Bill Text: NY A04667 | 2021-2022 | General Assembly | Introduced

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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 - Dead) 2022-01-05 - referred to insurance [A04667 Detail]

Download: New_York-2021-A04667-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          4667

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                    February 4, 2021
                                       ___________

        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.
    22    (3) An increase in patient cost-sharing or disincentives for  prescri-
    23  bers  or dispensers shall not be allowed to achieve compliance with this
    24  section.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD06823-01-1
        A. 4667                             2

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