Healthcare (Prescription Drugs)

in committee · New York · Senate Jan 7, 2026

S 4689: Relates to reporting information regarding step therapy override requests and determinations; repealer

Requires disclosure, in such form as the superintendent shall require, of non-confidential information regarding step therapy override requests and determinations on a website that is readily accessible to the public.

Topics ✓ HealthcareSupports HealthcareMandates public disclosure of step therapy override decisions, improving transparency and patient access to necessary treatments.90% confidence

Sub-Topics Prescription Drugs

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in committee · New York · Assembly Jan 7, 2026

A 5074: Requires insurance coverage for the cost of donated breast milk

This bill requires all health insurance plans covering prescription drugs to also cover the cost of donated breast milk. It directly affects insurance companies and policyholders by mandating this coverage under existing prescription drug coverage policies. The key provision amends three sections of the insurance law to explicitly include donated breast milk costs in all relevant insurance policies, effective immediately. This creates a concrete policy change without altering existing coverage requirements for other medical expenses.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for donated breast milk, expanding health insurance benefits for infant nutrition access under prescription drug coverage policies.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · New York · Assembly Jan 27, 2026

A 2126: Relates to requiring a referenced rate for prescription drugs

This bill creates a pilot program requiring New York state health programs to pay no more than the lowest price for certain prescription drugs in Canada. It sets maximum prices based on the most recent drug pricing lists from Ontario, Quebec, British Columbia, and Alberta, starting with the five most expensive drugs. State agencies and health plans must pay these Canadian-based rates for covered drugs, and any savings generated must be passed directly to consumers through reduced costs. The program applies only to state-funded health plans and agencies purchasing drugs for state programs, excluding Medicaid.

Topics ✓ HealthcareSupports HealthcareMandates state programs to pay Canadian drug prices, passing savings to consumers and reducing prescription costs, improving access to affordable medications.95% confidence

Sub-Topics Medicaid Prescription Drugs

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in committee · New York · Assembly Jan 28, 2025

A 1040: Relates to establishing the expanded pharmaceutical insurance coverage panel

This bill creates a new "expanded pharmaceutical insurance coverage panel" within New York's executive department to manage expanded prescription drug coverage for residents. The panel, composed of agency leaders (including health and aging officials), will set program rules, determine patient cost-sharing amounts, and develop outreach to inform eligible people about benefits - particularly affecting seniors and low-income New Yorkers who rely on prescription drug coverage. Key mechanisms include annual reporting on enrollment, costs, and program effectiveness, as well as coordinating with federal programs like Medicare. The panel will operate without paid members, focusing on implementing expanded coverage under existing state law.

Topics ✓ HealthcareSupports HealthcareCreates panel to expand prescription drug coverage for seniors/low-income residents, improving access and managing cost-sharing under new program rules.95% confidence

Sub-Topics Medicare Prescription Drugs

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in committee · New York · Assembly Jun 1, 2026

A 3605: Relates to establishing the expanded pharmaceutical insurance coverage panel

This bill establishes the "expanded pharmaceutical insurance coverage panel" within New York's executive department to broaden access to prescription drug coverage. The panel, composed of state agency leaders (including health, aging, and budget officials), will set cost-sharing rules, develop outreach programs for eligible residents, and report annually on enrollment and program costs. It directly affects elderly and low-income New York residents by expanding access to state and federal prescription drug benefits. The panel will operate without member compensation, focusing on improving coverage efficiency and informing applicants about available benefits.

Topics ✓ HealthcareSupports HealthcareExpands prescription drug coverage access for elderly/low-income residents via new panel setting cost-sharing rules and outreach programs, directly advancing healthcare access.95% confidence

Sub-Topics Prescription Drugs

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passed · New York · Senate Feb 24, 2026

S 371: Relates to creating a wholesale prescription drug importation program

Creates a wholesale prescription drug importation program which complies with federal standards and regulations for the purpose of generating substantial savings for consumers.

Topics ✓ HealthcareSupports HealthcareCreates prescription drug importation program to generate consumer savings, directly improving affordability and access to medications under healthcare policy.95% confidence

Sub-Topics Prescription Drugs

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in committee · New York · Assembly May 20, 2026

A 2640: Relates to requiring prescription drug containers be labeled with a description of the size, shape, color and imprint of the prescription drug it contains if such drug is in tablet or capsule form

This bill requires pharmacies to label prescription drug containers with a physical description of the pill itself, including its size, shape, color, and any imprint markings. It directly affects pharmacies and pharmacists who dispense prescription medications, adding these specific details to existing label requirements. The key provision updates current labeling rules by mandating that the container label must include these visual characteristics to help patients and healthcare providers identify the medication accurately. This change aims to improve safety and reduce medication errors by providing clearer visual identification of prescription drugs.

Topics ✓ HealthcareSupports HealthcareMandates clear pill labeling to prevent medication errors, enhancing patient safety and rights in healthcare delivery.85% confidence

Sub-Topics Prescription Drugs

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in committee · New York · Senate Jan 7, 2026

S 6937: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

This bill requires health insurance plans to cover at least one abuse-deterrent opioid pain medication for each active ingredient used to treat pain. It ensures patients pay no more for these abuse-deterrent options than for non-abuse-deterrent opioids (e.g., same copay level), and prohibits insurers from increasing patient costs or creating barriers to access these medications. The law also prevents prior authorization rules from forcing patients to try non-abuse-deterrent opioids first to get access to abuse-deterrent versions. It directly affects patients prescribed opioid pain medications and all health insurance plans operating in New York. The policy aims to improve access to medications designed to reduce opioid misuse without increasing out-of-pocket costs for patients.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for abuse-deterrent opioids at same cost as non-abuse-deterrent options, improving patient access to safer pain management without financial barriers.95% confidence

Sub-Topics Prescription Drugs Substance Abuse

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in committee · New York · Assembly May 20, 2026

A 3789: Relates to utilization review program standards and pre-authorization for certain health care services

Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.

Topics ✓ HealthcareSupports HealthcareRequires evidence-based clinical criteria for utilization reviews and pre-authorization, reducing arbitrary denials and improving access to medically necessary care.95% confidence

Sub-Topics Prescription Drugs

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passed both · New York · Assembly Jun 1, 2026

A 1428: Requires insurers to cover the substitution of a brand name prescription drug when the federal food and drug administration has declared that there is a supply issue with a generic drug

Requires insurers to cover the substitution of a brand name prescription drug when the federal food and drug administration has declared that there is a supply issue with a generic drug.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for brand drugs during generic shortages, expanding patient access to necessary medications without cost barriers.90% confidence

Sub-Topics Insurance Prescription Drugs

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