New York A11256 mandates health plans to cover generic drugs and biosimilars if their wholesale acquisition cost is lower than the brand drug's cost.

New York A11256 amends the insurance law to require health plans to include coverage for generic drugs and biosimilars when their wholesale acquisition cost is lower than the brand drug's cost. This applies to policies and contracts issued, renewed, or amended after the bill's effective date. Health plans must make these lower-cost alternatives available on the formulary with more favorable cost-sharing and cannot impose restrictions that make it harder for enrollees to access them. The superintendent is authorized to create rules and regulations necessary for implementing these provisions.

New York A11256 mandates health plans to cover generic drugs and biosimilars if their wholesale acquisition cost is lower than the brand drug's cost.

New York A11256 amends the insurance law to require health plans to include coverage for generic drugs and biosimilars when their wholesale acquisition cost is lower than the brand drug's cost. This applies to policies and contracts issued, renewed, or amended after the bill's effective date. Health plans must make these lower-cost alternatives available on the formulary with more favorable cost-sharing and cannot impose restrictions that make it harder for enrollees to access them. The superintendent is authorized to create rules and regulations necessary for implementing these provisions.