New York Pharmacy Benefits Bureau Issues Fourth Request for Public Comments on the Controversial PBM Practice of Patient-Steering

New York’s Pharmacy Benefits Bureau (“Bureau”) has requested input from the public on three separate occasions regarding New York’s laws governing Pharmacy Benefit Managers (PBMs). The Bureau has now issued its Fourth Request for Public Comments. The Bureau, as an Administrative Agency, is authorized to enact rules and regulations that could potentially benefit independent pharmacy providers, plan sponsors, and other stakeholders throughout New York (and beyond).

The Bureau’s first request sought public comments on the duty, accountability, and transparency of PBMs to health plans under Public Health Law Section 280-a(2). The Bureau’s second request, which is still pending, seeks comments regarding the applicability of New York’s PBM laws to PBMs providing services to Medicare Part D plans. The Bureau’s third request, also still pending, seeks input and information from the public on the reporting requirements for PBMs under New York Insurance Law Section 2904. The Bureau’s fourth and most recent request for public comment provides an important opportunity to offer guidance directly to the Bureau on the controversial PBM tactic of patient-steering.

More specifically, the Bureau has asked for “comments from any interested parties on . . . patient-steering by PBMs in New York State” and feedback as to whether and how the Bureau should implement specific rules to address patient-steering. Along with comments, the Bureau requests “written data, views, facts, and opinions” related to patient-steering.

The Bureau encourages any interested parties to submit any comments by August 19, 2022. If you would like to work with Frier Levitt to participate in this process, please contact us as soon as possible as there is limited time to prepare and submit a comment to the Bureau.

This is another important opportunity to be a leader on important issues and offer unique insight and perspective on PBMs with the Bureau and participate in New York’s rulemaking process.

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Frier Levitt represents thousands of pharmacies across the United States along with other industry stakeholders, and emphasizes PBM issues (including in New York), and has successfully taken on some of the most troubling PBM tactics including patient-steering, as well as 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 as they relate to 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.

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