N.Y. Comp. Codes R. & Regs. tit. 11 § 450.7

Current through Register Vol. 46, No. 53, December 31, 2024

Section 450.7 - Applicability

(a) The following provisions of this Chapter shall not apply to a pharmacy benefit manager's provision of pharmacy benefit management services to a Medicare prescription drug plan offered pursuant to the "Medicare Prescription Drug, Improvement, and Modernization Act of 2003," codified at 42 U.S.C.¹ section 1395w-101 et. seq., as amended: section 456.2(a)(1) and (2), section 458.2(d), and Part 459 of this Title. To the extent a pharmacy benefit manager is providing services for other health plans in addition to Medicare prescription drug plans, the provisions of this Chapter shall continue to apply to the pharmacy benefit manager in its performance of pharmacy benefit management services to those other health plans. For avoidance of any doubt, the exemption contained in this subdivision shall apply to any health plan which is offered pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 regardless of the nomenclature used to describe it.

(b) Except for Part 454 of this Title, this Chapter shall not apply to a pharmacy benefit manager's provision of pharmacy benefit management services to a health plan governed by the Workers Compensation Law of this State. To the extent a pharmacy benefit manager is providing services for other health plans the provisions of this Chapter shall continue to apply to the pharmacy benefit manager in its performance of pharmacy benefit management services to those other health plans.

(c) If any provision of this Chapter is held to be illegal or invalid for any reason by a court of competent jurisdiction, the illegality or invalidity shall not affect the remaining provisions of this Chapter, but such provision shall be fully severable and this Chapter shall be construed and enforced as if the illegal or invalid provision had never been included in this Chapter. In particular, if a court of competent jurisdiction were to hold that any provision of this Chapter as applied to a pharmacy benefit manager providing pharmacy benefit management services to a health plan is preempted by federal law or regulations promulgated thereunder, then such provision shall be fully severable only to the extent preempted and this Chapter shall be construed and enforced as if the provision did not apply to the pharmacy benefit manager providing pharmacy benefit management services to that specific health plan to the extent preempted and the provisions shall not be construed and enforced as not applying to the same pharmacy benefit manager performing pharmacy benefit management services for other health plans for which there is no preemption.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 450.7

Adopted New York State Register November 27, 2024/Volume XLVI, Issue 48, eff. 11/27/2024