prescription drug is more than ten percent, including the
12 proposed increase and the cumulative increases that occurred within the
13 previous twenty-four months. For purposes of this section, a "course of
14 therapy" is defined as either of the following:
15 (i) the recommended daily dosage units of a prescription drug pursuant
16 to its prescribing label as approved by the federal Food and Drug Admin-
17 istration for thirty days; or
18 (ii) the recommended daily dosage units of a prescription drug pursu-
19 ant to its prescribing label as approved by the federal Food and Drug
20 Administration for a normal course of treatment that is less than thirty
21 days.
22 (2) (i) The notice required by paragraph (1) of this subsection shall
23 be provided in writing to the superintendent at least sixty days prior
24 to the planned effective date of the increase and shall include the
25 proposed increase and the cumulative increases that occurred within the
26 previous twenty-four months.
27 (ii) The superintendent shall forthwith publish the notice required by
28 paragraph (a) of this subdivision on the department of financial
29 services website within five days of its receipt.
30 (3) (i) The notice required by paragraph (1) of this subsection shall
31 include the date of the increase, the current wholesale acquisition cost
32 of the prescription drug, and the dollar amount of the future increase
33 in the wholesale acquisition cost of the prescription drug.
34 (ii) The notice required by paragraph (1) of this subsection shall
35 include a statement regarding whether a change or improvement in the
36 drug necessitates the price increase. If so, the manufacturer shall
37 describe the change or improvement.
38 (4) Information supplied by a manufacturer pursuant to this section
39 that the manufacturer has designated as a trade secret shall be consid-
40 ered confidential and a trade secret and shall not be disclosed directly
41 or indirectly by the superintendent. Notwithstanding the foregoing
42 sentence, the superintendent shall be permitted to disclose information
43 in an aggregated format if such aggregate information cannot directly or
44 indirectly be used to identify trade secret information related to a
45 specific manufacturer or the manufacturer's prescription drug, including
46 but not limited to any information related to pricing for the manufac-
47 turer's prescription drug that has been designated as a trade secret.
48 (5) In the event that a manufacturer of a prescription drug subject to
49 this section does not report the information required in paragraph (1)
50 of this subsection, the superintendent is authorized to impose any
51 penalty or remedy authorized by this chapter, after notice and a hear-
52 ing, against such manufacturer of up to five thousand dollars per day
53 for every day after the reporting period described in this section that
54 the required information is not reported.
55 § 2. This act shall take effect immediately.
