Bill Text: NY A07281 | 2019-2020 | General Assembly | Introduced


Bill Title: Prohibits health insurers, health care plans and HMOs from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection.

Spectrum: Strong Partisan Bill (Democrat 26-2)

Status: (Introduced) 2019-04-18 - referred to insurance [A07281 Detail]

Download: New_York-2019-A07281-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          7281
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                     April 18, 2019
                                       ___________
        Introduced  by  M. of A. GOTTFRIED, ARROYO, BRONSON, COLTON, COOK, CRUZ,
          DE LA ROSA, GLICK, GUNTHER, GRIFFIN, HEVESI, JAFFEE, McDONOUGH,  NIOU,
          ORTIZ,  REYES,  SAYEGH,  SCHMITT,  SEAWRIGHT,  SIMON, SIMOTAS, TAYLOR,
          THIELE, WOERNER, WRIGHT -- Multi-Sponsored by -- M. of A. GALEF, NOLAN
          -- read once and referred to the Committee on Insurance
        AN ACT to amend the public health law and the insurance law, in relation
          to prohibiting health insurers from requiring prior authorization  for
          pre-exposure prophylaxis used to prevent HIV infection
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Section 4406-c of the  public  health  law  is  amended  by
     2  adding a new subdivision 11 to read as follows:
     3    11. A health care plan which provides prescription drug coverage shall
     4  not require a prior authorization determination for pre-exposure prophy-
     5  laxis  used  to prevent HIV infection. Nothing in this subdivision shall
     6  prohibit a health care plan from denying a claim for  such  services  if
     7  the services are subsequently determined not medically necessary.
     8    §  2.  Section  3217-b of the insurance law is amended by adding a new
     9  subsection (l) to read as follows:
    10    (l) An insurer which provides prescription  drug  coverage  shall  not
    11  require a prior authorization determination for pre-exposure prophylaxis
    12  used to prevent HIV infection. Nothing in this subsection shall prohibit
    13  an  insurer  from  denying a claim for such services if the services are
    14  subsequently determined not medically necessary.
    15    § 3. Section 4325 of the insurance law is  amended  by  adding  a  new
    16  subsection (m) to read as follows:
    17    (m)   A  corporation  organized  under  this  article  which  provides
    18  prescription drug coverage  shall  not  require  a  prior  authorization
    19  determination   for   pre-exposure   prophylaxis  used  to  prevent  HIV
    20  infection. Nothing in  this  subsection  shall  prohibit  a  corporation
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD08766-03-9

        A. 7281                             2
     1  organized  under  this article from denying a claim for such services if
     2  the services are subsequently determined not medically necessary.
     3    § 4. This act shall take effect on the one hundred eightieth day after
     4  it shall have become a law.
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