S T A T E O F N E W Y O R K
________________________________________________________________________
2049
2009-2010 Regular Sessions
I N A S S E M B L Y
January 15, 2009
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Introduced by M. of A. JOHN, O'DONNELL, PEOPLES, JACOBS, MILLMAN, ROBIN-
SON, PERRY, LAVINE, ESPAILLAT -- Multi-Sponsored by -- M. of A. COOK,
DIAZ, FARRELL, FIELDS, GREENE, GUNTHER, HOOPER, McENENY, N. RIVERA,
SCARBOROUGH, TITUS, TOWNS, WEISENBERG -- read once and referred to the
Committee on Social Services
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 8 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 EIGHT OF THIS SECTION:
8. (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
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04740-01-9
A. 2049 2
LAW, SHALL NOT RESTRICT BY PRIOR AUTHORIZATION OR PREFERRED DRUG LIST
PROGRAM REQUIREMENT ANY PRESCRIPTION DRUG, INCLUDED IN CERTAIN THERAPEU-
TIC DRUG CLASSES, AS PRESCRIBED AND DETERMINED BY A PRESCRIBING PRACTI-
TIONER LICENSED BY THE STATE, TO BE MEDICALLY NECESSARY FOR THE TREAT-
MENT 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.