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11/12/2025 (NY): Voice Support to Halt Below-Cost Reimbursement by PBMs
In the final days of the 2025 legislative session, the New York Senate passed the Patient Access to Pharmacy Act (S5939B/A5882B). The legislation — which would provide a minimum reimbursement level that pharmacy benefit managers (PBMs) are required to pay participating pharmacies in state-regulated commercial insurance plans — was unfortunately then stalled in the Assembly. 

Ahead of the new legislative session in January, we need all NY RxIMPACT advocates to contact their Assemblymembers and urge their support for the legislation — including signing on as a co-sponsor if they haven’t already. 

Although New York has been a leader in enacting reforms around PBM licensure requirements, state oversight via a new PBM Bureau at the Department of Financial Services, and recent Market Conduct regulations, it has not yet addressed the inadequate payments that PBMs provide to pharmacies, which are often below their costs to procure and dispense prescription drugs for New Yorkers.

In addition to requiring that PBMs reimburse pharmacies, at a minimum, at the National Average Drug Acquisition Cost (NADAC) benchmark level, the legislation would also create a process for pharmacies dispensing medications which may require special handling, increased delivery costs and other special services which increase pharmacy expenses to ensure they receive an adequate dispensing fee to cover their costs in these instances.

Help NACDS RxIMPACT build support for this legislation by contacting your Assemblymember today! Please click the “Take Action Now” button, enter your contact information, and the system will automatically populate a letter to your member.

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