Bill Text: NY S06779 | 2019-2020 | General Assembly | Amended

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

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2020-12-28 - COMMITTED TO RULES [S06779 Detail]

Download: New_York-2019-S06779-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         6779--A
            Cal. No. 422

                               2019-2020 Regular Sessions

                    IN SENATE

                                    October 16, 2019
                                       ___________

        Introduced  by  Sens. HOYLMAN, JACKSON, RIVERA -- read twice and ordered
          printed, and when printed to be committed to the Committee on Rules --
          recommitted to the Committee on Health in accordance with Senate  Rule
          6,  sec. 8 -- reported favorably from said committee, ordered to first
          and second report, ordered to a third  reading,  amended  and  ordered
          reprinted, retaining its place in the order of third reading

        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 (m) to read as follows:
    10    (m)  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 (n) to read as follows:
    17    (n)  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.
                                                                   LBD08766-05-0
        S. 6779--A                          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.