The New York Department of Financial Services has adopted new regulations for Pharmacy Benefit Managers (PBMs) operating within the state. These regulations are aimed at reducing prescription drug and health insurance costs, ensuring access to medications for New Yorkers, and supporting small, independent pharmacies.

Notably, workers' compensation PBMs have been exempted from a majority of the provisions, with the exception of the PBM licensing requirement.

This exemption was secured through collaborative efforts that included the Healthesystems' Advocacy & Compliance team, who engaged with the Department of Financial Services. Our team argued that additional regulations would place unnecessary burdens on stakeholders in the workers' compensation sector, given the existing oversight by the New York Workers' Compensation Board.

These new regulations are scheduled to be published in the State Register on November 27th.