Bill > S08098

This bill expands pharmacy benefit management (PBM) services to include durable medical equipment (DME), which are medical devices and equipment like orthopedic appliances, medical/surgical supplies, and equipment used for specific medical conditions. The bill defines durable medical equipment as items that can withstand repeated use, are primarily used for medical purposes, and are not typically useful outside of treating an illness or injury. The legislation modifies multiple sections of New York state law to incorporate DME into existing regulations governing pharmacy benefit managers, including audit procedures, network creation, cost-sharing information, and appeals processes. Key changes include requiring PBMs to follow the same audit rules for DME providers as they do for pharmacies, allowing DME providers to appeal pricing and claims, mandating transparency in cost-sharing information for DME, and establishing penalties for violations of these new regulations. The bill aims to provide more oversight and consistency in how durable medical equipment is managed and reimbursed, similar to existing regulations for prescription drugs, ultimately seeking to protect consumers and healthcare providers.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/S8098