Healthcare (Prescription Drugs)

in committee · New York · Assembly Jan 7, 2026

A 6546: Prohibits the ownership, operation or control of pharmacies by pharmacy benefit managers

This bill prohibits pharmacy benefit managers (PBMs) - companies that manage prescription drug coverage for insurers - from owning, operating, or controlling pharmacies directly or indirectly. It applies to all entities (including corporations and associations) currently violating this rule, requiring them to sell their pharmacy holdings within three years. The law defines "pharmacy benefit manager" using an existing public health law definition. This creates a clear separation between PBMs and pharmacies, aiming to prevent conflicts of interest in drug pricing and patient care.

Topics ✓ HealthcareSupports HealthcareProhibits PBMs from owning pharmacies to prevent conflicts of interest, ensuring fairer prescription drug coverage and improving patient access to pharmacy services.95% confidence

Sub-Topics Prescription Drugs Public Health

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in committee · New York · Assembly Jan 7, 2026

A 8576: Preserves access to affordable drugs

Relates to preserving access to affordable drugs; provides that an agreement resolving or settling, on a final or interim basis, a patent infringement claim, in connection with the sale of a pharmaceutical product, shall be presumed to have anticompetitive effects if a nonreference drug filer receives anything of value from another company asserting patent infringement and if the nonreference drug filer agrees to limit or forego research, development, manufacturing, marketing, or sales of the nonreference drug filer's product for any period of time.

Topics ✓ HealthcareSupports HealthcareBill prevents anticompetitive patent settlements delaying generic drug entry, directly improving patient access to affordable medications per title and summary.95% confidence

Sub-Topics Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 7900: Relates to prescription drug cost-sharing assistance

Authorizes insurance policies which provide coverage for prescription drugs where cost-sharing obligations are determined by category of prescription drugs to offer a program to insureds that utilizes rebates or discounts to lower an insured's cost-sharing for prescription drugs if the insured's cost-sharing under such program would be more favorable than the cost-sharing that would otherwise be applicable to the prescription drug.

Topics ✓ HealthcareSupports HealthcareBill lowers patient prescription drug costs via rebates/discounts, improving affordability and access to medications under insurance coverage.95% confidence

Sub-Topics Insurance Prescription Drugs

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vetoed · New York · Senate Oct 16, 2025

S 6441: Requires certain health insurance policies include coverage for services provided by pharmacists related to contraceptives

This bill requires most health insurance plans to cover contraceptive services provided by pharmacists without cost-sharing. It mandates coverage for all FDA-approved contraceptives (including over-the-counter options), emergency contraception, patient counseling, and follow-up care like device insertion/removal. Plans must allow dispensing up to 12 months of contraceptives at once and reimburse pharmacists the same rate as other healthcare providers. The law applies to group/blanket health insurance policies issued or renewed on or after January 1, 2025, directly affecting insured individuals and pharmacists providing these services.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for contraceptive services without cost-sharing, expanding access to reproductive healthcare services.95% confidence

Sub-Topics Insurance Prescription Drugs Women's Health

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in committee · New York · Senate Jan 7, 2026

S 1794: Requires DOH to develop a payment methodology for federally qualified health centers and rural health centers that dispense ovulation enhancing drugs

Requires federally qualified health centers and rural health centers cover the cost of all ovulation enhancing drugs dispensed and other covered entities pursuant to section 340B of the federal public health service act.

Topics ✓ HealthcareSupports HealthcareMandates coverage of ovulation drugs for FQHCs/RHCs under 340B, expanding access to reproductive health services without cost barriers.90% confidence

Sub-Topics Prescription Drugs Public Health

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in committee · New York · Senate Jan 7, 2026

S 1795: Relates to the substitution of brand name epinephrine auto-injectors with alternate epinephrine auto-injectors

This bill allows pharmacists to swap brand-name epinephrine auto-injectors (like EpiPens) with cheaper, equally effective generic versions when a patient is prescribed one. It requires pharmacists to confirm the alternative is less expensive, get the patient’s consent, and provide proper usage instructions. The swap is permitted only if the doctor didn’t specify "dispense as written" on the prescription. This aims to lower costs for patients while ensuring safety through pharmacist counseling.

Topics ✓ HealthcareSupports HealthcareReduces patient costs for essential epinephrine injectors via pharmacist substitution, improving access while mandating safety counseling and consent.92% confidence

Sub-Topics Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 5013: Requires health insurers to provide coverage for opioid antagonists and devices

This bill requires health insurers to cover at least one opioid antagonist (like naloxone) and related devices in all prescription drug plans. It directly affects insurers, patients at risk of opioid overdose, and healthcare providers who can prescribe these medications via standing orders. The law mandates coverage without eliminating deductibles or co-insurance, which may apply as they do for other covered treatments. Naloxone is specifically named as the primary opioid antagonist to be covered, as defined by the FDA and New York’s Department of Health.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for naloxone, expanding access to life-saving opioid overdose reversal treatment without eliminating cost-sharing.95% confidence

Sub-Topics Prescription Drugs Substance Abuse

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in committee · New York · Senate Jan 7, 2026

S 987: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

This bill (S 987) requires health insurance plans to cover at least one abuse-deterrent opioid pain medication per active ingredient, ensuring patients can access FDA-approved options designed to reduce misuse. It prohibits higher copays or deductibles for these medications compared to standard opioids and bans prior authorization rules that force patients to try non-abuse-deterrent opioids first. The law applies to all insurance plans covering opioid pain medications, directly affecting patients, insurers, and healthcare providers. Key provisions mandate equal cost-sharing for abuse-deterrent and non-abuse-deterrent versions and prevent insurers from adding financial barriers to access these medications. The bill takes effect 120 days after enactment for new or renewed insurance policies.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage of abuse-deterrent opioids without higher costs or prior authorization, improving patient access to safer pain medication options per bill summary.95% confidence

Sub-Topics Insurance Prescription Drugs Substance Abuse

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in committee · New York · Senate Jan 30, 2026

S 1351: Relates to requiring a referenced rate for prescription drugs

S 1351 creates a pilot program to control prescription drug costs by setting maximum prices ("referenced rates") based on the lowest prices for the same drugs in four Canadian provinces (Ontario, Quebec, British Columbia, and Alberta). It applies to state health programs and pharmacies purchasing drugs for state-funded health plans, requiring them to pay no more than the referenced rate for the five most expensive drugs identified by the state. Any savings generated from this pricing cap must be directly passed to consumers through reduced costs. The pilot runs for one year, with a report due to state leaders assessing its feasibility for broader expansion.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill caps state drug costs at Canadian rates, reducing expenditures on health programs and promoting fiscal responsibility through cost containment.90% confidence ✓ HealthcareSupports HealthcareBill caps prescription drug prices for state programs, reducing costs and improving patient access to medications through referenced rates.95% confidence

Sub-Topics Procurement Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 6164: Relates to prescription drugs in Medicaid managed care programs; repealer

Requires Medicaid managed care, and Child Health Plus plans to adopt the procedural protections of the Preferred Drug Program, including "prescriber prevails", for all drugs.

Topics ✓ HealthcareSupports HealthcareRequires Medicaid managed care to adopt 'prescriber prevails' protections, ensuring doctors' drug choices aren't overridden, improving patient access and rights.95% confidence

Sub-Topics Children's Health Medicaid Prescription Drugs

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