New York 2025-2026 Regular Session

New York Assembly Bill A07119

Introduced
3/20/25  
Refer
3/20/25  

Caption

Requires managed care providers to annually provide each participant in their programs with a written list of mail-order pharmacies with which the managed care provider has a contract for coverage of prescription drugs.

Summary

Bill A07119 mandates that managed care providers in New York must annually provide participants with a written list of mail-order pharmacies that are contracted for prescription drug coverage. This requirement aims to enhance transparency and accessibility for patients regarding their medication options, particularly those who utilize mail-order services. The bill also clarifies that participants can fill prescriptions at any pharmacy within the managed care provider's network, provided that the chosen pharmacy offers comparable pricing to designated pharmacies.

Impact

The bill will amend the social services law, specifically section 364-j, to ensure that managed care providers are obligated to inform participants about their mail-order pharmacy options. This change is expected to improve patient awareness and potentially increase competition among pharmacies, which could lead to better pricing and service options for consumers. It will apply to all contracts and agreements entered into after the bill's effective date.

Sentiment

The sentiment surrounding Bill A07119 appears to be generally positive, with support for increased transparency in prescription drug coverage. However, there may be concerns from managed care providers regarding the administrative burden of complying with the new requirements. The lack of recorded votes or detailed committee discussions suggests that the bill has not yet faced significant opposition or debate.

Contention

Notable points of contention may arise from managed care providers who could argue that the requirement to provide annual lists of mail-order pharmacies adds to their operational costs and complexity. Conversely, advocates for patient rights and healthcare transparency support the bill, emphasizing the importance of informed choices for patients regarding their medication options.

Companion Bills

No companion bills found.

Previously Filed As

NY A01036

Requires managed care providers that provide coverage for prescription drugs to provide coverage for home delivery of any covered prescription by any non-mail-order retail pharmacy in the managed care provider network.

NY A07149

Requires managed care providers that provide coverage for prescription drugs to provide coverage for home delivery of any covered prescription by any non-mail-order retail pharmacy in the managed care provider network.

NY SSB1207

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs.

NY SB60

Pharmacy Benefits Managers; managers have a duty of care to insureds, health plans, and providers; provide

NY HF852

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(Formerly HSB 99.)

NY HB1956

Provider contracts; pharmacies allowed to refuse to fill certain prescriptions.

NY SSB1074

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See SF 383.)

NY HSB99

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See HF 852.)

NY S2918

Requires prescription drug coverage for serious mental illness without prior authorization or utilization management, including step therapy.

NY A4694

Requires prescription drug coverage for serious mental illness without prior authorization or utilization management, including step therapy.

Similar Bills

KS HB2551

Enacting the Kansas pharmacy services administrative organization act.

MS HB1125

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

MS HB558

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

AR SB593

To Amend The Arkansas Pharmacy Benefits Manager Licensure Act; And To Create The Pharmacy Services Administrative Organization Act.

NJ S2345

"Patient and Provider Protection Act."

AR SB475

To Establish The Pharmacy Services Administrative Organization Act; And To Regulate Pharmacy Services Administrative Organizations.

MS HB1119

Pharmacy benefit managers; revise provisions related to.

AZ HB2429

Pharmacy benefits; pharmacy management networks