Requires insurers to cover the substitution of a brand name prescription drug when the federal food and drug administration has declared that there is a supply issue with a generic drug.
Summary
Bill A01428 amends the New York insurance law to require insurers to provide coverage for brand name prescription drugs when a generic equivalent is unavailable due to a recognized supply issue by the federal Food and Drug Administration (FDA). The bill defines eligible prescription drugs and outlines the conditions under which coverage for brand name drugs must be provided, ensuring that patients can continue their treatment without interruption when generic alternatives are not accessible.
Impact
The bill impacts state insurance laws by mandating that insurers cover brand name drugs at the same level as their generic counterparts during recognized drug shortages. This change aims to protect patients from potential health risks associated with abrupt changes in their medication regimen due to supply issues, thereby enhancing patient care and access to necessary medications.
Sentiment
The sentiment around Bill A01428 has been generally favorable, as evidenced by the supportive votes in both the Assembly and Senate. The Assembly Insurance Committee initially voted 18-4 in favor, and the final passage votes in both chambers showed a majority of support, indicating a recognition of the importance of ensuring drug availability for patients in need.
Contention
Notable points of contention include concerns from some legislators about the potential increased costs for insurers and the implications for drug pricing. Opponents argue that mandating coverage for brand name drugs could lead to higher premiums for consumers, while proponents emphasize the necessity of maintaining treatment continuity for patients during drug shortages.
Same As
Requires insurers to cover the substitution of a brand name prescription drug when the federal food and drug administration has declared that there is a supply issue with a generic drug.
Requires insurers to cover the substitution of a brand name prescription drug when the federal food and drug administration has declared that there is a supply issue with a generic drug.
Requires health plan coverage to include generic drugs and biosimilars where the wholesale acquisition cost of such generic drugs or biosimilars is lower than the brand drug's wholesale acquisition cost.
Authorizes insurance policies which provide coverage for prescription drugs where cost-sharing obligations are determined by category of prescription drugs to offer a program to insureds that utilizes rebates or discounts to lower an insured's cost-sharing for prescription drugs if the insured's cost-sharing under such program would be more favorable than the cost-sharing that would otherwise be applicable to the prescription drug.
Authorizes insurance policies which provide coverage for prescription drugs where cost-sharing obligations are determined by category of prescription drugs to offer a program to insureds that utilizes rebates or discounts to lower an insured's cost-sharing for prescription drugs if the insured's cost-sharing under such program would be more favorable than the cost-sharing that would otherwise be applicable to the prescription drug.
Prohibiting certain health insurers from requiring cost-sharing for nonopioid prescription drugs or providing less favorable coverage for such drug than that for opioid or narcotic prescription drugs for the treatment of pain.
An act to amend Section 4073.5 of the Business and Professions Code, to amend Section 1367.22 of the Health and Safety Code, and to add Section 10123.190 to the Insurance Code, relating to prescription drugs.
Prescriptions for testosterone not allowed to be transmitted or reported within the prescription drug monitoring database and removes from the records all existing information concerning prior testosterone prescriptions.
Prescriptions for testosterone not allowed to be transmitted or reported within the prescription drug monitoring database and removes from the records all existing information concerning prior testosterone prescriptions.
Increases the maximum fill for non-opioid, non-narcotic controlled substances found in schedule II, so that a sixty-day (60) supply may be dispensed at any one time.
Increases the maximum fill for non-opioid, non-narcotic controlled substances found in schedule II, so that a ninety-day (90) supply may be dispensed at any one time.