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Pharmacy Benefit Managers

Pharmacy Benefit Managers
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Regulations

Related regulations can be viewed in the free access online version of the New York Codes, Rules and Regulations (NYCRR) maintained by Thompson Reuters.

Proposed regulations, including those adopted on an emergency basis, can be found on our Regulatory and Legislative Activities page.

Registration

PBM registration with the Department is required by June 1 through December 31, 2023. On or after January 1, 2024, licensing with the Department is required.

The application for registration must be filed with the Department this year on or before June 1, 2022.

PBMs should create an account and log in to the DFS Portal to securely register. A registration application can be started, and then completed in separate portal sessions. After filing, an email receipt will be sent that includes a PDF of the completed application.

To get started, visit the DFS Portal.

To open the application, go to "Ask for Apps" and select "Pharmacy Benefit Managers”.

Annual Report

An Annual Report must be completed and submitted to the Department each year by no later than July 1.

A first annual report must be filed with the Department this year on or before July 1, 2022.

Specific instructions can be found in the Annual Report Form along with a checklist of all documents that must be completed/compiled and submitted. The primary contact person listed in the PBM registration application will receive a link shortly after the application is submitted to file the Annual Report. If a link is not received within one week of submission, contact the Department.

Public Notice

Request for Data on Pricing Models and Pharmacy Reimbursement Practices by Pharmacy Benefit Managers in New York State

The Department is inviting submissions of data or documented evidence from the public related to pricing models and pharmacy reimbursement practices by pharmacy benefit managers (“PBMs”) in New York State.

Responses should be emailed to [email protected], with “PBM2022-06” included in the subject line. Failure to include “PBM2022-06” in the subject line may result in your comment not being considered. The deadline for responses is October 31, 2022.

FAQs

Read the Industry Letter published May 5, 2022, addressing questions related to the filing of the mandatory registration and a first annual report.

Report a Violation

Any corporation, firm, association, or person may file a verified complaint about a PBM with the Department by email at [email protected]. A copy of the complaint may be shared with the PBM.

The Department will provide additional direction on the complaint process in future guidance.

Contact Us

Send an email to [email protected].