The New York Department of Financial Services (“DFS”), which oversees New York’s Pharmacy Benefits Bureau, published proposed regulations regarding Pharmacy Benefit Managers (“PBMs”), which are now in a 60-day comment period. Prior to publishing these proposed regulations, DFS’s New York’s Pharmacy Benefits Bureau (“Bureau”) sought feedback on PBMs’ conduct in New York. The Bureau made seven pre-rulemaking requests for information and comments on a variety of topics involving PBMs including:
- PBM duties to health plans
- PBM reporting requirements
- PBM business practices including patient-steering
- PBM pharmacy credentialing practices
- PBM pricing models
- PBM reimbursement practices
- PBM pharmacy audit practices
Now that DFS has completed the process of gathering information about PBM business practices and other conduct in New York, it seems poised to transition into formal rulemaking, a process which also entails consideration of comments from the public about the proposed rules and regulations. This represents a critical juncture for the many stakeholders impacted by PBMs in New York.
Any provider that is impacted by PBMs must participate in this process to ensure that any final rules or regulations enacted by the DFS and Pharmacy Benefits Bureau reflect the practical realities of providers doing business with PBMs. Providers must not miss out on this important opportunity to voice their concerns. During the 60-day comment period, DFS will consider and review comments which could lead to DFS revising the regulations before they are finalized and implemented.
Comments must be submitted no later than October 15, 2023. Frier Levitt has experience preparing and submitting comments to various government agencies, including DFS, and can assist you today. To participate in this process, please contact us as soon as possible as there is limited time to prepare and submit a comment to DFS.
This is another opportunity to be a leader on important issues and offer unique insight and perspective on PBMs with DFS, as well as participate in New York’s rulemaking process.
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Frier Levitt represents thousands of pharmacies across the United States as well as various other life sciences and healthcare industry stakeholders with an emphasis on PBM issues (including in New York) and has successfully taken on some of the most troubling PBM tactics including improper PBM audit and recoupment practices, PBM network access issues, DIR fees, and PBM reimbursement issues. Our attorneys have extensive knowledge of all aspects of PBMs in terms of their relationships with payors and pharmacies. Contact us to speak with an attorney about how payors and pharmacies can leverage the various laws and protections afforded to such entities, including the important PBM laws in New York.
