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.