Bill Text: NY S03668 | 2017-2018 | General Assembly | Introduced


Bill Title: Enacts the "comprehensive contraception coverage act" to provide insurance coverage for FDA-approved contraceptive drugs, devices and products.

Spectrum: Strong Partisan Bill (Democrat 27-2)

Status: (Introduced) 2017-01-25 - REFERRED TO INSURANCE [S03668 Detail]

Download: New_York-2017-S03668-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          3668
                               2017-2018 Regular Sessions
                    IN SENATE
                                    January 25, 2017
                                       ___________
        Introduced  by  Sens.  BONACIC,  AVELLA  --  (at request of the Attorney
          General) -- read twice and ordered printed, and  when  printed  to  be
          committed to the Committee on Insurance
        AN  ACT  to amend the insurance law, the social services law, the educa-
          tion law and the public health law, in relation  to  requiring  health
          insurance  policies to include coverage of all FDA-approved contracep-
          tive drugs, devices, and products, as well as voluntary  sterilization
          procedures, contraceptive education and counseling, and related follow
          up  services  and  prohibiting a health insurance policy from imposing
          any cost-sharing requirements or other  restrictions  or  delays  with
          respect to this coverage
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. This act shall be known and may be cited as the "comprehen-
     2  sive contraception coverage act".
     3    § 2. Paragraph 16 of subsection (l) of section 3221 of  the  insurance
     4  law,  as added by chapter 554 of the laws of 2002, is amended to read as
     5  follows:
     6    (16) (A) Every group or blanket policy [which  provides  coverage  for
     7  prescription  drugs shall include coverage for the cost of contraceptive
     8  drugs or devices approved by the federal food and drug administration or
     9  generic equivalents approved as substitutes by such food and drug admin-
    10  istration under the prescription  of  a  health  care  provider  legally
    11  authorized  to  prescribe  under  title  eight of the education law. The
    12  coverage required by this section shall  be  included  in  policies  and
    13  certificates only through the addition of a rider.
    14    (A)]  that  is  issued, amended, renewed, effective or delivered on or
    15  after January first, two thousand eighteen, shall provide  coverage  for
    16  all of the following services and contraceptive methods:
    17    (1) All FDA-approved contraceptive drugs, devices, and other products.
    18  This  includes  all  FDA-approved  over-the-counter contraceptive drugs,
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD06579-01-7

        S. 3668                             2
     1  devices, and products as prescribed or  as  otherwise  authorized  under
     2  state or federal law. The following applies to this coverage:
     3    (a)  where the FDA has approved one or more therapeutic and pharmaceu-
     4  tical equivalent, as defined by the FDA,  versions  of  a  contraceptive
     5  drug,  device,  or product, a group or blanket policy is not required to
     6  include all such therapeutic and pharmaceutical equivalent  versions  in
     7  its  formulary,  so long as at least one is included and covered without
     8  cost-sharing and in accordance with this paragraph;
     9    (b) if the covered therapeutic and pharmaceutical equivalent  versions
    10  of  a drug, device, or product are not available or are deemed medically
    11  inadvisable a group or blanket policy  shall  provide  coverage  for  an
    12  alternate  therapeutic  and  pharmaceutical  equivalent  version  of the
    13  contraceptive drug, device, or product without cost-sharing;
    14    (c) this coverage shall include emergency contraception without  cost-
    15  sharing  when provided pursuant to an ordinary prescription, non-patient
    16  specific regimen order, or order under section sixty-eight hundred thir-
    17  ty-one of the education  law  and  when  lawfully  provided  other  than
    18  through a prescription or order; and
    19    (d) this coverage must allow for the dispensing of twelve months worth
    20  of a contraceptive at one time;
    21    (2) Voluntary sterilization procedures;
    22    (3) Patient education and counseling on contraception; and
    23    (4)  Follow-up  services  related to the drugs, devices, products, and
    24  procedures covered under this paragraph, including, but not limited  to,
    25  management  of  side  effects,  counseling  for continued adherence, and
    26  device insertion and removal.
    27    (B) A group or blanket policy subject  to  this  paragraph  shall  not
    28  impose  a  deductible, coinsurance, copayment, or any other cost-sharing
    29  requirement on the coverage provided pursuant to this paragraph.
    30    (C) Except as otherwise authorized under this paragraph,  a  group  or
    31  blanket policy shall not impose any restrictions or delays on the cover-
    32  age required under this paragraph.
    33    (D)  Benefits  for  an enrollee under this paragraph shall be the same
    34  for an  enrollee's  covered  spouse  or  domestic  partner  and  covered
    35  nonspouse dependents.
    36    (E)  Notwithstanding  any  other provision of this subsection, a reli-
    37  gious employer may request a contract without coverage for federal  food
    38  and drug administration approved contraceptive methods that are contrary
    39  to  the  religious  employer's  religious  tenets. If so requested, such
    40  contract shall be provided without coverage for  contraceptive  methods.
    41  This  paragraph  shall not be construed to deny an enrollee coverage of,
    42  and timely access to, contraceptive methods.
    43    (1) For purposes of this subsection,  a  "religious  employer"  is  an
    44  entity for which each of the following is true:
    45    (a) The inculcation of religious values is the purpose of the entity.
    46    (b)  The  entity  primarily  employs  persons  who share the religious
    47  tenets of the entity.
    48    (c) The entity serves primarily persons who share the religious tenets
    49  of the entity.
    50    (d) The entity is a nonprofit organization  as  described  in  Section
    51  6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended.
    52    (2) Every religious employer that invokes the exemption provided under
    53  this  paragraph  shall  provide  written notice to prospective enrollees
    54  prior to enrollment with the plan, listing the contraceptive health care
    55  services the employer refuses to cover for religious reasons.

        S. 3668                             3
     1    [(B) (i)] (F) (1) Where a group policyholder makes an election not  to
     2  purchase  coverage for contraceptive drugs or devices in accordance with
     3  subparagraph [(A)] (E) of this paragraph each certificateholder  covered
     4  under  the policy issued to that group policyholder shall have the right
     5  to  directly  purchase  the  rider  required  by this paragraph from the
     6  insurer which issued the group policy  at  the  prevailing  small  group
     7  community  rate  for such rider whether or not the employee is part of a
     8  small group.
     9    [(ii)] (2) Where  a  group  policyholder  makes  an  election  not  to
    10  purchase  coverage for contraceptive drugs or devices in accordance with
    11  subparagraph [(A)] (E) of this paragraph, the insurer that provides such
    12  coverage shall provide written notice to certificateholders upon enroll-
    13  ment with the insurer of their right to directly purchase  a  rider  for
    14  coverage  for  the  cost  of  contraceptive drugs or devices. The notice
    15  shall also advise the certificateholders of the additional  premium  for
    16  such coverage.
    17    [(C)]  (G) Nothing in this paragraph shall be construed as authorizing
    18  a group or blanket policy which provides coverage for prescription drugs
    19  to exclude coverage for prescription drugs prescribed for reasons  other
    20  than contraceptive purposes.
    21    [(D) Such coverage may be subject to reasonable annual deductibles and
    22  coinsurance  as  may  be deemed appropriate by the superintendent and as
    23  are consistent with those established for other drugs or devices covered
    24  under the policy.]
    25    § 3. Subsection (cc) of section 4303 of the insurance law, as added by
    26  chapter 554 of the laws of 2002, is amended to read as follows:
    27    (cc) (1) Every contract  [which  provides  coverage  for  prescription
    28  drugs  shall  include  coverage  for  the cost of contraceptive drugs or
    29  devices approved by the federal food and drug administration or  generic
    30  equivalents approved as substitutes by such food and drug administration
    31  under  the  prescription of a health care provider legally authorized to
    32  prescribe under title eight of the education law. The coverage  required
    33  by  this  section  shall  be included in contracts and certificates only
    34  through the addition of a rider.
    35    (1)] that is issued, amended, renewed, effective or  delivered  on  or
    36  after  January  first, two thousand eighteen, shall provide coverage for
    37  all of the following services and contraceptive methods:
    38    (A) All FDA-approved contraceptive drugs, devices, and other products.
    39  This includes all  FDA-approved  over-the-counter  contraceptive  drugs,
    40  devices,  and  products  as  prescribed or as otherwise authorized under
    41  state or federal law.  The following applies to this coverage:
    42    (i) where the FDA has approved one or more therapeutic and  pharmaceu-
    43  tical  equivalent,  as  defined  by the FDA, versions of a contraceptive
    44  drug, device, or product, a contract is not required to include all such
    45  therapeutic and pharmaceutical equivalent versions in its formulary,  so
    46  long as at least one is included and covered without cost-sharing and in
    47  accordance with this subsection;
    48    (ii) if the covered therapeutic and pharmaceutical equivalent versions
    49  of  a drug, device, or product are not available or are deemed medically
    50  inadvisable a contract shall provide coverage for an alternate therapeu-
    51  tic and pharmaceutical equivalent version  of  the  contraceptive  drug,
    52  device, or product without cost-sharing;
    53    (iii)  this  coverage  shall  include  emergency contraception without
    54  cost-sharing when provided pursuant to an ordinary prescription, non-pa-
    55  tient specific regimen order, or order under section sixty-eight hundred

        S. 3668                             4
     1  thirty-one of the education law and when lawfully  provided  other  than
     2  through a prescription or order; and
     3    (iv)  this  coverage  must  allow  for the dispensing of twelve months
     4  worth of a contraceptive at one time;
     5    (B) Voluntary sterilization procedures;
     6    (C) Patient education and counseling on contraception; and
     7    (D) Follow-up services related to the drugs,  devices,  products,  and
     8  procedures covered under this subsection, including, but not limited to,
     9  management  of  side  effects,  counseling  for continued adherence, and
    10  device insertion and removal.
    11    (2) A contract subject to this subsection shall not impose  a  deduct-
    12  ible,  coinsurance,  copayment, or any other cost-sharing requirement on
    13  the coverage provided pursuant to this subsection.
    14    (3) Except as otherwise authorized under this subsection,  a  contract
    15  shall  not  impose  any  restrictions or delays on the coverage required
    16  under this subsection.
    17    (4) Benefits for an enrollee under this subsection shall be  the  same
    18  for  an  enrollee's  covered  spouse  or  domestic  partner  and covered
    19  nonspouse dependents.
    20    (5) Notwithstanding any other provision of this  subsection,  a  reli-
    21  gious  employer may request a contract without coverage for federal food
    22  and drug administration approved contraceptive methods that are contrary
    23  to the religious employer's religious  tenets.  If  so  requested,  such
    24  contract  shall  be provided without coverage for contraceptive methods.
    25  This paragraph shall not be construed to deny an enrollee  coverage  of,
    26  and timely access to, contraceptive methods.
    27    (A)  For  purposes  of  this  subsection, a "religious employer" is an
    28  entity for which each of the following is true:
    29    (i) The inculcation of religious values is the purpose of the entity.
    30    (ii) The entity primarily employs  persons  who  share  the  religious
    31  tenets of the entity.
    32    (iii)  The  entity  serves  primarily  persons who share the religious
    33  tenets of the entity.
    34    (iv) The entity is a nonprofit organization as  described  in  Section
    35  6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended.
    36    (B) Every religious employer that invokes the exemption provided under
    37  this  paragraph  shall  provide  written notice to prospective enrollees
    38  prior to enrollment with the plan, listing the contraceptive health care
    39  services the employer refuses to cover for religious reasons.
    40    [(2)](6) (A) Where a group contractholder makes  an  election  not  to
    41  purchase  coverage for contraceptive drugs or devices in accordance with
    42  paragraph [one] five of this subsection, each enrollee covered under the
    43  contract issued to that group contractholder shall  have  the  right  to
    44  directly purchase the rider required by this subsection from the insurer
    45  or  health  maintenance  organization which issued the group contract at
    46  the prevailing small group community rate for such rider whether or  not
    47  the employee is part of a small group.
    48    (B)  Where  a  group  contractholder makes an election not to purchase
    49  coverage for contraceptive drugs or devices in accordance with paragraph
    50  [one] five of this subsection, the insurer or health maintenance  organ-
    51  ization  that  provides  such  coverage  shall provide written notice to
    52  enrollees upon enrollment with the insurer or health maintenance  organ-
    53  ization of their right to directly purchase a rider for coverage for the
    54  cost of contraceptive drugs or devices. The notice shall also advise the
    55  enrollees of the additional premium for such coverage.

        S. 3668                             5
     1    [(3)](7)  Nothing in this subsection shall be construed as authorizing
     2  a contract which provides coverage for  prescription  drugs  to  exclude
     3  coverage  for  prescription  drugs  prescribed  for  reasons  other than
     4  contraceptive purposes.
     5    [(4) Such coverage may be subject to reasonable annual deductibles and
     6  coinsurance  as  may  be deemed appropriate by the superintendent and as
     7  are consistent with those established for other drugs or devices covered
     8  under the policy.]
     9    § 4. Subparagraph (E) of paragraph 17 of  subsection  (i)  of  section
    10  3216  of the insurance law is amended by adding a new clause (v) to read
    11  as follows:
    12    (v) all FDA-approved contraceptive drugs, devices, and other products,
    13  including  all  over-the-counter  contraceptive  drugs,   devices,   and
    14  products as prescribed or as otherwise authorized under state or federal
    15  law;  voluntary  sterilization  procedures;  patient education and coun-
    16  seling on contraception; and follow-up services related  to  the  drugs,
    17  devices,  products, and procedures covered under this clause, including,
    18  but not limited to, management of side effects, counseling for continued
    19  adherence, and device insertion and removal. Except as otherwise author-
    20  ized under this clause, a contract shall not impose any restrictions  or
    21  delays  on  the  coverage required under this clause. However, where the
    22  FDA has approved one or more therapeutic and pharmaceutical  equivalent,
    23  as  defined  by  the  FDA,  versions of a contraceptive drug, device, or
    24  product, a contract is not required to include all such therapeutic  and
    25  pharmaceutical equivalent versions in its formulary, so long as at least
    26  one  is included and covered without cost-sharing and in accordance with
    27  this clause. If the covered therapeutic  and  pharmaceutical  equivalent
    28  versions  of  a drug, device, or product are not available or are deemed
    29  medically inadvisable a contract shall provide coverage for an alternate
    30  therapeutic and pharmaceutical equivalent version of  the  contraceptive
    31  drug,  device,  or  product  without  cost-sharing.  This coverage shall
    32  include  emergency  contraception  without  cost-sharing  when  provided
    33  pursuant  to  an  ordinary  prescription,  non-patient  specific regimen
    34  order, or order under section  sixty-eight  hundred  thirty-one  of  the
    35  education   law   and  when  lawfully  provided  other  than  through  a
    36  prescription or order; and this coverage must allow for  the  dispensing
    37  of twelve months worth of a contraceptive at one time.
    38    §  5.  Paragraph  (d)  of subdivision 3 of section 365-a of the social
    39  services law, as amended by chapter 909 of  the  laws  of  1974  and  as
    40  relettered  by  chapter  82  of  the laws of 1995, is amended to read as
    41  follows:
    42    (d) family planning services and twelve months of supplies for  eligi-
    43  ble  persons  of  childbearing  age, including children under twenty-one
    44  years of age who can be considered  sexually  active,  who  desire  such
    45  services  and  supplies,  in accordance with the requirements of federal
    46  law and regulations and the regulations of  the  department.  No  person
    47  shall be compelled or coerced to accept such services or supplies.
    48    §  6.  Subdivision 6 of section 6527 of the education law, as added by
    49  chapter 573 of the laws of 1999, paragraph (c) as amended by chapter 464
    50  of the laws of 2015, paragraph (d) as added by chapter 429 of  the  laws
    51  of  2005,  paragraph  (e)  as  added by chapter 352 of the laws of 2014,
    52  paragraph (f) as added by section 6 of part V of chapter 57 of the  laws
    53  of  2015  and paragraph (g) as added by chapter 502 of the laws of 2016,
    54  is amended to read as follows:
    55    6. A licensed physician may prescribe and order a non-patient specific
    56  regimen [to a registered professional nurse],  pursuant  to  regulations

        S. 3668                             6
     1  promulgated  by  the commissioner, and consistent with the public health
     2  law, [for] to:
     3    (a) a registered professional nurse for:
     4    (i) administering immunizations[.];
     5    [(b)] (ii) the emergency treatment of anaphylaxis[.];
     6    [(c)]  (iii)  administering purified protein derivative (PPD) tests or
     7  other tests to detect or screen for tuberculosis infections[.];
     8    [(d)] (iv) administering tests to determine the presence of the  human
     9  immunodeficiency virus[.];
    10    [(e)] (v) administering tests to determine the presence of the hepati-
    11  tis C virus[.];
    12    [(f)] (vi) emergency contraception, to be administered to or dispensed
    13  to  be  self-administered  by  the  patient,  under  section sixty-eight
    14  hundred thirty-two of this title;
    15    (vii) the urgent or emergency treatment of opioid related overdose  or
    16  suspected opioid related overdose[.]; or
    17    [(g)]  (viii)  screening  of  persons  at  increased risk of syphilis,
    18  gonorrhea and chlamydia.
    19    (b) a licensed pharmacist, for dispensing emergency contraception,  to
    20  be  self-administered  by the patient, under section sixty-eight hundred
    21  thirty-two of this title.
    22    § 7. Subdivision 3 of section 6807 of the education law, as  added  by
    23  chapter  573  of the laws of 1999, is amended and a new subdivision 4 is
    24  added to read as follows:
    25    3. A pharmacist may dispense drugs and devices to a registered profes-
    26  sional nurse, and a registered professional nurse may possess and admin-
    27  ister, drugs and devices, pursuant to  a  non-patient  specific  regimen
    28  prescribed  or  ordered  by  a  licensed  physician, licensed midwife or
    29  certified nurse practitioner, pursuant to regulations promulgated by the
    30  commissioner and the public health law.
    31    4. A pharmacist may dispense a non-patient specific regimen  of  emer-
    32  gency  contraception, to be self-administered by the patient, prescribed
    33  or ordered by a licensed physician,  certified  nurse  practitioner,  or
    34  licensed  midwife,  under section sixty-eight hundred thirty-two of this
    35  article.
    36    § 8. The education law is amended by adding a new section 6832 to read
    37  as follows:
    38    § 6832. Emergency contraception; non-patient specific prescription  or
    39  order.  1.  As  used in this section, the following terms shall have the
    40  following meanings, unless the context requires otherwise:
    41    (a) "Emergency  contraception"  means  one  or  more  prescription  or
    42  nonprescription  drugs,  used  separately or in combination, in a dosage
    43  and manner for preventing pregnancy when used after  intercourse,  found
    44  safe  and  effective  for  that  use  by the United States food and drug
    45  administration, and dispensed or administered for that purpose.
    46    (b) "Prescriber" means a licensed physician, certified  nurse  practi-
    47  tioner or licensed midwife.
    48    2. This section applies to the administering or dispensing of emergen-
    49  cy contraception by a registered professional nurse or the dispensing of
    50  emergency   contraception   by  a  licensed  pharmacist  pursuant  to  a
    51  prescription or order for a non-patient specific regimen made by a pres-
    52  criber under section sixty-five hundred twenty-seven, sixty-nine hundred
    53  nine or sixty-nine hundred fifty-one of this title.  This  section  does
    54  not  apply  to  administering or dispensing emergency contraception when
    55  lawfully done without such a prescription or order.

        S. 3668                             7
     1    3. The administering or dispensing of  emergency  contraception  by  a
     2  registered  professional nurse or the dispensing of emergency contracep-
     3  tion by a licensed pharmacist shall be done in accordance  with  profes-
     4  sional  standards  of practice and in accordance with written procedures
     5  and protocols agreed to by the registered professional nurse or licensed
     6  pharmacist  and  the  prescriber  or  a hospital (licensed under article
     7  twenty-eight of the public health law) that  provides  gynecological  or
     8  family planning services.
     9    4.  (a) When emergency contraception is administered or dispensed, the
    10  registered professional nurse or licensed pharmacist  shall  provide  to
    11  the  patient  written material that includes: (i) the clinical consider-
    12  ations and recommendations for use of the  drug;  (ii)  the  appropriate
    13  method  for  using  the  drug;  (iii)  information  on the importance of
    14  follow-up health care; (iv) information on the health  risks  and  other
    15  dangers  of unprotected intercourse; and (v) referral information relat-
    16  ing to health care and services relating to sexual  abuse  and  domestic
    17  violence.
    18    (b)  Such  written  material  shall  be  developed  or approved by the
    19  commissioner in consultation with the department of health and the Amer-
    20  ican college of obstetricians and gynecologists.
    21    § 9. Subdivision 4 of section 6909 of the education law, as  added  by
    22  chapter 573 of the laws of 1999, paragraph (a) as amended by chapter 221
    23  of the laws of 2002, paragraph (c) as amended by chapter 464 of the laws
    24  of  2015,  paragraph  (d)  as  added by chapter 429 of the laws of 2005,
    25  paragraph (e) as added by chapter 352 of the laws of 2014, paragraph (f)
    26  as added by section 5 of part V of chapter 57 of the laws  of  2015  and
    27  paragraph (g) as added by chapter 502 of the laws of 2016, is amended to
    28  read as follows:
    29    4.  A  certified  nurse practitioner may prescribe and order a non-pa-
    30  tient specific regimen [to a registered professional nurse], pursuant to
    31  regulations promulgated by the commissioner, consistent with subdivision
    32  three of section [six thousand nine]  sixty-nine  hundred  two  of  this
    33  article, and consistent with the public health law, for:
    34    (a) a registered professional nurse for:
    35    (i) administering immunizations[.];
    36    [(b)] (ii) the emergency treatment of anaphylaxis[.];
    37    [(c)]  (iii)  administering purified protein derivative (PPD) tests or
    38  other tests to detect or screen for tuberculosis infections[.];
    39    [(d)] (iv) administering tests to determine the presence of the  human
    40  immunodeficiency virus[.];
    41    [(e)] (v) administering tests to determine the presence of the hepati-
    42  tis C virus[.];
    43    [(f)] (vi) emergency contraception, to be administered to or dispensed
    44  to  be  self-administered  by  the  patient,  under  section sixty-eight
    45  hundred thirty-two of this title;
    46    (vii) the urgent or emergency treatment of opioid related overdose  or
    47  suspected opioid related overdose[.]; or
    48    [(g)]  (viii)  screening  of  persons  at increased risk for syphilis,
    49  gonorrhea and chlamydia.
    50    (b) a licensed pharmacist, for dispensing emergency contraception,  to
    51  be  self-administered  by the patient, under section sixty-eight hundred
    52  thirty-two of this title.
    53    § 10. Subdivision 5 of section 6909 of the education law, as added  by
    54  chapter 573 of the laws of 1999, is amended to read as follows:
    55    5.  A registered professional nurse may execute a non-patient specific
    56  regimen prescribed or ordered by a licensed physician, licensed  midwife

        S. 3668                             8
     1  or  certified nurse practitioner, pursuant to regulations promulgated by
     2  the commissioner.
     3    §  11.  Section  6951  of the education law is amended by adding a new
     4  subdivision 4 to read as follows:
     5    4. A licensed midwife may prescribe and order a  non-patient  specific
     6  regimen   pursuant  to  regulations  promulgated  by  the  commissioner,
     7  consistent with this section and the public health law, to:
     8    (a) a registered professional nurse for emergency contraception, to be
     9  administered to or dispensed to be  self-administered  by  the  patient,
    10  under section sixty-eight hundred thirty-two of this title; or
    11    (b)  a licensed pharmacist, for dispensing emergency contraception, to
    12  be self-administered by the patient, under section  sixty-eight  hundred
    13  thirty-two of this title.
    14    § 12. Subdivision 1 of section 207 of the public health law is amended
    15  by adding a new paragraph (n) to read as follows:
    16    (n)  Emergency  contraception, including information about its safety,
    17  efficacy, appropriate use and availability.
    18    § 13. This act shall  take  effect  January  1,  2018;  provided  that
    19  section  six  of  this  act shall take effect January 1, 2019; provided,
    20  however, that effective  immediately,  the  addition,  amendment  and/or
    21  repeal  of  any  rule  or regulation necessary for the implementation of
    22  this act on its effective date are authorized and directed  to  be  made
    23  and  completed by the commissioner of education and the board of regents
    24  on or before such effective date.
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