New York A01722 amends the insurance law to reduce pharmacy benefit manager costs by implementing a pass-through pricing model.

New York A01722 amends the insurance law by adding a new section that mandates health insurers to use a pass-through pricing model for pharmacy benefit management services. This model limits payments to pharmacy benefit managers to actual ingredient costs, dispensing fees, and an administrative fee. The bill also requires pharmacy benefit managers to identify all sources and amounts of income, payments, and financial benefits. Additionally, it prohibits the use of spread pricing and mandates full disclosure of income and benefits to the health care plan and the department.

New York A01722 amends the insurance law to reduce pharmacy benefit manager costs by implementing a pass-through pricing model.

New York A01722 amends the insurance law by adding a new section that mandates health insurers to use a pass-through pricing model for pharmacy benefit management services. This model limits payments to pharmacy benefit managers to actual ingredient costs, dispensing fees, and an administrative fee. The bill also requires pharmacy benefit managers to identify all sources and amounts of income, payments, and financial benefits. Additionally, it prohibits the use of spread pricing and mandates full disclosure of income and benefits to the health care plan and the department.