Bill Text: NY A10478 | 2015-2016 | 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: Bipartisan Bill

Status: (Introduced - Dead) 2016-06-16 - substituted by s6962a [A10478 Detail]

Download: New_York-2015-A10478-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          10478
                   IN ASSEMBLY
                                      May 27, 2016
                                       ___________
        Introduced by M. of A. CUSICK -- read once and referred to the Committee
          on Insurance
        AN  ACT to amend the insurance law, in relation to the use of abuse-det-
          errent 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. The insurance law is amended by adding a new section 3216-a
     2  to read as follows:
     3    § 3216-a.  Access to abuse-deterrent opioid medications. (a) An insur-
     4  ance carrier or health plan shall provide  coverage  on  its  formulary,
     5  drug  list  or  other lists of similar construct for at least one abuse-
     6  deterrent opioid analgesic drug  product  per  opioid  analgesic  active
     7  ingredient.
     8    (1)  Cost-sharing for brand name abuse-deterrent opioid analgesic drug
     9  products covered pursuant to this section shall not  exceed  the  lowest
    10  cost-sharing  level  applied  to  brand  name non-abuse deterrent opioid
    11  drugs covered under the applicable health plan or policy.
    12    (2) Cost-sharing for generic  abuse-deterrent  opioid  analgesic  drug
    13  products  covered  pursuant  to this section shall not exceed the lowest
    14  cost-sharing level applied to generic non-abuse deterrent  opioid  drugs
    15  covered under the applicable health plan or policy.
    16    (3)  An increase in patient cost-sharing or disincentives for prescri-
    17  bers or dispensers shall not be allowed to achieve compliance with  this
    18  section.
    19    (b)  Any  prior-authorization requirements or other utilization review
    20  measures for opioid analgesics, and any service  denials  made  pursuant
    21  thereto, shall not require use of opioid analgesic drug products without
    22  abuse-deterrent  properties  in  order  to access abuse-deterrent opioid
    23  analgesic drug products.
    24    (c) Definitions. As used in this section:
    25    (1) "Opioid analgesic drug product" means a drug in the  opioid  anal-
    26  gesic  drug  class  prescribed to treat moderate to severe pain or other
    27  conditions, whether in immediate release or extended long acting release
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14477-04-6
        A. 10478                            2
     1  form and whether or not combined with other drug substances  to  form  a
     2  single drug product or other dosage form.
     3    (2)  "Abuse  deterrent opioid analgesic drug product" means a brand or
     4  generic opioid analgesic drug product approved by the federal  food  and
     5  drug administration with abuse-deterrence labeling claims indicating its
     6  abuse-deterrent properties are expected to deter or reduce its abuse.
     7    (3)  "Cost-sharing"  means any coverage limit, copayment, coinsurance,
     8  deductible or other out-of-pocket patient expense requirements.
     9    § 2. This act shall take effect on the one hundred twentieth day after
    10  it shall have become  a  law,  and  shall  apply  to  all  policies  and
    11  contracts issued, renewed, modified, altered or amended on or after such
    12  date.