What's happening
This bill imposes civil penalties on pharmacy benefit managers for violations and updates appeal denial requirements to provide more detailed pricing information.
Why it matters
Empowers greater enforcement against pharmacy benefit managers (PBMs). by allowing the state to impose civil penalties (up to $5,000 per violation) for violations of appeal-related provisions, which could deter unfair or non-transparent practices.
Strengthens the Attorney General’s role. by specifically authorizing the office to bring actions to collect civil penalties and seek additional remedies, which could lead to more consistent accountability for PBMs.
Improves transparency for denied pharmacy appeals. by requiring PBMs to provide detailed written information, including the exact drug code, the specific wholesaler used to determine pricing, and the date the price was checked—making it easier for pharmacies to verify and challenge reimbursement decisions.
May benefit independent and community pharmacies. by giving them more leverage and information when disputing PBM reimbursement rates, potentially supporting their financial viability and access to fair pricing.
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Who cares
Headline styles
Fine Pharmacy Benefit Violations
Plain English, a few words. Used as the page title.
Sponsors
History
- Referred to health
- Delivered to senate
- Passed assembly
- Ordered to third reading cal.337
- Returned to assembly
- Died in senate
- Referred to rules
- Delivered to senate
- Passed assembly
- Ordered to third reading rules cal.669
- Rules report cal.669
- Reported
Show 5 earlier actions
- Reported referred to rules
- Reported referred to codes
- Print number 4717a
- Amend (t) and recommit to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Fine PBMs for Contract Violations
In Senate Committee · Health · Sponsor Kemp Hannon
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4717--A
2017-2018 Regular Sessions
IN ASSEMBLY
February 3, 2017
Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the public health law, in relation to civil penalties for violations concerning the pharmacy benefit manager contract appeals process; and in relation to the process for appeal
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 280-a of the public health law is amended by adding two new subdivisions 3 and 4 to read as follows:
3. Any pharmacy benefit manager who violates the provisions of subdivision two of this section shall be subject to a civil penalty not to exceed five thousand dollars for each violation.
4. The attorney general shall bring an action to recover the civil penalties provided by subdivision three of this section and for such other relief as may be deemed necessary.
§ 2. Paragraph (e) of subdivision 2 of section 280-a of the public health law, as added by chapter 540 of the laws of 2015, is amended to read as follows:
(e) if an appeal is denied, the pharmacy benefit manager shall identify [the national drug code of a therapeutically equivalent drug, as determined by the federal Food and Drug Administration, that is available for purchase by pharmacies in this state from wholesalers registered pursuant to subdivision four of section sixty-eight hundred eight of the education law at a price which is equal to or less than the maximum allowable cost for that drug as determined by the pharmacy benefit manager] in writing: (i) the national drug code of a therapeutically equivalent drug as determined by the food and drug administration that is available for purchase by retail community pharmacies in the same package size, (ii) the name of the wholesaler registered pursuant to subdivision four of section sixty-eight hundred eight of the education law from which the price was obtained, and (iii) the date on which the price was determined.
§ 3. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07427-02-7
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.