S T A T E   O F   N E W   Y O R K
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                                  1832

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 13, 2015
                               ___________

Introduced by M. of A. GUNTHER, PEOPLES-STOKES, ROBINSON, PERRY, LAVINE,
  TITONE, MOYA, JAFFEE, COLTON, DenDEKKER -- Multi-Sponsored by -- M. of
  A.  COOK,  DUPREY, FARRELL, GLICK, HOOPER, RIVERA, ROSENTHAL, SCARBOR-
  OUGH, SCHIMEL, TITUS -- read once and referred  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 section 6 of part D of chapter 56
of  the  laws  of  2013, is amended and a new subdivision 10 is added to
read as follows:
  "Standard coverage" 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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02948-01-5
              

A. 1832                             2

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
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.