Gov. Kathy Hochul (D) recently announced new insurance coverage requirements that took effect on January 1, 2026, including a $100 annual cap on out-of-pocket costs for EpiPens. The law applies to state-regulated commercial insurance policies and contracts that are issued, renewed, modified, altered or amended on or after January 1. Because not all policies renew or change on that date, implementation will occur on a rolling basis throughout the year, with full compliance expected by year-end. The cap does not apply to Medicare, Medicaid or ERISA self-insured plans and applies only after deductibles are met for high-deductible plans.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.