Bill Text: NY A01168 | 2013-2014 | General Assembly | Introduced


Bill Title: Prohibits medicaid's use of any prior approval or preferred drug list requirement for AIDS, HIV, infection, or hepatitis C.

Spectrum: Partisan Bill (Democrat 22-1)

Status: (Introduced - Dead) 2014-01-08 - referred to health [A01168 Detail]

Download: New_York-2013-A01168-Introduced.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         1168
                              2013-2014 Regular Sessions
                                 I N  A S S E M B L Y
                                      (PREFILED)
                                    January 9, 2013
                                      ___________
       Introduced  by M. of A. GUNTHER, PEOPLES-STOKES, JACOBS, MILLMAN, ROBIN-
         SON, PERRY, LAVINE -- Multi-Sponsored by -- M. of  A.  COOK,  FARRELL,
         GLICK,  HOOPER, ROSENTHAL, SCARBOROUGH, TITUS, WEISENBERG -- read once
         and referred to the Committee on Health
       AN ACT to amend the social services law, in relation to  establishing  a
         prohibition  on prior approval or preferred drug list requirements for
         certain drugs used to treat AIDS, HIV infection or hepatitis C
         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section  1. The opening paragraph of subdivision 2 of section 365-a of
    2  the social services law, as amended by chapter 41 of the laws  of  1992,
    3  is amended and a new subdivision 10 is added to read as follows:
    4    "Medical  assistance" shall mean payment of part or all of the cost of
    5  medically necessary medical, dental  and  remedial  care,  services  and
    6  supplies,  as authorized in this title or the regulations of the depart-
    7  ment, which are necessary to prevent, diagnose, correct or  cure  condi-
    8  tions in the person that cause acute suffering, endanger life, result in
    9  illness  or  infirmity, interfere with such person's capacity for normal
   10  activity, or threaten some significant handicap and which are  furnished
   11  an  eligible person in accordance with this title and the regulations of
   12  the department. Such care,  services  and  supplies  shall  include  the
   13  following  medical  care,  services  and  supplies,  together  with such
   14  medical care, services and supplies provided for in subdivisions  three,
   15  four  and  five  of  this  section,  and such medical care, services and
   16  supplies as  are  authorized  in  the  regulations  of  the  department,
   17  NOTWITHSTANDING  ANY  INCONSISTENT  PROVISION  OF  LAW,  SUBJECT  TO THE
   18  PROVISIONS OF SUBDIVISION TEN OF THIS SECTION:
   19    10. (A) UNLESS REQUIRED BY FEDERAL LAW AND REGULATION AS  A  CONDITION
   20  OF  QUALIFYING  FOR  FEDERAL  FINANCIAL  PARTICIPATION  IN  THE MEDICAID
   21  PROGRAM,  THE  DEPARTMENT  OTHERWISE  NOTWITHSTANDING  ANY  INCONSISTENT
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02469-01-3
       A. 1168                             2
    1  PROVISION OF LAW, SHALL NOT RESTRICT BY PRIOR AUTHORIZATION OR PREFERRED
    2  DRUG LIST PROGRAM REQUIREMENT ANY PRESCRIPTION DRUG, INCLUDED IN CERTAIN
    3  THERAPEUTIC  DRUG CLASSES, AS PRESCRIBED AND DETERMINED BY A PRESCRIBING
    4  PRACTITIONER  LICENSED  BY  THE STATE, TO BE MEDICALLY NECESSARY FOR THE
    5  TREATMENT AND PREVENTION OF AIDS, HIV INFECTION, AND HEPATITIS C.
    6    (B) THERAPEUTIC CLASSES CONTAINING PRESCRIPTION DRUGS WHICH  SHALL  BE
    7  EXCLUDED  FROM  ANY  PRIOR  AUTHORIZATION OR PREFERRED DRUG LIST PROGRAM
    8  REQUIREMENT PROVISIONS SHALL INCLUDE THE FOLLOWING:
    9    (1) ANTI-RETROVIRAL MEDICATIONS, INCLUDING BUT NOT LIMITED TO PROTEASE
   10  INHIBITORS, NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS,  NUCLEOSIDE
   11  REVERSE  TRANSCRIPTASE  INHIBITORS,  ANTI-VIRALS,  AND FUSION INHIBITORS
   12  PRESCRIBED FOR THE TREATMENT OF AIDS OR HIV INFECTION.
   13    (2)  IMMUNOMODULATORS  AND  HEPATITIS   C-SPECIFIC   ANTIVIRAL   DRUGS
   14  PRESCRIBED FOR THE TREATMENT OF HEPATITIS C.
   15    S 2. Severability. If any clause, sentence, paragraph, section or part
   16  of  this act shall be adjudged by any court of competent jurisdiction to
   17  be invalid and after exhaustion of  all  further  judicial  review,  the
   18  judgment  shall  not affect, impair or invalidate the remainder thereof,
   19  but shall be confined in its operation to the  clause,  sentence,  para-
   20  graph,  section or part of this act directly involved in the controversy
   21  in which the judgment shall have been rendered.
   22    S 3. This act shall take effect on the first of January next  succeed-
   23  ing  the  date  on  which  it shall have become a law; provided that the
   24  state commissioner of health is authorized to  promulgate  any  and  all
   25  rules and regulations and take any other measures necessary to implement
   26  this act on its effective date on or before such date.
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