Bill Text: NY S05535 | 2019-2020 | General Assembly | Introduced

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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 1-0)

Status: (Introduced - Dead) 2020-01-08 - REFERRED TO INSURANCE [S05535 Detail]

Download: New_York-2019-S05535-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          5535
                               2019-2020 Regular Sessions
                    IN SENATE
                                       May 6, 2019
                                       ___________
        Introduced  by Sen. HARCKHAM -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
        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
    22  initial or renewal prescription for prescription  drugs  prescribed  for
    23  the  treatment  of substance abuse disorder suffered by a covered person
    24  with an addiction to opioids.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01571-02-9
        S. 5535                             2
     1    (B) Coverage provided under this paragraph may be  subject  to  annual
     2  deductibles and co-insurance as deemed appropriate by the superintendent
     3  and  that  are  consistent with those imposed on other benefits within a
     4  given policy.
     5    (C) For the purposes of this paragraph, "prescription drugs prescribed
     6  for  the  treatment  of substance abuse disorder" shall mean medications
     7  and prescription drugs approved by the food and drug administration  for
     8  the detoxification or maintenance treatment of substance use disorder.
     9    §  3.  Section  4303  of  the insurance law is amended by adding a new
    10  subsection (l-3) to read as follows:
    11    (l-3) Every contract that provides medical, major medical  or  similar
    12  comprehensive-type  coverage,  or  coverage  for prescription drugs must
    13  provide coverage, without prior authorization or step  therapy,  for  an
    14  initial  or  renewal  prescription for prescription drugs prescribed for
    15  the treatment of substance abuse disorder suffered by a  covered  person
    16  with  an  addiction  to opioids. Coverage provided under this subsection
    17  may be subject to annual deductibles and co-insurance as  deemed  appro-
    18  priate  by the superintendent and that are consistent with those imposed
    19  on other benefits within a given contract.  For  the  purposes  of  this
    20  subsection,   "prescription   drugs  prescribed  for  the  treatment  of
    21  substance abuse disorder" shall mean medications and prescription  drugs
    22  approved  by  the food and drug administration for the detoxification or
    23  maintenance treatment of substance use disorder.
    24    § 4. This act shall take effect immediately.