senate Bill S564

Prohibits medicaid's use of any prior approval or preferred drug list requirement for AIDS, HIV, infection, or hepatitis C

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 05 / Jan / 2011
    • REFERRED TO HEALTH
  • 04 / Jan / 2012
    • REFERRED TO HEALTH

Summary

Prohibits medicaid's use of any prior approval or preferred drug list requirement for AIDS, HIV, infection, or hepatitis C.

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Bill Details

See Assembly Version of this Bill:
A1962
Versions:
S564
Legislative Cycle:
2011-2012
Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd §365-a, Soc Serv L
Versions Introduced in Previous Legislative Cycles:
2009-2010: S1093, A2049
2007-2008: A6457

Sponsor Memo

BILL NUMBER:S564

TITLE OF BILL:
An act
to amend the social services
law, in relation to establishing a prohibition on prior approval
or preferred drug list requirements
for certain drugs used to treat AIDS, HIV
infection or hepatitis C

PURPOSE:
To prohibit prior approval or preferred drug list requirements for
certain drugs used to treat AIDS, HIV infection, or hepatitis C.

SUMMARY OF PROVISIONS:
Section 1 prohibits prior authorization or preferred drug list program
requirements for prescription drugs deemed to be medically necessary
for the treatment and prevention of AIDS, HIV infection and hepatitis
C.
Section 2 is the severability clause.

JUSTIFICATION:
Hepatitis C is rapidly emerging as one of New York's most significant
public health issues. Currently, there are approximately 342,000 New
Yorkers living with acute or chronic Hepatitis C and approximately
40,000 New Yorkers living with co-infection of HIV and Hepatitis C.
Of this 40,000 it is estimated that 43% are African American and 29%
are Hispanic. For these New Yorkers, hope lies in early treatment.
Early diagnosis, early treatment and early access to Hepatitis C
drugs are essential to the long-term health of the patient. The use
of Hepatitis C drugs in the early stages of the virus, not only
reduces the likelihood that a patient will spread the virus, but also
reduces the likelihood that a patient will require an expensive liver
transplant. The establishment of a prohibition on prior approval or
preferred drug list requirements for certain AIDS, HIV infection and
Hepatitis C drugs will help prevent the possibility of a future
barrier to drug treatment and will help put the patient on a faster
track to wellness.

LEGISLATIVE HISTORY:
01/09/08 REFERRED TO SOCIAL SERVICES, CHILDREN AND FAMILIES

FISCAL IMPLICATIONS:
To be determined.

EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                   564

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 5, 2011
                               ___________

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

AN ACT to amend the social services law, in relation to  establishing  a
  prohibition  on prior approval or preferred drug list requirements for
  certain drugs used to treat AIDS, HIV infection or hepatitis C

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. The opening paragraph of subdivision 2 of section 365-a of
the social services law, as amended by chapter 41 of the laws  of  1992,
is amended and a new subdivision 10 is added to read as follows:
  "Medical  assistance" shall mean payment of part or all of the cost of
medically necessary medical, dental  and  remedial  care,  services  and
supplies,  as authorized in this title or the regulations of the depart-
ment, which are necessary to prevent, diagnose, correct or  cure  condi-
tions in the person that cause acute suffering, endanger life, result in
illness  or  infirmity, interfere with such person's capacity for normal
activity, or threaten some significant handicap and which are  furnished
an  eligible person in accordance with this title and the regulations of
the department. Such care,  services  and  supplies  shall  include  the
following  medical  care,  services  and  supplies,  together  with such
medical care, services and supplies provided for in subdivisions  three,
four  and  five  of  this  section,  and such medical care, services and
supplies as  are  authorized  in  the  regulations  of  the  department,
NOTWITHSTANDING  ANY  INCONSISTENT  PROVISION  OF  LAW,  SUBJECT  TO THE
PROVISIONS OF SUBDIVISION TEN OF THIS SECTION:
  10. (A) UNLESS REQUIRED BY FEDERAL LAW AND REGULATION AS  A  CONDITION
OF  QUALIFYING  FOR  FEDERAL  FINANCIAL  PARTICIPATION  IN  THE MEDICAID
PROGRAM,  THE  DEPARTMENT  OTHERWISE  NOTWITHSTANDING  ANY  INCONSISTENT
PROVISION OF LAW, SHALL NOT RESTRICT BY PRIOR AUTHORIZATION OR PREFERRED
DRUG LIST PROGRAM REQUIREMENT ANY PRESCRIPTION DRUG, INCLUDED IN CERTAIN

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01989-01-1

S. 564                              2

THERAPEUTIC  DRUG CLASSES, AS PRESCRIBED AND DETERMINED BY A PRESCRIBING
PRACTITIONER LICENSED BY THE STATE, TO BE MEDICALLY  NECESSARY  FOR  THE
TREATMENT AND PREVENTION OF AIDS, HIV INFECTION, AND HEPATITIS C.
  (B)  THERAPEUTIC  CLASSES CONTAINING PRESCRIPTION DRUGS WHICH SHALL BE
EXCLUDED FROM ANY PRIOR AUTHORIZATION OR  PREFERRED  DRUG  LIST  PROGRAM
REQUIREMENT PROVISIONS SHALL INCLUDE THE FOLLOWING:
  (1) ANTI-RETROVIRAL MEDICATIONS, INCLUDING BUT NOT LIMITED TO PROTEASE
INHIBITORS,  NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS, NUCLEOSIDE
REVERSE TRANSCRIPTASE INHIBITORS,  ANTI-VIRALS,  AND  FUSION  INHIBITORS
PRESCRIBED FOR THE TREATMENT OF AIDS OR HIV INFECTION.
  (2)   IMMUNOMODULATORS   AND   HEPATITIS  C-SPECIFIC  ANTIVIRAL  DRUGS
PRESCRIBED FOR THE TREATMENT OF HEPATITIS C.
  S 2. Severability. If any clause, sentence, paragraph, section or part
of this act shall be adjudged by any court of competent jurisdiction  to
be  invalid  and  after  exhaustion  of all further judicial review, the
judgment shall not affect, impair or invalidate the  remainder  thereof,
but  shall  be  confined in its operation to the clause, sentence, para-
graph, section or part of this act directly involved in the  controversy
in which the judgment shall have been rendered.
  S  3. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become  a  law;  provided  that  the
state  commissioner  of  health  is authorized to promulgate any and all
rules and regulations and take any other measures necessary to implement
this act on its effective date on or before such date.

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