Bill Text: NY A00062 | 2023-2024 | General Assembly | Introduced

---

Bill Title: Provides for patient access to FDA approved abuse-deterrent technology to help combat opioid abuse.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-01-03 - referred to insurance [A00062 Detail]

Download: New_York-2023-A00062-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________

                                           62

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                       (Prefiled)

                                     January 4, 2023
                                       ___________

        Introduced by M. of A. SAYEGH -- read once and referred to the Committee
          on Insurance

        AN ACT to amend the public health law and the insurance law, in relation
          to  the  use  of abuse-deterrent technology for opioids as a mechanism
          for reducing abuse and diversion of opioid drugs

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

     1    Section 1. Section 273 of the public health law is amended by adding a
     2  new subdivision 11 to read as follows:
     3    11.  Any prior authorization requirements for opioid analgesic and any
     4  service denials made pursuant thereto shall not require  use  of  opioid
     5  analgesic   drug  products  without  abuse-deterrent  properties  before
     6  authorizing the use of abuse-deterrent opioid analgesic drug products.
     7    § 2. The insurance law is amended by adding a new  section  3216-a  to
     8  read as follows:
     9    § 3216-a.  Access to abuse-deterrent opioid medications. (a) An insur-
    10  ance  carrier  or  health  plan shall provide coverage on its formulary,
    11  drug list or other lists of similar construct for at  least  one  abuse-
    12  deterrent  opioid  analgesics  drug product per opioid analgesics active
    13  ingredient.
    14    (1) Cost-sharing for brand name abuse-deterrent opioid analgesic  drug
    15  products  covered  pursuant  to this section shall not exceed the lowest
    16  cost-sharing level applied to  brand  name  non-abuse  deterrent  opioid
    17  drugs covered under the applicable health plan or policy.
    18    (2)  Cost-sharing  for  generic  abuse-deterrent opioid analgesic drug
    19  products covered pursuant to this section shall not  exceed  the  lowest
    20  cost-sharing  level  applied to generic non-abuse deterrent opioid drugs
    21  covered under the applicable health plan or policy.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01769-01-3
        A. 62                               2

     1    (3) An increase in patient cost-sharing or disincentives for  prescri-
     2  bers  or dispensers shall not be allowed to achieve compliance with this
     3  section.
     4    (b)  Any  prior-authorization requirements or other utilization review
     5  measures for opioid analgesics, and any service  denials  made  pursuant
     6  thereto, shall not require use of opioid analgesic drug products without
     7  abuse-deterrent  properties  in  order  to access abuse-deterrent opioid
     8  analgesic drug products.
     9    (c) Definitions. As used in this section:
    10    (1) "Opioid analgesic drug product" means a drug in the  opioid  anal-
    11  gesic  drug  class  prescribed to treat moderate to severe pain or other
    12  conditions, whether in immediate release or extended long acting release
    13  form and whether or not combined with other drug substances  to  form  a
    14  single drug product or other dosage form.
    15    (2)  "Abuse  deterrent opioid analgesic drug product" means a brand or
    16  generic opioid analgesic drug product approved by the federal  food  and
    17  drug administration with abuse-deterrence labeling claims indicating its
    18  abuse-deterrent properties are expected to deter or reduce its abuse.
    19    (3)  "Cost-sharing"  means any coverage limit, copayment, coinsurance,
    20  deductible or other out-of-pocket patient expense requirements.
    21    § 3. This act shall take effect on the one hundred twentieth day after
    22  it shall have become  a  law,  and  shall  apply  to  all  policies  and
    23  contracts issued, renewed, modified, altered or amended on or after such
    24  date.