STATE OF NEW YORK ________________________________________________________________________ 10622 IN ASSEMBLY May 9, 2018 ___________ Introduced by M. of A. L. ROSENTHAL -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring health insurers to provide coverage for opioid antagonists and devices 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) (i) Every policy which provides coverage for prescription 4 drugs shall include coverage for at least one opioid antagonist and 5 device. Prior authorization may be required for non-generic forms of 6 opioid antagonists and devices. 7 (ii) As used in this paragraph "opioid antagonist and device" means a 8 drug approved by the Food and Drug Administration that, when adminis- 9 tered, negates or neutralizes in whole or in part the pharmacological 10 effects of an opioid in the body. "Opioid antagonist" shall be limited 11 to naloxone and other medications approved by the department of health 12 for such purpose. 13 (B) The coverage mandated by this paragraph shall include opioid 14 antagonists prescribed or dispensed via standing order or collaborative 15 practice agreement intended for use on patients other than the insured. 16 (C) Coverage provided under this paragraph may be subject to annual 17 deductibles and co-insurance as deemed appropriate by the superintendent 18 and that are consistent with those imposed on other benefits within a 19 given policy. 20 § 2. Subsection (l) of section 3221 of the insurance law is amended by 21 adding a new paragraph 7-c to read as follows: 22 (7-c) (A) (i) Every policy which provides coverage for prescription 23 drugs shall include coverage for at least one opioid antagonist and 24 device. Prior authorization may be required for non-generic forms of 25 opioid antagonists and devices. 26 (ii) As used in this paragraph "opioid antagonist and device" means a 27 drug approved by the Food and Drug Administration that, when adminis- 28 tered, negates or neutralizes in whole or in part the pharmacological EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD15406-03-8A. 10622 2 1 effects of an opioid in the body. "Opioid antagonist" shall be limited 2 to naloxone and other medications approved by the department of health 3 for such purpose. 4 (B) The coverage mandated by this paragraph shall include opioid 5 antagonists prescribed or dispensed via standing order or collaborative 6 practice agreement intended for use on patients other than the insured. 7 (C) Coverage provided under this paragraph may be subject to annual 8 deductibles and co-insurance as deemed appropriate by the superintendent 9 and that are consistent with those imposed on other benefits within a 10 given policy. 11 § 3. Section 4303 of the insurance law is amended by adding a new 12 subsection (ss) to read as follows: 13 (ss) (1) (A) Every policy which provides coverage for prescription 14 drugs shall include coverage for at least one opioid antagonist and 15 device. Prior authorization may be required for non-generic forms of 16 opioid antagonists and devices. 17 (B) As used in this subsection "opioid antagonist and device" means a 18 drug approved by the Food and Drug Administration that, when adminis- 19 tered, negates or neutralizes in whole or in part the pharmacological 20 effects of an opioid in the body. "Opioid antagonist" shall be limited 21 to naloxone and other medications approved by the department of health 22 for such purpose. 23 (2) Coverage provided under this subsection may be subject to annual 24 deductibles and co-insurance as deemed appropriate by the superintendent 25 and that are consistent with those imposed on other benefits within a 26 given policy. 27 § 4. This act shall take effect on the thirtieth day after it shall 28 have become a law.