Bill Text: NY S03227 | 2023-2024 | General Assembly | Amended

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Bill Title: Prohibits health insurers, health care plans and HMOs from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection.

Spectrum: Partisan Bill (Democrat 6-0)

Status: (Engrossed) 2024-06-05 - referred to health [S03227 Detail]

Download: New_York-2023-S03227-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         3227--A

                               2023-2024 Regular Sessions

                    IN SENATE

                                    January 30, 2023
                                       ___________

        Introduced  by  Sens.  HOYLMAN-SIGAL, JACKSON, MYRIE, RIVERA, SALAZAR --
          read twice and ordered printed, and when printed to  be  committed  to
          the  Committee  on Health -- recommitted to the Committee on Health in
          accordance with Senate Rule 6, sec. 8 --  committee  discharged,  bill
          amended,  ordered reprinted as amended and recommitted to said commit-
          tee

        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 14 to read as follows:
     3    14. 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 (p) to read as follows:
    10    (p) 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 (p) to read as follows:
    17    (p)   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.
                                                                   LBD07908-02-4
        S. 3227--A                          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.