Top Tags

Tag pharmacy

Joint Press Release: Gov. Cuomo Vetoes Bill to Regulate Pharmacy Benefit Managers and Protect Consumers

Bill would have added accountability, increased fiscal disclosure, and addressed deceptive and anti-competitive practices

(December 26, 2019) Governor Cuomo this evening vetoed legislation to increase oversight, transparency, and accountability of pharmacy benefit managers (PBMs).  PBMs are companies that manage prescription drug benefits for health plans.  Their negotiations, discounts, and rebate structures are highly secretive and PBMs have been accused of practices including profiteering by overcharging health plans more than they subsequently reimburse pharmacists and pocketing the difference, a practice known as “spread pricing.”

In response to these and other concerns, New York’s 2019 State budget included language eliminating spread pricing and implementing other regulations on PBMs that work with Medicaid.  This bill would have applied similar rules to private health plans.

“The PBM industry spent a lot of money lobbying against this consumer protection bill,” said Assembly Health Committee Chair and bill sponsor Richard N. Gottfried.  “PBMs are widely recognized as major players in driving up drug costs and profiteering at the expense of people who pay health insurance premiums, patients, and pharmacists.  They’re a black box, operating in secret with no effective regulation.  There is plenty of evidence, including an analysis by the State Senate, showing what happens when regulators can’t see into this growing segment of the health care economy.  This veto means higher drug prices, higher costs for health plans and the people who pay their premiums, and lost income for pharmacies.”

“New York was on the cusp of becoming the leading state in protecting consumers, bringing questionable practices to light and saving millions of dollars with the bold proposal by Assemblyman Richard Gottfried and Senator Neil Breslin to finally join over two thirds of the states in regulating pharmacy benefit management companies,” said Assembly Insurance Committee Chair and bill co-sponsor Kevin Cahill.  Instead, with the stroke of his veto pen, Governor Andrew Cuomo leaves New Yorkers unprotected and these shadowy corporate behemoths free to plunder the sick, over-burdened health insurance public.”

“In this past budget, the Governor supported some protections for the Medicaid program in its dealing with PBMs,” added Gottfried.  “But he now insists that the only way he would’ve signed this bill is if we agreed to gut the bill by taking out key consumer protections, including those that parallel what we did for Medicaid.   The Governor even wanted us to take out a requirement that PBMs operate ‘with care, skill, prudence, diligence, and professionalism, and for the best interests’ of the consumer and health plans. It is incomprehensible to me.  I will be re-introducing the bill shortly and resuming the fight to get it passed and signed.”

Cahill added:  “While we remain only one of about a dozen states without any regulation of this shadow industry and with no adequate recourse for their secretive decisions, impacting millions of patients and professionals and costing millions of dollars, there is a consolation here in that we stood up to the governor’s bald attempt to substitute a fake regulatory schema that protects PBMs instead of consumers.” 

#     #     #

Press Release: Assembly Passes Gottfried Bill to Help Seniors Coordinate Prescriptions

Today the Assembly passed A. 2785, a bill I sponsored that would allow pharmacists to synchronize the dispensing of prescriptions for Medicaid patients so that patients can pick up multiple refills at the same time.

Crain’s: Assembly and Senate propose restoration of Medicaid funding

The Assembly and state Senate on Tuesday released details of their budget proposals, restoring $550 million in Medicaid funding that Gov. Andrew Cuomo had stripped from his spending plan after a downward revision in expected tax revenue.

Fortune: The Justice Department Approved the CVS-Aetna Merger, But It’s Still Not a Done Deal. Here’s Why

Bloomberg News, October 19

New York state officials are considering blocking parts of the $68 billion mergerof drugstore store chain CVS Health Corp. and Aetna Inc., jeopardizing billions of dollars in insurance premiums for Aetna.

CVS (CVS, +0.38%) and Aetna won approval from the U.S. Justice Department on Oct. 10, contingent on Aetna (AET, +0.00%) divesting its Medicare Part D business, which covers prescription drugs for seniors. But the deal still needs to pass through state regulatory bodies.

At a public hearing in Manhattan on Thursday, Maria Vullo, superintendent of the state Department of Financial Services, said her agency might block CVS’s merger with Aetna’s New York unit. She called U.S. approval of the overall deal “myopic” and repeatedly asked CVS and Aetna representatives for written evidence that they would deliver on promises to lower prices.

Several groups, including the Pharmacists Society of the State of New York and the Medical Society of the State of New York, urged the state to block the deal. They said the merger would limit competition and drive up the cost of prescription drugs. Assemblyman Richard Gottfried, chairman of the Health Committee, said the deal introduces “dangerous trends” in consumer access.

Elizabeth Ferguson, deputy general counsel for CVS, said there wasn’t a plan to lower prices.

CVS and Aetna announced the deal in December 2017 but continue to face regulatory hurdles. Connecticut approved the deal Oct. 17, and the New York will reach a decision after Oct. 25.

Shares of CVS and Aetna were little changed in New York Thursday.

Public Hearing – Opioid Overdose Reversal Drugs

NOTICE OF PUBLIC HEARING

SUBJECT:  Opioid overdose reversal drugs: assessing and improving access to and availability of drugs to prevent opioid overdose deaths.

PURPOSE:  The purpose of this hearing is to examine access to and availability of opioid overdose reversal drugs, such as naloxone, and to identify, if necessary, means by which to expand access and availability statewide.

New York City
Thursday, May 17
11:00 A.M.
Assembly Hearing Room
19th Floor
250 Broadway

Opioid antagonists, such as naloxone, are potentially life-saving prescription medications used to reverse overdoses caused by heroin and opioids. New York State has made progress expanding access to naloxone and similar drugs. In 2006, New York State passed a law authorizing non-medical personnel to administer naloxone to individuals who seek it. A 2014 law expanded this to allow the prescribing, dispensing, and distribution of opioid antagonists by a non-patient specific order. In addition, many first responders now receive training to administer naloxone.

Times-Union: N.Y. lawmakers question health officials on drug prices, executive power, spending

By Claire Hughes, 2/16/17

Drug price controls, the adequacy of Medicaid payments and expanding the power of the Health Department were among the topics discussed at a legislative hearing Thursday on Gov. Andrew Cuomo’s proposed budget for health and Medicaid.

An underlying theme was uncertainty about what action President Donald Trump and a Republican-led Congress might take on the Affordable Care Act, which could affect health insurance subsidies for New Yorkers, and funding for women’s reproductive health clinics, including Planned Parenthood.

 “Much is happening in Washington,” state Health Commissioner Howard Zucker told lawmakers. “If the ACA were repealed, that would be a major concern, with millions of people potentially losing health care.”

Buffalo News – Cuomo proposes prescription drug price controls

By Tom Precious, 1/11/17

ALBANY – The state will establish a new cost-control system to stop some “unconscionable” drug companies from gouging consumers with high prescription drug prices, Gov. Andrew M. Cuomo said Wednesday.

In his sixth — and final — State of the State address, Cuomo said he will propose in his upcoming budget the creation of a state review board to establish a “fair price” that New York will pay for individual prescription drugs in its Medicaid program.

That price would then also apply to sales in the private marketplace.

Press Release – Assembly Health Committee Update

Assembly Health Committee Update:
New Legislation Advanced to Improve Access to Medical Marijuana

The Assembly Committee on Health favorably reported 10 bills at its meeting on April 5. The Health Committee had not met since its March 1 meeting because of work on the state budget.

The Committee reported bills to expand public access to epinephrine auto-injectors (“epi-pens”); establish age-appropriate sex education grant programs; and require apartment building owners to develop and distribute smoking policies.

The Committee also reported three bills to improve the 2014 Compassionate Care Act medical marijuana law and expand patient access. Changes required by the Executive as conditions of signing the bill, and Health Department regulations, drastically limited the scope of the program. The three bills reported by the Committee would:

  • Allow physician assistants and nurse practitioners to prescribe medical marijuana (today they are already fully authorized to write prescriptions for even the strongest and most dangerous controlled substances).
  • Expand the list of eligible conditions. The conditions added in this bill were initially passed by the Assembly but deleted from the final law at the Executive’s insistence.
  • Create an advisory committee to assist the Commissioner in making regulations, advise the Commissioner on clinical matters, and review appeals of denials of patient or caregiver applications; require that medical marijuana regulations conform to the legislative intent and have a valid clinical or public safety basis.

Assembly Health Committee Update, 1/21/16

Assembly Health Committee Update

The Assembly Committee on Health favorably reported 22 bills at its first meeting of the 2016 session on January 21.

The Committee reported the bill to establish safe staffing requirements in hospitals and nursing homes (A8580, Gunther). The evidence is clear that having enough nurses on staff has a direct impact on the quality of patient care. Research published by the American Medical Association estimates five additional deaths per 1,000 patients in hospitals with an 8-to-1 patient-to-nurse ratio compared to those with just a 4-to-1 ratio. More nurses per patient means fewer deaths and improves patient outcomes. It is well documented that hospitals with better staff ratios have lower rates of problems such as pneu­monia, shock, and cardiac arrest.

The ratios in the bill are based on academic and evidence-based studies. The Health Department could also set more demanding and specific ratios. California was the first state to mandate nurse staffing ratios and it has seen significant improvements in outcomes for both patients and staff.

For more information on a particular bill, please contact the sponsor listed after the description. For the text of a bill, supporting memorandum, and information on its status, go to: http://public.leginfo.state.ny.us/menuf.cgi

Genetic Disease Screening and Counseling – Authorizes grants for familial dysautonomia, Canavan’s and Tay-Sachs disease screening and counseling. (A126, Dinowitz)

Adult Home Residents Right to Sue – Lets adult home residents go to court for a court-appointed receiver to operate the adult home when the operator has endangered the health, safety, or welfare of the residents. (A154A, Weinstein) 

Times-Union: Cuomo urged to sign bill giving doctors final say in Medicaid Rx disputes

By Claire Hughes, August 4

Supporters of a bill that would ensure doctors have the final say in prescription disputes with Medicaid managed care plans are urging Gov. Andrew Cuomo to sign the measure into law.

The measure, one of about 700 bills passed by the state lawmakers this year and under review by counsel, has not reached the governor’s desk, according to Cuomo spokesman Rich Azzopardi.

Given the administration’s past stance on language in the bill, however, supporters are concerned over the chance of a veto.

“The Health Department opposed this language when it was raised during budget discussions,” said Assembly Health Committee Chairman Richard Gottfried, D-Manhattan, a bill sponsor.