New York Senate Bill S00355

New York 2025-2026 Regular Session

• Introduced: 1/8/25
• Refer: 1/8/25
• Report Pass: 2/4/25
• Engrossed: 5/20/25
• Refer: 5/20/25

Caption

Relates to program eligibility for plans comparable to Medicare part D; provides for analysis of health plans by the department of health to determine whether such health plans meet or exceed the Medicare part D standard; requires the department of health, in consultation with the department of financial services, to notify prescription drug insurers of the provisions of this act.

Impact

The bill's provisions would modify the Elder Law and public health law, ensuring that program participants are enrolled in Medicare Part D or an equivalent plan certified by the Centers for Medicare & Medicaid Services (CMS). This ensures that eligible individuals would receive assistance with their prescription drug premiums, particularly targeting those with lower income levels. The implications of passing this act could significantly enhance the affordability and accessibility of prescription drugs for the elderly population, while also placing a responsibility on insurers to prove that their plans align with Medicare standards.

Summary

Bill S00355 aims to amend existing laws related to eligibility for health plans comparable to Medicare Part D, specifically focusing on prescription drug coverage. The legislation establishes new guidelines for how the state's Department of Health will evaluate and analyze health plans to ensure that they meet or exceed the standards set by Medicare Part D. By allowing for the assessment of both public and private drug plans, the bill seeks to expand the options available to participants in programs such as the Elderly Pharmaceutical Insurance Coverage (EPIC) program, making it easier for them to access necessary medications.

Contention

Key points of contention regarding Bill S00355 primarily stem from concerns about the adequacy of the assessment process and the potential impact on beneficiaries who may not have access to comparable plans. Critics may argue that while the assessment process is designed to ensure quality coverage, it may inadvertently limit the choices for consumers if only a few plans meet the established criteria. There are also apprehensions about the administrative burden this places on both state agencies and insurers, which may complicate the landscape for health plan offerings in New York.