Bill > S05719

This bill amends the New York Public Health Law to address pharmacy benefit manager (PBM) reimbursement practices by establishing new requirements for drug pricing and reimbursement. Specifically, the bill requires PBMs to identify therapeutically equivalent drugs available at or below their maximum allowable cost, and if a pharmacy cannot purchase a drug at the specified cost, the PBM must adjust its pricing methodology and allow the pharmacy to reverse and rebill affected claims. Moreover, the bill prohibits PBMs from reimbursing a pharmacy or pharmacist less than what they would reimburse their own affiliate for the same pharmacist services, with reimbursement calculated on a per-unit basis using the same generic product identifier. This legislation aims to ensure that pharmacies are not forced to dispense medications at a loss and to create more equitable reimbursement practices in the pharmaceutical supply chain. The bill will take effect 90 days after becoming law, providing a transition period for implementation.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/S5719