|Assembly Actions - Lowercase
Senate Actions - UPPERCASE
|Jan 08, 2014||referred to insurance|
|Jan 10, 2013||referred to insurance|
senate Bill S2086
Archive: Last Bill Status - In Committee
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
S2086 - Details
S2086 - Summary
Prohibits first fail accident and/or health insurance policies; enacts penalties and defines terms.
S2086 - Sponsor Memo
BILL NUMBER:S2086 TITLE OF BILL: An act to amend the insurance law, in relation to the prohibition on first fail policies PURPOSE: This bill would amend the insurance law by adding Article 33 which would prohibit fail first accident/or health insurance policies that require a patient to exhaust the least expensive drug options before insurers will cover more expensive treatment options. The bill would also prohibit switching patients to a different prescription drug without the full knowledge and consent of the prescribing physician and the patient, would require simple, common-sense steps to protect patients from the risks of ill-considered changes in their prescribed medicines. The bill would provide consumers with safeguards, transparency, and medical oversight that is necessary to ensure their health and safety. SUMMARY OF PROVISIONS: This bill would amend the insurance law by adding a new article 33 which would prohibit fail first accident/or health insurance policies and unauthorized therapeutic substitution. Section 3301 defines key terms. Section 3302 prohibits health benefit plans that provide prescription coverage from reducing, limiting, or denying coverage when the insured was taking the medication or was currently covered by a policy that
S2086 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 2086 2013-2014 Regular Sessions I N S E N A T E January 10, 2013 ___________ Introduced by Sens. YOUNG, ADDABBO -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to the prohibition on first fail policies THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The insurance law is amended by adding a new article 33 to read as follows: ARTICLE 33 PROHIBITION ON FIRST FAIL POLICIES AND UNAUTHORIZED THERAPEUTIC SUBSTITUTION SECTION 3301. DEFINITIONS. 3302. PRESCRIPTION DRUG DENIALS. 3303. SWITCH COMMUNICATIONS/CONSUMER RIGHT TO KNOW. 3304. PENALTIES. 3305. PRESCRIPTION DRUG RESTRICTION OVERRIDES. S 3301. DEFINITIONS. AS USED IN THIS ARTICLE: (A) "INSURER" SHALL MEAN ANY PERSON OR ENTITY WHO OFFERS A POLICY OF ACCIDENT AND/OR HEALTH INSURANCE PURSUANT TO SECTION THREE THOUSAND TWO HUNDRED SIXTEEN, THREE THOUSAND TWO HUNDRED TWENTY-ONE, OR FOUR THOUSAND THREE HUNDRED THREE OF THIS CHAPTER OR ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW; EXCEPT WHEN SUCH HEALTH CARE SERVICES ARE PROVIDED, DELIV- ERED, ARRANGED FOR, PAID FOR, OR REIMBURSED BY ANY STATE, DEPARTMENT OR AGENCY; (B) "PHARMACY BENEFITS MANAGER" OR "PBM", MEANS A PERSON OR ENTITY OTHER THAN A PHARMACY OR PHARMACIST ACTING AS AN ADMINISTRATOR IN CONNECTION WITH PHARMACY BENEFITS; (C) "SWITCH COMMUNICATION", MEANS A WRITTEN COMMUNICATION FROM ANY INSURER OR PBM TO A PATIENT OR THE PATIENT'S PHYSICIAN THAT RECOMMENDS A PATIENT'S MEDICATION BE SWITCHED BY THE ORIGINAL PRESCRIBING HEALTH CARE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04369-01-3
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