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Bill

A 7142

Relates to requiring certain health insurance issuers to certify that at least a majority of prescription drug rebates are provided to patients at the point of sale

2025 Regular Session Introduced by George Alvarez and 14 co-sponsors

Requires insurers to certify that a majority of prescription drug rebates are passed through to patients at purchase, boosting transparency and lowering out-of-pocket costs.

REFERRED TO INSURANCE
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Bill Summary · A 7142

Bill A 7142 — Summary

A 7142 would require health insurance issuers to certify that a majority of prescription drug rebates are provided to patients at the point of sale. The bill is currently in the legislative referral stage.

Purpose and intent

  • Establish transparency and ensure patient-facing benefit from prescription drug rebates.
  • Target the portion of negotiated rebates (between drug manufacturers and payers) that actually reduces patient out-of-pocket costs at the moment a prescription is purchased.

Key provisions (as indicated by the bill title)

  • Health insurance issuers would be required to certify that at least a majority of prescription drug rebates are passed through to patients at the point of sale.
  • Certification presumably would be submitted to the appropriate state regulator or designated authority, with details of the certification process to be specified in the bill text (not provided here).
  • The requirement may entail verification or reporting standards to confirm POS pass-through, and could involve audits or penalties for noncompliance as defined in the final text.

Note: The exact mechanics (threshold definitions, audit rights, oversight agency, penalties, exceptions, and effective dates) are not included in the information provided. The bill’s text would clarify these details.

Who would be affected

  • Health insurance issuers operating in the state (private and potentially public plans that issue prescription drug benefits).
  • Pharmacy networks and PBMs could be involved in implementing POS rebate pass-through if rebates are routed or recognized at sale.
  • Consumers/patients who rely on lower out-of-pocket costs at the point of purchase for prescription drugs.

Procedural and timeline aspects

  • Introduced: March 20, 2025.
  • Status: REFERRED TO INSURANCE (Assembly committee stage).
  • Legislative actions recorded on the same date (referral twice listed) indicate committee consideration moves forward as the next step.
  • No enacted effective date is provided; will depend on committee action and eventual floor votes.

Related legislation

  • Related NY Assembly bills: A 8310, A 5218, A 1962 (prior-session references).
  • Related NY Senate bill: S 2128 (companion bill).
  • The presence of multiple related measures suggests cross-filed efforts to address rebate transparency and patient access from both houses.

Potential impact and considerations

  • Positive implications if pass-through is achieved: lower patient costs at the pharmacy counter, increased transparency in rebate use, and potential price sensitivity for consumers.
  • Administrative burden: issuers may need to modify certification processes, reporting systems, and internal rebate routing to ensure compliance.
  • Market effects are uncertain and depend on final text, including any exemptions, enforcement mechanisms, and how “majority” is defined in practice.

Next steps / what to watch

  • Review the full bill text for detailed requirements, definitions, and enforcement provisions.
  • Monitor committee hearings in the Insurance committee for amendments and potential passage.
  • Compare with related bills (A 8310, A 5218, A 1962, S 2128) for alignment or divergence in approach.

Compiled from official sources — confirm details with the bill’s official record.

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