Bill Text: NY S05374 | 2023-2024 | General Assembly | Introduced

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Bill Title: Prohibits health insurers, health care plans and HMOs from requiring prior authorization for anti-retroviral medication used to treat and prevent HIV infection.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2024-05-13 - ADVANCED TO THIRD READING [S05374 Detail]

Download: New_York-2023-S05374-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          5374

                               2023-2024 Regular Sessions

                    IN SENATE

                                      March 3, 2023
                                       ___________

        Introduced  by Sen. HARCKHAM -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health

        AN ACT to amend the public health law and the insurance law, in relation
          to prohibiting health insurers from requiring prior authorization  for
          anti-retroviral medication used to treat and 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 13 to read as follows:
     3    13. A health care plan which provides prescription drug coverage shall
     4  not  require  a  prior  authorization  determination for anti-retroviral
     5  medication used to treat and prevent  HIV  infection.  Nothing  in  this
     6  subdivision  shall  prohibit a health care plan from denying a claim for
     7  such services if the services are subsequently determined not  medically
     8  necessary.
     9    §  2.  Section  3217-b of the insurance law is amended by adding a new
    10  subsection (p) to read as follows:
    11    (p) An insurer which provides prescription  drug  coverage  shall  not
    12  require  a prior authorization determination for anti-retroviral medica-
    13  tion used to treat and prevent HIV infection. Nothing in this subsection
    14  shall prohibit an insurer from denying a claim for such services if  the
    15  services are subsequently determined not medically necessary.
    16    §  3.  Section  4325  of  the insurance law is amended by adding a new
    17  subsection (p) to read as follows:
    18    (p)  A  corporation  organized  under  this  article  which   provides
    19  prescription  drug  coverage  shall  not  require  a prior authorization
    20  determination for anti-retroviral medication used to treat  and  prevent
    21  HIV  infection.  Nothing in this subsection shall prohibit a corporation
    22  organized under this article from denying a claim for such  services  if
    23  the services are subsequently determined not medically necessary.
    24    § 4. This act shall take effect on the one hundred eightieth day after
    25  it shall have become a law.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09965-01-3