STATE OF NEW YORK
________________________________________________________________________
6764
2025-2026 Regular Sessions
IN ASSEMBLY
March 12, 2025
___________
Introduced by M. of A. WEPRIN -- read once and referred to the Committee
on Insurance
AN ACT to amend the insurance law, in relation to reporting requirements
for pharmacy benefit managers
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph 1 of subsection (a) of section 2904 of the insur-
2 ance law, as amended by chapter 128 of the laws of 2022, is amended to
3 read as follows:
4 (1) (i) On or before July first of each year, every pharmacy benefit
5 manager shall report to the superintendent, in a statement subscribed
6 and affirmed as true under penalties of perjury, the information
7 requested by the superintendent including, without limitation,
8 [(i)] (A) any pricing discounts, rebates of any kind, inflationary
9 payments, credits, clawbacks, fees, grants, chargebacks, reimbursements,
10 other financial or other reimbursements, incentives, inducements,
11 refunds or other benefits received by the pharmacy benefit manager;
12 [and]
13 [(ii)] (B) the terms and conditions of any contract or arrangement,
14 including other financial or other reimbursements incentives, induce-
15 ments or refunds between the pharmacy benefit manager and any other
16 party relating to pharmacy benefit management services provided to a
17 health plan including but not limited to, dispensing fees paid to phar-
18 macies[.];
19 (C) the aggregated dollar amount of rebates, fees, price protection
20 payments and any other payments the pharmacy benefit manager received
21 from drug manufacturers through rebate contracts;
22 (D) the portions of the amount in clause (C) of this subparagraph
23 which were:
24 1. passed on to health plans; or
25 2. retained by the pharmacy benefit manager; and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10316-01-5
A. 6764 2
1 (E) for each rebate contract in effect during the reporting period:
2 1. the names of the contracting parties;
3 2. the execution date and the term of the contract, including exten-
4 sions;
5 3. the name of the drugs and the associated national drug codes
6 covered by the rebate contract, and for each drug:
7 (I) a summary of the contract terms regarding formulary placement,
8 formulary exclusion, or prior authorization requirements or step edits,
9 of any drugs considered to compete with each drug;
10 (II) a summary of all terms requiring or incentivizing volume or
11 market share for each drug, including base rebate amounts, bundled
12 rebates and incremental rebates, stated separately, and price conces-
13 sion, stated separately for each drug; and
14 (III) the total number of prescriptions filled and units dispensed for
15 which a rebate, discount, price concession or other consideration was
16 received by the pharmacy benefit manager for each drug;
17 4. the rebate percentage and dollar amount retained by the pharmacy
18 benefit manager for every rebate, discount, price concession or other
19 consideration under each rebate contract; and
20 5. the dollar amount of any other compensation paid by a drug manufac-
21 turer to a pharmacy benefit manager for services including distribution
22 management services, data or data services, marketing or promotional
23 services, research programs, or other ancillary services, under each
24 rebate contract.
25 (ii) For the purposes of this subsection, the term "rebate contract"
26 means any agreement entered into by a pharmacy benefit manager with any
27 drug manufacturer or agent or affiliate of a drug manufacturer that
28 determines any rebate, discount, administrative or other fee, price
29 concession, or other consideration related to the dispensing of
30 prescription drugs for a health plan.
31 § 2. Severability. If any provision of this act, or any application of
32 any provision of this act, is held to be invalid, that shall not affect
33 the validity or effectiveness of any other provision of this act, or of
34 any other application of any provision of this act.
35 § 3. This act shall take effect on the one hundred eightieth day after
36 it shall have become a law.
