Bill Text: NY S06397 | 2019-2020 | 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: Partisan Bill (Democrat 5-0)

Status: (Engrossed - Dead) 2020-02-04 - referred to insurance [S06397 Detail]

Download: New_York-2019-S06397-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          6397

                               2019-2020 Regular Sessions

                    IN SENATE

                                      June 7, 2019
                                       ___________

        Introduced  by Sen. CARLUCCI -- read twice and ordered printed, and when
          printed to be committed to the Committee on Rules

        AN ACT to amend the public health law and the insurance law, in relation
          to the use of abuse-deterrent 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. Section 273 of the public health law is amended by adding a
     2  new subdivision 11 to read as follows:
     3    11. Any prior authorization requirements for opioid analgesic and  any
     4  service  denials  made  pursuant thereto shall not require use of opioid
     5  analgesic  drug  products  without  abuse-deterrent  properties   before
     6  authorizing the use of abuse-deterrent opioid analgesic drug products.
     7    §  2.  The  insurance law is amended by adding a new section 3216-a to
     8  read as follows:
     9    § 3216-a.  Access to abuse-deterrent opioid medications. (a) An insur-
    10  ance carrier or health plan shall provide  coverage  on  its  formulary,
    11  drug  list  or  other lists of similar construct for at least one abuse-
    12  deterrent opioid analgesics drug product per  opioid  analgesics  active
    13  ingredient.
    14    (1)  Cost-sharing for brand name abuse-deterrent opioid analgesic drug
    15  products covered pursuant to this section shall not  exceed  the  lowest
    16  cost-sharing  level  applied  to  brand  name non-abuse deterrent opioid
    17  drugs covered under the applicable health plan or policy.
    18    (2) Cost-sharing for generic  abuse-deterrent  opioid  analgesic  drug
    19  products  covered  pursuant  to this section shall not exceed the lowest
    20  cost-sharing level applied to generic non-abuse deterrent  opioid  drugs
    21  covered under the applicable health plan or policy.
    22    (3)  An increase in patient cost-sharing or disincentives for prescri-
    23  bers or dispensers shall not be allowed to achieve compliance with  this
    24  section.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13268-01-9
        S. 6397                             2

     1    (b)  Any  prior-authorization requirements or other utilization review
     2  measures for opioid analgesics, and any service  denials  made  pursuant
     3  thereto, shall not require use of opioid analgesic drug products without
     4  abuse-deterrent  properties  in  order  to access abuse-deterrent opioid
     5  analgesic drug products.
     6    (c) Definitions. As used in this section:
     7    (1)  "Opioid  analgesic drug product" means a drug in the opioid anal-
     8  gesic drug class prescribed to treat moderate to severe  pain  or  other
     9  conditions, whether in immediate release or extended long acting release
    10  form  and  whether  or not combined with other drug substances to form a
    11  single drug product or other dosage form.
    12    (2) "Abuse deterrent opioid analgesic drug product" means a  brand  or
    13  generic  opioid  analgesic drug product approved by the federal food and
    14  drug administration with abuse-deterrence labeling claims indicating its
    15  abuse-deterrent properties are expected to deter or reduce its abuse.
    16    (3) "Cost-sharing" means any coverage limit,  copayment,  coinsurance,
    17  deductible or other out-of-pocket patient expense requirements.
    18    § 3. This act shall take effect on the one hundred twentieth day after
    19  it  shall  have  become  a  law,  and  shall  apply  to all policies and
    20  contracts issued, renewed, modified, altered or amended on or after such
    21  date.