Bill Text: NY A04899 | 2017-2018 | General Assembly | Amended

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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 4-0)

Status: (Introduced - Dead) 2018-06-18 - ordered to third reading rules cal.296 [A04899 Detail]

Download: New_York-2017-A04899-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                         4899--C
                               2017-2018 Regular Sessions
                   IN ASSEMBLY
                                    February 6, 2017
                                       ___________
        Introduced  by  M.  of  A. L. ROSENTHAL, BRINDISI, HUNTER, GALEF -- read
          once and referred to the Committee on Insurance -- recommitted to  the
          Committee  on  Insurance in accordance with Assembly Rule 3, sec. 2 --
          committee discharged, bill amended, ordered reprinted as  amended  and
          recommitted  to  said  committee -- again reported from said committee
          with amendments, ordered reprinted as amended and recommitted to  said
          committee  --  reported  and  referred  to  the  Committee on Codes --
          reported and referred to the Committee on Ways and Means --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
        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 35 to read as follows:
     3    (35)(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.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05152-05-8
        A. 4899--C                          2
     1    § 2. Subsection (l) of section 3221 of the insurance law is amended by
     2  adding a new paragraph 7-c to read as follows:
     3    (7-c)(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    § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
    18  subsection (l-3) to read as follows:
    19    (l-3)  Every  contract 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. Coverage provided  under  this  subsection
    25  may  be  subject to annual deductibles and co-insurance as deemed appro-
    26  priate by the superintendent and that are consistent with those  imposed
    27  on  other  benefits  within  a  given contract. For the purposes of this
    28  subsection,  "prescription  drugs  prescribed  for  the   treatment   of
    29  substance  abuse disorder" shall mean medications and prescription drugs
    30  approved by the food and drug administration for the  detoxification  or
    31  maintenance treatment of substance use disorder.
    32    § 4. This act shall take effect immediately.