On December 23, 2022, Gov. Hochul signed into law Assembly Bill No. 1741-A, which amends the prescription drug coverage requirements regarding the calculation of an insured individual's contribution to any cost-sharing or out-of-pocket maximum. The amendment applies to individual and group policies delivered or issued for delivery in the state that provide coverage for prescription drugs.
Specifically, the amendment requires any third-party payments, financial assistance, discount, voucher or other price reduction instrument for out-of-pocket expenses made on behalf of an insured individual for the cost of prescription drugs to be applied to the insured's deductible, copayment, coinsurance, out-of-pocket maximum, or any other cost-sharing requirement when calculating such insured’s overall contribution to any out-of-pocket maximum or any cost-sharing requirement. However, the requirement applies to the deductible of a qualified HDHP only after the statutory minimum deductible is met, except with respect to items and services that are disregarded as preventive care. Accordingly, the amendment does not negatively impact HSA eligibility for individuals enrolled in qualified HDHPs.
Employers that sponsor insured plans that provide prescription drug coverage should be aware of this amendment. The amendment is effective January 1, 2023, and applies to all policies and contracts issued, renewed, modified, altered or amended after such date.
Assembly Bill 1741-A »
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