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Bill > A05882
NY A05882
NY A05882Requires a pharmacy benefit manager to pay a participating pharmacy at minimum at the national average drug acquisition cost (NADAC) rate, or at the pharmacy acquisition cost rate if greater or there is not a NADAC rate, plus a professional dispensing fee that is at minimum the professional dispensing fee paid under the state medical assistance program.
summary
Introduced
02/24/2025
02/24/2025
In Committee
01/07/2026
01/07/2026
Crossed Over
Passed
Dead
Introduced Session
2025-2026 General Assembly
Bill Summary
AN ACT to amend the public health law and the insurance law, in relation to payments by pharmacy benefit managers to participating pharmacies
AI Summary
This bill requires pharmacy benefit managers (PBMs), which are companies that manage prescription drug benefits on behalf of health insurers, to pay participating pharmacies at a minimum rate that covers the pharmacy's cost to acquire the medication plus a professional dispensing fee. Specifically, PBMs must pay pharmacies at least the National Average Drug Acquisition Cost (NADAC) rate, which is a federal survey of average drug costs at retail pharmacies, or the pharmacy's actual acquisition cost if there is no NADAC rate or if the pharmacy's cost is higher. Additionally, PBMs must pay a professional dispensing fee that is at least as much as the fee paid under the state's medical assistance program, and this fee can be higher for certain complex medications requiring special handling or patient education to ensure pharmacies are not paid less than their costs. The bill also mandates that PBMs establish a reasonable process for pharmacies to appeal disputes regarding drug pricing for generic, brand-name, and biologic drugs, and it defines "pharmacy acquisition cost rate" as the cost a pharmacy pays to acquire drugs based on invoices. This legislation, which takes effect in 2027, aims to ensure pharmacies are adequately reimbursed for the medications they dispense, with an exception for certain collectively bargained health plans.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (114)
Dana Levenberg (D)*,
John McDonald (D)*,
George Alvarez (D),
Joe Angelino (R),
Andrea Bailey (R),
Didi Barrett (D),
Anil Beephan Jr. (R),
Scott Bendett (R),
Michael Benedetto (D),
Ken Blankenbush (R),
Jake Blumencranz (R),
Paul Bologna (R),
Alex Bores (D),
Karl Brabenec (R),
Ed Braunstein (D),
Harry Bronson (D),
Keith Brown (R),
Chris Burdick (D),
Pat Burke (D),
Noah Burroughs (D),
Marianne Buttenschon (D),
Patrick Carroll (D),
Robert Carroll (D),
Patrick Chludzinski (R),
Sarah Clark (D),
William Conrad (D),
Catalina Cruz (D),
Brian Cunningham (D),
Landon Dais (D),
Maritza Davila (D),
Manny De Los Santos (D),
Joe DeStefano (R),
Erik Dilan (D),
Jeffrey Dinowitz (D),
Chris Eachus (D),
Charles Fall (D),
Mike Fitzpatrick (R),
Emily Gallagher (D),
Jeff Gallahan (R),
Deborah Glick (D),
Jessica González-Rojas (D),
Scott Gray (R),
Judy Griffin (D),
Steve Hawley (R),
Andrew Hevesi (D),
Larinda Hooks (D),
Pamela Hunter (D),
Alicia Hyndman (D),
Chantel Jackson (D),
Jonathan Jacobson (D),
Josh Jensen (R),
Billy Jones (D),
Rebecca Kassay (D),
Paula Kay (D),
Anna Kelles (D),
Ron Kim (D),
Micah Lasher (D),
Charles Lavine (D),
Grace Lee (D),
John Lemondes (R),
Nikki Lucas (D),
Jen Lunsford (D),
Donna Lupardo (D),
Bill Magnarelli (D),
Brian Maher (R),
Brian Manktelow (R),
Dave McDonough (R),
Karen McMahon (D),
Demond Meeks (D),
John Mikulin (R),
Brian Miller (R),
Angelo Morinello (R),
Misha Novakhov (R),
Kwani O'Pharrow (D),
Steve Otis (D),
Phil Palmesano (R),
Amy Paulin (D),
Crystal Peoples-Stokes (D),
Stacey Pheffer Amato (D),
Ed Ra (R),
Jenifer Rajkumar (D),
Karines Reyes (D),
Jonathan Rivera (D),
Gabriella Romero (D),
Linda Rosenthal (D),
Nily Rozic (D),
Angelo Santabarbara (D),
Nader Sayegh (D),
Thomas Schiavoni (D),
Rebecca Seawright (D),
Joseph Sempolinski (R),
Amanda Septimo (D),
Maryjane Shimsky (D),
Sarahana Shrestha (D),
Jo Anne Simon (D),
Tony Simone (D),
Matt Simpson (R),
Matt Slater (R),
Michaelle Solages (D),
Phara Souffrant Forrest (D),
Phil Steck (D),
Steve Stern (D),
Al Stirpe (D),
Yudelka Tapia (D),
Al Taylor (D),
Latrice Walker (D),
David Weprin (D),
Aron Wieder (D),
Jaime Williams (D),
Carrie Woerner (D),
Jordan Wright (D),
Kalman Yeger (D),
John Zaccaro (D),
Stefani Zinerman (D),
Last Action
print number 5882c (on 02/24/2026)
Official Document
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