assembly Bill A2834D

Signed By Governor
2015-2016 Legislative Session

Relates to expedited utilization review of prescription drugs

download bill text pdf

Sponsored By

Archive: Last Bill Status Via S3419 - Signed by Governor


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

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Actions

view actions (20)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Dec 31, 2016 signed chap.512
approval memo.30
Dec 20, 2016 delivered to governor
Jun 16, 2016 returned to senate
passed assembly
Jun 14, 2016 ordered to third reading rules cal.266
substituted for a2834d
Jun 14, 2016 substituted by s3419c
rules report cal.266
reported
Jun 07, 2016 amend and recommit to rules 2834d
Jun 01, 2016 reported referred to rules
May 27, 2016 print number 2834c
May 27, 2016 amend (t) and recommit to insurance
Feb 29, 2016 print number 2834b
Feb 29, 2016 amend and recommit to insurance
Jan 06, 2016 referred to insurance
May 07, 2015 print number 2834a
May 07, 2015 amend (t) and recommit to insurance
Jan 20, 2015 referred to insurance

Co-Sponsors

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Multi-Sponsors

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A2834 - Details

See Senate Version of this Bill:
S3419
Law Section:
Insurance Law
Laws Affected:
Amd §§3217-a, 4324, 4900, 4902 & 4903, Ins L; amd §§4408, 4900, 4902 & 4903, Pub Health L
Versions Introduced in Other Legislative Sessions:
2011-2012: S6464
2013-2014: S2711

A2834 - Summary

Relates to expedited utilization review of prescription drugs.

A2834 - Bill Text download pdf

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

                                  2834

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 20, 2015
                               ___________

Introduced  by  M. of A. TITONE, GOTTFRIED, RODRIGUEZ, ROBERTS, GUNTHER,
  ZEBROWSKI, QUART, PEOPLES-STOKES, MONTESANO, CUSICK, BRINDISI,  TEDIS-
  CO,  WEPRIN,  ROSENTHAL, SKOUFIS, ROZIC, JOHNS, JAFFEE, STIRPE, STECK,
  OTIS -- Multi-Sponsored by -- M.  of A. CRESPO, DUPREY,  FAHY,  GALEF,
  HEVESI,  KOLB,  LUPARDO, McLAUGHLIN, PERRY, RIVERA, SCHIMEL, SEPULVEDA
  -- read once and referred to the Committee on Insurance

AN ACT to amend the insurance law, in relation to the regulation of step
  therapy and 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
                     REGULATION OF STEP THERAPY AND
                           FIRST FAIL POLICIES
SECTION 3301. DEFINITIONS.
        3302. 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.
  (B)  "PHARMACY  BENEFIT  MANAGEMENT"  OR  "PBM" SHALL MEAN THE SERVICE
PROVIDED TO AN INSURER, DIRECTLY OR THROUGH  ANOTHER  ENTITY;  INCLUDING
THE  PROCUREMENT  OF  PRESCRIPTION  DRUGS  TO  BE  DISPENSED  TO COVERED
PERSONS, OR THE ADMINISTRATION OR MANAGEMENT OF PRESCRIPTION DRUG  BENE-
FITS INCLUDING, BUT NOT LIMITED TO, ANY OF THE FOLLOWING:
  (1) A MAIL ORDER PHARMACY;
  (2) CLAIMS PROCESSING, RETAIL NETWORK MANAGEMENT AND PAYMENT OF CLAIMS
TO PHARMACIES FOR DISPENSING PRESCRIPTION DRUGS;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03838-01-5

Co-Sponsors

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Multi-Sponsors

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A2834A - Details

See Senate Version of this Bill:
S3419
Law Section:
Insurance Law
Laws Affected:
Amd §§3217-a, 4324, 4900, 4902 & 4903, Ins L; amd §§4408, 4900, 4902 & 4903, Pub Health L
Versions Introduced in Other Legislative Sessions:
2011-2012: S6464
2013-2014: S2711

A2834A - Summary

Relates to expedited utilization review of prescription drugs.

A2834A - Bill Text download pdf

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

                                 2834--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 20, 2015
                               ___________

Introduced  by  M. of A. TITONE, GOTTFRIED, RODRIGUEZ, ROBERTS, GUNTHER,
  ZEBROWSKI, QUART, PEOPLES-STOKES, MONTESANO, CUSICK, BRINDISI,  TEDIS-
  CO,  WEPRIN,  ROSENTHAL, SKOUFIS, ROZIC, JOHNS, JAFFEE, STIRPE, STECK,
  OTIS, ABINANTI, CLARK, BARRETT -- Multi-Sponsored by -- M. of A. CRES-
  PO, DUPREY, FAHY, GALEF, HEVESI,  KOLB,  LUPARDO,  McLAUGHLIN,  PERRY,
  RIVERA,  SCHIMEL, SEPULVEDA -- read once and referred to the Committee
  on Insurance -- committee discharged, bill amended, ordered  reprinted
  as amended and recommitted to said committee

AN ACT to amend the insurance law, in relation to the regulation of step
  therapy policies

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

  Section 1. Legislative findings.  The  legislature  hereby  finds  and
declares that:
  (a) Health insurance plans are increasingly making use of step therapy
protocols  under  which  patients  are  required  to  try  one  or  more
prescription drugs before coverage is provided for a  drug  selected  by
the patient's health care provider.
  (b)  The  legislature  further finds that such step therapy protocols,
where they are based on well-developed scientific standards and adminis-
tered in a flexible manner that takes into account the individual  needs
of  patients,  can  play  an  important  role in controlling health care
costs.
  (c) The legislature further finds that, in  some  cases,  requiring  a
patient  to  follow  a  step  therapy protocol may have adverse and even
dangerous consequences for the patient who may  not  realize  a  benefit
from  taking a prescription drug or may suffer harm from taking an inap-
propriate drug.
  (d) The legislature further finds that, without  uniform  policies  in
the  state for step therapy protocols, patients may not receive the best
and most appropriate treatment.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03838-02-5

Co-Sponsors

view additional co-sponsors

Multi-Sponsors

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A2834B - Details

See Senate Version of this Bill:
S3419
Law Section:
Insurance Law
Laws Affected:
Amd §§3217-a, 4324, 4900, 4902 & 4903, Ins L; amd §§4408, 4900, 4902 & 4903, Pub Health L
Versions Introduced in Other Legislative Sessions:
2011-2012: S6464
2013-2014: S2711

A2834B - Summary

Relates to expedited utilization review of prescription drugs.

A2834B - Bill Text download pdf

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

                                 2834--B

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 20, 2015
                               ___________

Introduced by M. of A. TITONE, GOTTFRIED, RODRIGUEZ, GUNTHER, ZEBROWSKI,
  QUART,  PEOPLES-STOKES,  MONTESANO, CUSICK, BRINDISI, TEDISCO, WEPRIN,
  ROSENTHAL, SKOUFIS, ROZIC, JOHNS, JAFFEE, STIRPE, STECK, OTIS, ABINAN-
  TI, CLARK, BARRETT, THIELE, PICHARDO, KEARNS, SANTABARBARA  --  Multi-
  Sponsored by -- M. of A. CERETTO, CRESPO, DUPREY, FAHY, GALEF, HEVESI,
  KOLB,  LUPARDO,  McLAUGHLIN, PERRY, RIVERA, SCHIMEL, SEPULVEDA -- read
  once  and  referred  to  the  Committee  on  Insurance  --   committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to  said  committee  --  recommitted  to the Committee on Insurance in
  accordance with Assembly Rule 3, sec. 2 -- committee discharged,  bill
  amended,  ordered reprinted as amended and recommitted to said commit-
  tee

AN ACT to amend the insurance law, in relation to the regulation of step
  therapy policies

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

  Section  1.  Legislative  findings.  The  legislature hereby finds and
declares that:
  (a) Health insurance plans are increasingly making use of step therapy
protocols  under  which  patients  are  required  to  try  one  or  more
prescription  drugs  before  coverage is provided for a drug selected by
the patient's health care provider.
  (b) The legislature further finds that such  step  therapy  protocols,
where they are based on well-developed scientific standards and adminis-
tered  in a flexible manner that takes into account the individual needs
of patients, can play an  important  role  in  controlling  health  care
costs.
  (c)  The  legislature  further  finds that, in some cases, requiring a
patient to follow a step therapy protocol  may  have  adverse  and  even
dangerous  consequences  for  the  patient who may not realize a benefit

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03838-05-6

Co-Sponsors

view additional co-sponsors

Multi-Sponsors

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A2834C - Details

See Senate Version of this Bill:
S3419
Law Section:
Insurance Law
Laws Affected:
Amd §§3217-a, 4324, 4900, 4902 & 4903, Ins L; amd §§4408, 4900, 4902 & 4903, Pub Health L
Versions Introduced in Other Legislative Sessions:
2011-2012: S6464
2013-2014: S2711

A2834C - Summary

Relates to expedited utilization review of prescription drugs.

A2834C - Bill Text download pdf

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

                                 2834--C

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 20, 2015
                               ___________

Introduced by M. of A. TITONE, GOTTFRIED, RODRIGUEZ, GUNTHER, ZEBROWSKI,
  QUART,  PEOPLES-STOKES,  MONTESANO, CUSICK, BRINDISI, TEDISCO, WEPRIN,
  ROSENTHAL, SKOUFIS, ROZIC, JOHNS, JAFFEE, STIRPE, STECK, OTIS, ABINAN-
  TI, BARRETT, THIELE, PICHARDO, KEARNS, SANTABARBARA,  COLTON,  CROUCH,
  HUNTER,  PAULIN, COOK, CYMBROWITZ, JOYNER, GOLDFEDER, LAVINE, CASTORI-
  NA, DILAN,  McDONALD,  MOYA,  BRAUNSTEIN,  SEAWRIGHT,  RAIA,  WOERNER,
  MAGNARELLI  -- Multi-Sponsored by -- M. of A. BUCHWALD, CERETTO, CRES-
  PO, DUPREY, ENGLEBRIGHT, FAHY, FRIEND, GALEF,  HEVESI,  KOLB,  LENTOL,
  LUPARDO,  LUPINACCI,  McLAUGHLIN,  MURRAY, PERRY, RA, RIVERA, SCHIMEL,
  SEPULVEDA, TENNEY -- read once and referred to the Committee on Insur-
  ance -- committee  discharged,  bill  amended,  ordered  reprinted  as
  amended  and  recommitted  to  said  committee  --  recommitted to the
  Committee on Insurance in accordance with Assembly Rule 3, sec.  2  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee -- again reported  from  said  committee
  with  amendments, ordered reprinted as amended and recommitted to said
  committee

AN ACT to amend the insurance law and the public health law, in relation
  to expedited utilization review of prescription drugs

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

  Section  1.  Paragraph  10  of subsection (b) of section 3217-a of the
insurance law, as added by chapter 705 of the laws of 1996,  is  amended
to read as follow:
  (10)  upon  written  request, provide specific written clinical review
criteria relating to a particular condition or disease  INCLUDING  CLIN-
ICAL REVIEW CRITERIA RELATING TO A STEP THERAPY PROTOCOL OVERRIDE DETER-
MINATION  PURSUANT  TO SUBSECTION (C-1), SUBSECTION (C-2) AND SUBSECTION
(C-3) OF SECTION FORTY-NINE HUNDRED THREE OF THIS  CHAPTER,  and,  where
appropriate, other clinical information which the insurer might consider
in  its utilization review and the insurer may include with the informa-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03838-07-6

Co-Sponsors

view additional co-sponsors

Multi-Sponsors

view additional multi-sponsors

A2834D (ACTIVE) - Details

See Senate Version of this Bill:
S3419
Law Section:
Insurance Law
Laws Affected:
Amd §§3217-a, 4324, 4900, 4902 & 4903, Ins L; amd §§4408, 4900, 4902 & 4903, Pub Health L
Versions Introduced in Other Legislative Sessions:
2011-2012: S6464
2013-2014: S2711

A2834D (ACTIVE) - Summary

Relates to expedited utilization review of prescription drugs.

A2834D (ACTIVE) - Bill Text download pdf

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

                                 2834--D

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 20, 2015
                               ___________

Introduced by M. of A. TITONE, GOTTFRIED, RODRIGUEZ, GUNTHER, ZEBROWSKI,
  QUART,  PEOPLES-STOKES,  MONTESANO, CUSICK, BRINDISI, TEDISCO, WEPRIN,
  ROSENTHAL, SKOUFIS, ROZIC, JOHNS, JAFFEE, STIRPE, STECK, OTIS, ABINAN-
  TI, BARRETT, THIELE, PICHARDO, KEARNS, SANTABARBARA,  COLTON,  CROUCH,
  HUNTER,  PAULIN, COOK, CYMBROWITZ, JOYNER, GOLDFEDER, LAVINE, CASTORI-
  NA, DILAN,  McDONALD,  MOYA,  BRAUNSTEIN,  SEAWRIGHT,  RAIA,  WOERNER,
  MAGNARELLI,  BLAKE,  SOLAGES, WALTER -- Multi-Sponsored by -- M. of A.
  BUCHWALD, CERETTO, CRESPO, DUPREY, ENGLEBRIGHT, FAHY,  FRIEND,  GALEF,
  GLICK,  HEVESI,  KOLB, LENTOL, LUPARDO, LUPINACCI, McDONOUGH, McLAUGH-
  LIN, MURRAY, PERRY, RA, RIVERA, SCHIMEL,  SEPULVEDA,  TENNEY  --  read
  once   and  referred  to  the  Committee  on  Insurance  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee -- recommitted to  the  Committee  on  Insurance  in
  accordance  with Assembly Rule 3, sec. 2 -- committee discharged, bill
  amended, ordered reprinted as amended and recommitted to said  commit-
  tee  --  again  reported  from said committee with amendments, ordered
  reprinted as amended and recommitted to said committee -- reported and
  referred to the Committee on Rules -- Rules Committee discharged, bill
  amended, ordered reprinted as amended and recommitted to the Committee
  on Rules

AN ACT to amend the insurance law and the public health law, in relation
  to expedited utilization review of prescription drugs

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

  Section  1.  Paragraph  10  of subsection (b) of section 3217-a of the
insurance law, as added by chapter 705 of the laws of 1996,  is  amended
to read as follows:
  (10)  upon  written  request, provide specific written clinical review
criteria relating to a particular condition or disease  INCLUDING  CLIN-
ICAL REVIEW CRITERIA RELATING TO A STEP THERAPY PROTOCOL OVERRIDE DETER-
MINATION  PURSUANT  TO SUBSECTION (C-1), SUBSECTION (C-2) AND SUBSECTION

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03838-08-6

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