Bill Text: NY A00294 | 2019-2020 | General Assembly | Amended

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Bill Title: Requires insurers providing coverage of prescription drugs for opioid addiction, to provide coverage of such prescription drugs prescribed for the treatment of substance abuse disorder.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2020-01-08 - referred to insurance [A00294 Detail]

Download: New_York-2019-A00294-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         294--A

                               2019-2020 Regular Sessions

                   IN ASSEMBLY

                                       (Prefiled)

                                     January 9, 2019
                                       ___________

        Introduced  by M. of A. L. ROSENTHAL, HUNTER, GALEF, D'URSO -- read once
          and referred to the Committee on Insurance  --  committee  discharged,
          bill  amended,  ordered  reprinted  as amended and recommitted to said
          committee

        AN ACT to amend the insurance  law,  in  relation  to  requiring  health
          insurers  to  provide  coverage of opioid addiction prescription drugs
          prescribed for the treatment of substance abuse disorder

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
     2  amended by adding a new paragraph 36 to read as follows:
     3    (36)(A) Every policy that provides medical, major medical  or  similar
     4  comprehensive-type  coverage,  or  coverage  for prescription drugs must
     5  provide coverage, without prior authorization or step  therapy,  for  an
     6  initial  or  renewal  prescription for prescription drugs prescribed for
     7  the treatment of substance abuse disorder suffered by a  covered  person
     8  with an addiction to opioids.
     9    (B)  Coverage  provided  under this paragraph may be subject to annual
    10  deductibles and co-insurance as deemed appropriate by the superintendent
    11  and that are consistent with those imposed on other  benefits  within  a
    12  given policy.
    13    (C) For the purposes of this paragraph, "prescription drugs prescribed
    14  for  the  treatment  of substance abuse disorder" shall mean medications
    15  and prescription drugs approved by the food and drug administration  for
    16  the detoxification or maintenance treatment of substance use disorder.
    17    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    18  adding a new paragraph 7-c to read as follows:
    19    (7-c)(A)  Every policy that provides medical, major medical or similar
    20  comprehensive-type coverage, or coverage  for  prescription  drugs  must
    21  provide  coverage,  without  prior authorization or step therapy, for an

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01571-03-9
        A. 294--A                           2

     1  initial or renewal prescription for prescription  drugs  prescribed  for
     2  the  treatment  of substance abuse disorder suffered by a covered person
     3  with an addiction to opioids.
     4    (B)  Coverage  provided  under this paragraph may be subject to annual
     5  deductibles and co-insurance as deemed appropriate by the superintendent
     6  and that are consistent with those imposed on other  benefits  within  a
     7  given policy.
     8    (C) For the purposes of this paragraph, "prescription drugs prescribed
     9  for  the  treatment  of substance abuse disorder" shall mean medications
    10  and prescription drugs approved by the food and drug administration  for
    11  the detoxification or maintenance treatment of substance use disorder.
    12    §  3.  Section  4303  of  the insurance law is amended by adding a new
    13  subsection (l-3) to read as follows:
    14    (l-3) Every contract that provides medical, major medical  or  similar
    15  comprehensive-type  coverage,  or  coverage  for prescription drugs must
    16  provide coverage, without prior authorization or step  therapy,  for  an
    17  initial  or  renewal  prescription for prescription drugs prescribed for
    18  the treatment of substance abuse disorder suffered by a  covered  person
    19  with  an  addiction  to opioids. Coverage provided under this subsection
    20  may be subject to annual deductibles and co-insurance as  deemed  appro-
    21  priate  by the superintendent and that are consistent with those imposed
    22  on other benefits within a given contract.  For  the  purposes  of  this
    23  subsection,   "prescription   drugs  prescribed  for  the  treatment  of
    24  substance abuse disorder" shall mean medications and prescription  drugs
    25  approved  by  the food and drug administration for the detoxification or
    26  maintenance treatment of substance use disorder.
    27    § 4. This act shall take effect immediately.