2023 New York Laws › ISC - Insurance › Article 1 - General Provisions › 111-A - Notification of Prescription Drug Price Increases by Manufacturers.

* §  111-a.  Notification  of  prescription  drug  price  increases by
manufacturers. (a) This section shall  apply  to  a  manufacturer  of  a
prescription  drug  that is purchased or reimbursed in this state by any
of the following:
(1) An insurance company authorized in this state  to  write  accident
and   health   insurance,   a  company  organized  pursuant  to  article
forty-three of this chapter, a municipal cooperative health benefit plan
established  pursuant  to  article  forty-seven  of  this  chapter,   an
organization  certified  pursuant  to  article  forty-four of the public
health law, an institution of higher  education  certified  pursuant  to
section one thousand one hundred twenty-four of this chapter, or the New
York  state health insurance plan established pursuant to article eleven
of the civil service law; or
(2) A pharmacy benefit manager, including an entity that  directly  or
through an intermediary, manages the prescription drug coverage provided
by  a  health insurer under a contract or policy delivered or issued for
delivery in this state or a health plan subject to section three hundred
sixty-four-j of the social services law, including  the  processing  and
payment  of  claims  for  prescription  drugs,  the  performance of drug
utilization review, the processing of drug prior authorization requests,
the adjudication of appeals or grievances related to  prescription  drug
coverage,  contracting with network pharmacies, and controlling the cost
of covered prescription drugs.
(b) (1) A  manufacturer  of  a  prescription  drug  with  a  wholesale
acquisition  cost  of  more  than  forty dollars for a course of therapy
shall notify the superintendent, his or  her  deputy  or  other  officer
designated  by  the  superintendent,  if  the  increase in the wholesale
acquisition cost of such prescription drug is more than sixteen percent,
including the  proposed  increase  and  the  cumulative  increases  that
occurred  within  the  previous  twenty-four months prior to the planned
effective date of the increase. For purposes of this section, a  "course
of therapy" is defined as either of the following:
(i) the recommended daily dosage units of a prescription drug pursuant
to  its  prescribing  label  as  approved  by  the federal Food and Drug
Administration for thirty days; or
(ii) the  recommended  daily  dosage  units  of  a  prescription  drug
pursuant  to  its  prescribing label as approved by the federal Food and
Drug Administration for a normal course of treatment that is  less  than
thirty days.
(2)  (i) The notice required by paragraph one of this subsection shall
be provided in writing to the superintendent at least sixty  days  prior
to  the  planned  effective  date  of the increase and shall include the
proposed increase and the cumulative increases that occurred within  the
previous twenty-four months.
(ii) The superintendent shall forthwith publish the notice required by
paragraph one of this subsection on the department of financial services
website within five days of its receipt.
(3)  (i) The notice required by paragraph one of this subsection shall
include the date of the increase, the current wholesale acquisition cost
of the prescription drug, and the dollar amount of the  future  increase
in the wholesale acquisition cost of the prescription drug.
(ii)  The  notice  required  by paragraph one of this subsection shall
include a statement regarding whether a change  or  improvement  in  the
drug  necessitates  the  price  increase.  If so, the manufacturer shall
describe the change or improvement.
(4) Information supplied by a manufacturer pursuant  to  this  section
that  the manufacturer has reasonably designated as a trade secret shall
be considered confidential and a trade  secret,  shall  be  exempt  from

public  disclosure  and copying under article six of the public officers
law  and  shall  not  be  disclosed  directly  or  indirectly   by   the
superintendent.      Notwithstanding   the   foregoing   sentence,   the
superintendent   shall  be  permitted  to  disclose  information  in  an
aggregated format if  such  aggregate  information  cannot  directly  or
indirectly  be  used  to  identify trade secret information related to a
specific manufacturer or the manufacturer's prescription drug, including
but  not  limited  to  any  information  related  to  pricing  for   the
manufacturer's  prescription drug that has been reasonably designated as
a trade secret.
(5) In the event that a manufacturer of a prescription drug subject to
this section does not report the information required in  paragraph  one
of  this  subsection,  the  superintendent  is  authorized to impose any
penalty or remedy  authorized  by  this  chapter,  after  notice  and  a
hearing,  against  such  manufacturer of up to five thousand dollars per
day for every day after the reporting period described in  this  section
that the required information is not reported.
* NB Effective June 19, 2024