Relates to reimbursements practices of pharmacy benefit managers

S 5719 requires pharmacy benefit managers (PBMs) in New York to reimburse pharmacies for drugs at a rate equal to or higher than the pharmacy's actual cost of purchasing the drug. If a PBM denies a claim for a specific drug, it must provide a therapeutically equivalent alternative that the pharmacy can buy at or below the PBM's reimbursement rate; if unavailable at that cost, the PBM must adjust the reimbursement to cover the pharmacy's actual acquisition cost and allow rebilling. The bill also prohibits PBMs from reimbursing pharmacies less than they pay their own affiliated pharmacies for the same services, ensuring consistent payment rates. This directly affects pharmacies and PBMs operating in New York, aiming to prevent underpayment for drug procurement.