2023 New York Laws › PBH - Public Health › Article 2-A - Prescription Drugs › Title 2 - Prescription Drugs; Various Provisions › 280 - Medicaid Drug Cap.

* §  280.  Medicaid  drug  cap.  1.  The  legislature hereby finds and
declares that there is a significant public interest  for  the  Medicaid
program  to  manage  drug  costs in a manner that ensures patient access
while providing financial stability  for  the  state  and  participating
providers.    Since two thousand eleven, the state has taken significant
steps to contain costs in the Medicaid program by imposing  a  statutory
limit  on annual growth. Drug expenditures, however, continually outpace
other  cost  components  causing  significant  pressure  on  the  state,
providers,  and  patient access operating under the Medicaid global cap.
It is therefore intended that the department establish a  Medicaid  drug
cap  as a separate component within the Medicaid global cap as part of a
focused and sustained effort to balance the growth of drug  expenditures
with the growth of total Medicaid expenditures.
2.  The  commissioner  shall  establish  a  year to year department of
health state funds Medicaid drug expenditure growth target as follows:
(a)  for  state  fiscal  year  two  thousand  seventeen--two  thousand
eighteen,  be  limited  to  the  ten-year rolling average of the medical
component of the consumer price index plus  five  percent  and  minus  a
pharmacy savings target of fifty-five million dollars; and
(b)   for  state  fiscal  year  two  thousand  eighteen--two  thousand
nineteen, be limited to the ten-year  rolling  average  of  the  medical
component  of  the  consumer  price  index plus four percent and minus a
pharmacy savings target of eighty-five million dollars;
(c) for state fiscal year two thousand nineteen--two thousand  twenty,
be  limited  to the ten-year rolling average of the medical component of
the consumer price index plus four percent and minus a pharmacy  savings
target of eighty-five million dollars;
(d)   for   state   fiscal  year  two  thousand  twenty--two  thousand
twenty-one, be limited to the ten-year rolling average  of  the  medical
component of the consumer price index plus two percent; and
(e)  for  state  fiscal  year  two  thousand  twenty-one--two thousand
twenty-two and fiscal years thereafter, be limited  in  accordance  with
subdivision one of section ninety-one of part H of chapter fifty-nine of
the laws of two thousand eleven, as amended.
3.  The  department  and  the division of the budget shall assess on a
quarterly basis the projected total amount to be expended in the year on
a cash basis by the Medicaid program for each drug,  and  the  projected
annual  amount of state funds Medicaid drug expenditures on a cash basis
for all drugs, which shall be a component of the projected department of
health state funds Medicaid  expenditures  calculated  for  purposes  of
sections  ninety-one  and  ninety-two of part H of chapter fifty-nine of
the laws of two thousand eleven. For purposes  of  this  section,  state
funds  Medicaid  drug expenditures include amounts expended for drugs in
both the Medicaid fee-for-service  program  and  Medicaid  managed  care
programs,  minus  the  amount  of  any drug rebates or supplemental drug
rebates received  by  the  department,  including  rebates  pursuant  to
subdivision  five  of  this  section with respect to rebate targets. The
department and the division of the budget shall report  in  December  of
each  year, for the prior April through October, to the drug utilization
review board  the  projected  state  funds  Medicaid  drug  expenditures
including  the  amounts,  in  aggregate thereof, attributable to the net
cost of: changes in the utilization of  drugs  by  Medicaid  recipients;
changes  in  the  number  of Medicaid recipients; changes to the cost of
brand name  drugs  and  changes  to  the  cost  of  generic  drugs.  The
information  contained in the report shall not be publicly released in a
manner that allows for the  identification  of  an  individual  drug  or
manufacturer  or that is likely to compromise the financial competitive,
or proprietary nature of the information.
(a) In the event the director  of  the  budget  determines,  based  on
Medicaid  drug  expenditures  for the previous quarter or other relevant
information, that the total department of health  state  funds  Medicaid
drug  expenditure  is  projected  to exceed the annual growth limitation
imposed  by  subdivision  two  of  this  section,  the  commissioner may
identify  and  refer  drugs  to  the  drug  utilization   review   board
established  by  section  three  hundred  sixty-nine-bb  of  the  social
services law for a recommendation as to whether  a  target  supplemental
Medicaid  rebate  should  be paid by the manufacturer of the drug to the
department and the target amount of the rebate.
(b) If the department intends to refer a drug to the drug  utilization
review  board  pursuant  to  paragraph  (a)  of  this  subdivision,  the
department shall notify the manufacturer of such drug and shall  attempt
to  reach agreement with the manufacturer on a rebate for the drug prior
to referring the drug to the drug utilization review board  for  review.
Such  rebate may be based on evidence-based research, including, but not
limited to, such research operated or conducted by or  for  other  state
governments,  the  federal government, the governments of other nations,
and third party payers or multi-state coalitions, provided however  that
the  department  shall  account  for  the  effectiveness  of the drug in
treating the conditions for which it is prescribed  or  in  improving  a
patient's  health,  quality of life, or overall health outcomes, and the
likelihood that use of the drug will reduce the need for  other  medical
care, including hospitalization.
(c)  In  the  event  that  the  commissioner and the manufacturer have
previously agreed to a  supplemental  rebate  for  a  drug  pursuant  to
paragraph  (b) of this subdivision or paragraph (e) of subdivision seven
of section three hundred sixty-seven-a of the social services  law,  the
drug  shall not be referred to the drug utilization review board for any
further supplemental rebate for the  duration  of  the  previous  rebate
agreement,  provided  however,  the commissioner may refer a drug to the
drug utilization review board if the commissioner determines  there  are
significant   and  substantiated  utilization  or  market  changes,  new
evidence-based research, or statutory or federal regulatory changes that
warrant additional rebates. In such cases, the department  shall  notify
the  manufacturer  and  provide evidence of the changes or research that
would warrant additional rebates, and shall attempt to  reach  agreement
with  the  manufacturer  on a rebate for the drug prior to referring the
drug to the drug utilization review board for review.
(d) The department shall consider a drug's actual cost to  the  state,
including  current rebate amounts, prior to seeking an additional rebate
pursuant to paragraph (b) or (c) of this subdivision.
(e) The commissioner shall be authorized to take the actions described
in this section only so long as total  Medicaid  drug  expenditures  are
projected  to exceed the annual growth limitation imposed by subdivision
two of this section.
4. In determining whether to recommend a  target  supplemental  rebate
for  a drug, the drug utilization review board shall consider the actual
cost of the drug to the Medicaid program, including  federal  and  state
rebates, and may consider, among other things:
(a)  the drug's impact on the Medicaid drug spending growth target and
the adequacy of capitation rates of participating Medicaid managed  care
plans,  and  the drug's affordability and value to the Medicaid program;
or
(b) significant and unjustified increases in the price of the drug; or
(c)  whether  the  drug  may  be  priced  disproportionately  to   its
therapeutic benefits.
5. (a) If the drug utilization review board recommends a target rebate
amount  on  a  drug  referred  by the commissioner, the department shall
negotiate with the drug's manufacturer for a supplemental rebate  to  be
paid  by  the manufacturer in an amount not to exceed such target rebate
amount. A rebate requirement shall apply beginning with the first day of
the  state  fiscal  year  during  which  the rebate was required without
regard to the date the department enters into the rebate agreement  with
the manufacturer.
(b)  The  supplemental  rebate  required  by  paragraph  (a)  of  this
subdivision shall apply to drugs dispensed to enrollees of managed  care
providers  pursuant  to section three hundred sixty-four-j of the social
services law and to drugs dispensed to Medicaid recipients who  are  not
enrollees of such providers.
(c)  If  the  drug utilization review board recommends a target rebate
amount for a drug and the department is unable  to  negotiate  a  rebate
from the manufacturer in an amount that is at least seventy-five percent
of the target rebate amount, the commissioner is authorized to waive the
provisions  of paragraph (b) of subdivision three of section two hundred
seventy-three  of  this  article  and  the  provisions  of  subdivisions
twenty-five  and  twenty-five-a of section three hundred sixty-four-j of
the social services law with respect to such drug; however, this  waiver
shall  not be implemented in situations where it would prevent access by
a Medicaid recipient to a  drug  which  is  the  only  treatment  for  a
particular  disease  or  condition.  Under  no  circumstances  shall the
commissioner be authorized to waive such provisions with respect to more
than two drugs in a given time.
(d) Where the department  and  a  manufacturer  enter  into  a  rebate
agreement pursuant to this section, which may be in addition to existing
rebate  agreements  entered into by the manufacturer with respect to the
same drug, no additional rebates shall be required to  be  paid  by  the
manufacturer  to  a  managed  care  provider  or  any  of a managed care
provider's agents, including but not limited  to  any  pharmacy  benefit
manager,  while the department is collecting the rebate pursuant to this
section.
(e) In formulating a recommendation concerning a target rebate  amount
for a drug, the drug utilization review board may consider:
(i)  publicly  available  information  relevant  to the pricing of the
drug;
(ii) information supplied by the department relevant to the pricing of
the drug;
(iii) information relating to value-based pricing  provided,  however,
if   the   department  directly  invites  any  third  party  to  provide
cost-effectiveness analysis or research related to value-based  pricing,
and  the department receives and considers such analysis or research for
use by the board, such third party shall disclose any  funding  sources.
The  department  shall,  if reasonably possible, make publicly available
the following documents in its possession that it relies upon to provide
cost effectiveness analyses or research related to value-based  pricing:
(A)  descriptions  of  underlying  methodologies;  (B)  assumptions  and
limitations of research  findings;  and  (C)  if  available,  data  that
presents  results in a way that reflects different outcomes for affected
subpopulations;
(iv) the seriousness and prevalence of the disease or  condition  that
is treated by the drug;
(v) the extent of utilization of the drug;
(vi)  the  effectiveness  of  the  drug in treating the conditions for
which it is prescribed, or in improving a patient's health,  quality  of
life, or overall health outcomes;
(vii)  the  likelihood  that  use of the drug will reduce the need for
other medical care, including hospitalization;
(viii) the average wholesale price, wholesale acquisition cost, retail
price  of  the  drug,  and  the cost of the drug to the Medicaid program
minus rebates received by the state;
(ix) in the case  of  generic  drugs,  the  number  of  pharmaceutical
manufacturers that produce the drug;
(x) whether there are pharmaceutical equivalents to the drug; and
(xi)  information supplied by the manufacturer, if any, explaining the
relationship between the pricing of the drug and the cost of development
of the drug and/or the therapeutic benefit  of  the  drug,  or  that  is
otherwise  pertinent  to  the  manufacturer's pricing decision; any such
information provided shall be considered confidential and shall  not  be
disclosed by the drug utilization review board in a form that identifies
a   specific   manufacturer   or   prices  charged  for  drugs  by  such
manufacturer.
6. (a) If the drug utilization review board recommends a target rebate
amount or if the commissioner identifies a drug  as  a  high  cost  drug
pursuant  to  subparagraph  (vii)  of  paragraph (e) of subdivision 7 of
section three hundred sixty-seven-a of the social services law  and  the
department  is  unsuccessful  in entering into a rebate arrangement with
the manufacturer of the drug satisfactory to the  department,  the  drug
manufacturer  shall  in  that  event  be  required  to  provide  to  the
department, on a standard reporting form developed  by  the  department,
the following information:
(i) the actual cost of developing, manufacturing, producing (including
the cost per dose of production), and distributing the drug;
(ii) research and development costs of the drug, including payments to
predecessor  entities  conducting  research  and  development,  such  as
biotechnology companies, universities and medical schools,  and  private
research institutions;
(iii)  administrative,  marketing, and advertising costs for the drug,
apportioned by marketing activities  that  are  directed  to  consumers,
marketing  activities  that  are  directed to prescribers, and the total
cost of all marketing and advertising  that  is  directed  primarily  to
consumers  and  prescribers  in  New  York, including but not limited to
prescriber    detailing,    copayment     discount     programs,     and
direct-to-consumer marketing;
(iv) the extent of utilization of the drug;
(v)  prices  for  the  drug that are charged to purchasers outside the
United States;
(vi) prices charged to typical purchasers in the state, including  but
not  limited  to  pharmacies,  pharmacy chains, pharmacy wholesalers, or
other direct purchasers;
(vii) the average rebates and discounts provided per payer type in the
State; and
(viii) the average profit margin of each drug over the prior five-year
period and the projected profit margin anticipated for such drug.
(b) All information  disclosed  pursuant  to  paragraph  (a)  of  this
subdivision  shall be considered confidential and shall not be disclosed
by the department in a form that identifies a specific  manufacturer  or
prices charged for drugs by such manufacturer.
7.  (a)  If,  after  taking  into account all rebates and supplemental
rebates received by the department, including rebates received  to  date
pursuant  to  this  section,  total Medicaid drug expenditures are still
projected to exceed the annual growth limitation imposed by  subdivision
two  of  this  section,  the  commissioner  may:  subject  any drug of a
manufacturer referred to the drug utilization review  board  under  this

section  to  prior  approval  in  accordance with existing processes and
procedures when such manufacturer has not entered  into  a  supplemental
rebate  arrangement  as  required by this section; direct a managed care
plan  to  limit or reduce reimbursement for a drug provided by a medical
practitioner if the drug utilization review board  recommends  a  target
rebate  amount  for  such  drug and the manufacturer has failed to enter
into a rebate arrangement required by this section; direct managed  care
plans  to  remove  from  their  Medicaid  formularies  any  drugs  of  a
manufacturer who has a drug  that  the  drug  utilization  review  board
recommends a target rebate amount for and the manufacturer has failed to
enter  into  a  rebate arrangement required by this section; promote the
use of cost effective and clinically appropriate drugs other than  those
of  a manufacturer who has a drug that the drug utilization review board
recommends a target rebate amount and the  manufacturer  has  failed  to
enter  into  a  rebate  arrangement  required  by  this  section;  allow
manufacturers  to  accelerate  rebate  payments  under  existing  rebate
contracts; and such other actions as authorized by law. The commissioner
shall  provide  written  notice  to the legislature thirty days prior to
taking action pursuant to this paragraph, unless action is necessary  in
the  fourth  quarter  of  a  fiscal  year to prevent total Medicaid drug
expenditures from exceeding the limitation imposed by subdivision two of
this section, in which case such notice to the legislature may  be  less
than thirty days.
(b) The commissioner shall be authorized to take the actions described
in paragraph (a) of this subdivision only so long as total Medicaid drug
expenditures  are  projected  to  exceed  the  annual  growth limitation
imposed by subdivision two of this section. In addition, no such actions
shall be  deemed  to  supersede  the  provisions  of  paragraph  (b)  of
subdivision  three  of section two hundred seventy-three of this article
or the provisions  of  subdivisions  twenty-five  and  twenty-five-a  of
section three hundred sixty-four-j of the social services law, except as
allowed  by  paragraph (c) of subdivision five of this section; provided
further that nothing in this section shall prevent access by a  Medicaid
recipient to a drug which is the only treatment for a particular disease
or condition.
8.  The  commissioner  shall report by July first annually to the drug
utilization review board on savings achieved through the drug cap in the
last fiscal year. Such report shall provide data on  what  savings  were
achieved  through actions pursuant to subdivisions three, five and seven
of this section, respectively, and what savings  were  achieved  through
other means and how such savings were calculated and implemented.
* NB Effective until October 1, 2024
* §  280.  Medicaid  drug  cap.  1.  The  legislature hereby finds and
declares that there is a significant public interest  for  the  Medicaid
program  to  manage  drug  costs in a manner that ensures patient access
while providing financial stability  for  the  state  and  participating
providers.    Since two thousand eleven, the state has taken significant
steps to contain costs in the Medicaid program by imposing  a  statutory
limit  on annual growth. Drug expenditures, however, continually outpace
other  cost  components  causing  significant  pressure  on  the  state,
providers,  and  patient access operating under the Medicaid global cap.
It is therefore intended that the department  establish  a  supplemental
rebate  program as part of a focused and sustained effort to balance the
growth  of  drug  expenditures  with  the  growth  of   total   Medicaid
expenditures.
2.  The  commissioner shall review at least annually the department of
health state funds Medicaid drug expenditures to identify drugs  in  the

eightieth  percentile  or higher of total spend, net of rebate or in the
eightieth percentile or higher based on cost per claim, net of rebate.
3.  (a) The commissioner may identify and refer drugs in the eightieth
percentile or higher of total spend, net of rebate or in  the  eightieth
percentile or higher based on cost per claim, net of rebate, to the drug
utilization   review   board   established   by  section  three  hundred
sixty-nine-bb of the social services law  for  a  recommendation  as  to
whether  a  target  supplemental  Medicaid  rebate should be paid by the
manufacturer of the drug to the department and the target amount of  the
rebate.
(b)  If the department intends to refer a drug to the drug utilization
review  board  pursuant  to  paragraph  (a)  of  this  subdivision,  the
department  shall notify the manufacturer of such drug and shall attempt
to reach agreement with the manufacturer on a rebate for the drug  prior
to  referring  the drug to the drug utilization review board for review.
Such rebate may be based on evidence-based research, including, but  not
limited  to,  such  research operated or conducted by or for other state
governments, the federal government, the governments of  other  nations,
and  third party payers or multi-state coalitions, provided however that
the department shall account  for  the  effectiveness  of  the  drug  in
treating  the  conditions  for  which it is prescribed or in improving a
patient's health, quality of life, or overall health outcomes,  and  the
likelihood  that  use of the drug will reduce the need for other medical
care, including hospitalization.
(c) In the event that  the  commissioner  and  the  manufacturer  have
previously  agreed  to  a  supplemental  rebate  for  a drug pursuant to
paragraph (b) of this subdivision or paragraph (e) of subdivision  seven
of  section  three hundred sixty-seven-a of the social services law, the
drug shall not be referred to the drug utilization review board for  any
further  supplemental  rebate  for  the  duration of the previous rebate
agreement, provided however, the commissioner may refer a  drug  to  the
drug  utilization  review board if the commissioner determines there are
significant  and  substantiated  utilization  or  market  changes,   new
evidence-based research, or statutory or federal regulatory changes that
warrant  additional  rebates. In such cases, the department shall notify
the manufacturer and provide evidence of the changes  or  research  that
would  warrant  additional rebates, and shall attempt to reach agreement
with the manufacturer on a rebate for the drug prior  to  referring  the
drug to the drug utilization review board for review.
(d)  The  department shall consider a drug's actual cost to the state,
including current rebate amounts, prior to seeking an additional  rebate
pursuant to paragraph (b) or (c) of this subdivision.
(e)  If  the  commissioner  is  unsuccessful in entering into a rebate
arrangement with the  manufacturer  of  the  drug  satisfactory  to  the
department,  the  drug  manufacturer shall, in that event be required to
provide to the department, on a standard reporting form developed by the
department, the following information:
(i) the actual cost of developing, manufacturing, producing (including
the cost per dose of production), and distributing the drug;
(ii) research and development costs of the drug, including payments to
predecessor  entities  conducting  research  and  development,  such  as
biotechnology  companies,  universities and medical schools, and private
research institutions;
(iii) administrative, marketing, and advertising costs for  the  drug,
apportioned  by  marketing  activities  that  are directed to consumers,
marketing activities that are directed to  prescribers,  and  the  total
cost  of  all  marketing  and  advertising that is directed primarily to
consumers and prescribers in New York,  including  but  not  limited  to

prescriber     detailing,     copayment     discount    programs,    and
direct-to-consumer marketing;
(iv) the extent of utilization of the drug;
(v)  prices  for  the  drug that are charged to purchasers outside the
United States;
(vi) prices charged to typical purchasers in the state, including  but
not  limited  to  pharmacies,  pharmacy chains, pharmacy wholesalers, or
other direct purchasers;
(vii) the average rebates and discounts provided per payer type in the
state; and
(viii) the average profit margin of each drug over the prior five-year
period and the projected profit margin anticipated for such drug.
(f) All information  disclosed  pursuant  to  paragraph  (e)  of  this
subdivision  shall be considered confidential and shall not be disclosed
by the department in a form that identifies a specific  manufacturer  or
prices charged for drugs by such manufacturer.
4.  In  determining  whether to recommend a target supplemental rebate
for a drug, the drug utilization review board shall consider the  actual
cost  of  the  drug to the Medicaid program, including federal and state
rebates, and may consider, among other things:
(a) the drug's impact on Medicaid drug spending, and the  adequacy  of
capitation  rates  of participating Medicaid managed care plans, and the
drug's affordability and value to the Medicaid program; or
(b) significant and unjustified increases in the price of the drug; or
(c)  whether  the  drug  may  be  priced  disproportionately  to   its
therapeutic benefits.
5. (a) If the drug utilization review board recommends a target rebate
amount  on  a  drug  referred  by the commissioner, the department shall
negotiate with the drug's manufacturer for a supplemental rebate  to  be
paid  by  the manufacturer in an amount not to exceed such target rebate
amount.
(b)  The  supplemental  rebate  required  by  paragraph  (a)  of  this
subdivision  shall apply to drugs dispensed to enrollees of managed care
providers pursuant to section three hundred sixty-four-j of  the  social
services  law  and to drugs dispensed to Medicaid recipients who are not
enrollees of such providers.
(c) Where the department  and  a  manufacturer  enter  into  a  rebate
agreement pursuant to this section, which may be in addition to existing
rebate  agreements  entered into by the manufacturer with respect to the
same drug, no additional rebates shall be required to  be  paid  by  the
manufacturer  to  a  managed  care  provider  or  any  of a managed care
provider's agents, including but not limited  to  any  pharmacy  benefit
manager,  while the department is collecting the rebate pursuant to this
section.
(d) In formulating a recommendation concerning a target rebate  amount
for a drug, the drug utilization review board may consider:
(i)  publicly  available  information  relevant  to the pricing of the
drug;
(ii) information supplied by the department relevant to the pricing of
the drug;
(iii) information relating to value-based pricing  provided,  however,
if   the   department  directly  invites  any  third  party  to  provide
cost-effectiveness analysis or research related to value-based  pricing,
and  the department receives and considers such analysis or research for
use by the board, such third party shall disclose any  funding  sources.
The  department  shall,  if reasonably possible, make publicly available
the following documents in its possession that it relies upon to provide
cost effectiveness analyses or research related to value-based  pricing:

(A)  descriptions  of  underlying  methodologies;  (B)  assumptions  and
limitations of research  findings;  and  (C)  if  available,  data  that
presents  results in a way that reflects different outcomes for affected
subpopulations;
(iv)  the  seriousness and prevalence of the disease or condition that
is treated by the drug;
(v) the extent of utilization of the drug;
(vi) the effectiveness of the drug  in  treating  the  conditions  for
which  it  is prescribed, or in improving a patient's health, quality of
life, or overall health outcomes;
(vii) the likelihood that use of the drug will  reduce  the  need  for
other medical care, including hospitalization;
(viii) the average wholesale price, wholesale acquisition cost, retail
price  of  the  drug,  and  the cost of the drug to the Medicaid program
minus rebates received by the state;
(ix) in the case  of  generic  drugs,  the  number  of  pharmaceutical
manufacturers that produce the drug;
(x) whether there are pharmaceutical equivalents to the drug; and
(xi)  information supplied by the manufacturer, if any, explaining the
relationship between the pricing of the drug and the cost of development
of the drug and/or the therapeutic benefit  of  the  drug,  or  that  is
otherwise  pertinent  to  the  manufacturer's pricing decision; any such
information, including the information on the  standard  reporting  form
requirement  in  paragraph  (e)  of  subdivision  three of this section,
provided shall be considered confidential and shall not be disclosed  by
the  drug  utilization review board in a form that identifies a specific
manufacturer or prices charged for drugs by such manufacturer.
6. (a) After taking into account all rebates and supplemental  rebates
received  by the department, including rebates received to date pursuant
to  this  section,  the  commissioner  may:  subject  any  drug   of   a
manufacturer  referred  to  the drug utilization review board under this
section to prior approval in  accordance  with  existing  processes  and
procedures  when  such  manufacturer has not entered into a supplemental
rebate arrangement as required by this section; direct  a  managed  care
plan  to  limit or reduce reimbursement for a drug provided by a medical
practitioner if the drug utilization review board  recommends  a  target
rebate  amount  for  such  drug and the manufacturer has failed to enter
into a rebate arrangement required by this section; direct managed  care
plans  to  remove  from  their  Medicaid  formularies  any  drugs  of  a
manufacturer who has a drug  that  the  drug  utilization  review  board
recommends a target rebate amount for and the manufacturer has failed to
enter  into  a  rebate arrangement required by this section; promote the
use of cost effective and clinically appropriate drugs other than  those
of  a manufacturer who has a drug that the drug utilization review board
recommends a target rebate amount and the  manufacturer  has  failed  to
enter  into  a  rebate  arrangement  required  by  this  section;  allow
manufacturers  to  accelerate  rebate  payments  under  existing  rebate
contracts; and such other actions as authorized by law. The commissioner
shall  provide  written  notice  to the legislature at least thirty days
prior to taking action pursuant to this paragraph.
(b) The commissioner shall be authorized to take the actions described
in paragraph (a) of this subdivision. In addition, no such actions shall
be deemed to supersede the provisions of paragraph  (b)  of  subdivision
three  of  section  two  hundred  seventy-three  of  this article or the
provisions of subdivisions  twenty-five  and  twenty-five-a  of  section
three  hundred sixty-four-j of the social services law; provided further
that nothing  in  this  section  shall  prevent  access  by  a  Medicaid

recipient to a drug which is the only treatment for a particular disease
or condition.
7.  The  commissioner shall provide a report by July first annually to
the drug utilization review board, the  governor,  the  speaker  of  the
assembly,  and the temporary president of the senate on savings achieved
through the supplemental rebate programs in the last fiscal  year.  Such
report  shall provide data on what savings were achieved through actions
pursuant  to  subdivisions  three,  five  and  six  of   this   section,
respectively, and what savings were achieved through other means and how
such savings were calculated and implemented.
* NB Effective October 1, 2024