STATE OF NEW YORK ________________________________________________________________________ 7281 2019-2020 Regular Sessions IN ASSEMBLY April 18, 2019 ___________ Introduced by M. of A. GOTTFRIED, ARROYO, BRONSON, COLTON, COOK, CRUZ, DE LA ROSA, GLICK, GUNTHER, GRIFFIN, HEVESI, JAFFEE, McDONOUGH, NIOU, ORTIZ, REYES, SAYEGH, SCHMITT, SEAWRIGHT, SIMON, SIMOTAS, TAYLOR, THIELE, WOERNER, WRIGHT -- Multi-Sponsored by -- M. of A. GALEF, NOLAN -- read once and referred to the Committee on Insurance 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 (l) to read as follows: 10 (l) 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 (m) to read as follows: 17 (m) 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. LBD08766-03-9A. 7281 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.