Assembly Bill A6983A

Signed By Governor
2015-2016 Legislative Session

Directs the commissioner of health and superintendent of financial services to establish a standard prior authorization request for a utilization review of prescription drug coverage

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Archive: Last Bill Status Via S4721 - Signed by Governor

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

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Bill Amendments

2015-A6983 - Details

See Senate Version of this Bill:
S4721
Law Section:
Public Health Law
Laws Affected:
Amd §4903, Pub Health L; amd §4903, Ins L
Versions Introduced in 2013-2014 Legislative Session:
A9765, S7369

2015-A6983 - Summary

Directs the commissioner of health and superintendent of financial services to establish a standard prior authorization request for a utilization review of prescription drug coverage.

2015-A6983 - Bill Text download pdf 

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

                                  6983

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                             April 16, 2015
                               ___________

Introduced by M. of A. McDONALD -- read once and referred to the Commit-
  tee on Health

AN ACT to amend the public health law and the insurance law, in relation
  to  a  standard  prior  authorization  request  form for a utilization
  review of prescription drug coverage

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

  Section  1. Section 4903 of the public health law is amended by adding
a new subdivision 8 to read as follows:
  8. THE COMMISSIONER, IN CONJUNCTION WITH THE SUPERINTENDENT OF  FINAN-
CIAL SERVICES, SHALL DEVELOP A STANDARD PRIOR AUTHORIZATION REQUEST FORM
TO BE UTILIZED BY ALL HEALTH CARE PLANS FOR THE PURPOSES OF SUBMITTING A
REQUEST   FOR   A  UTILIZATION  REVIEW  DETERMINATION  FOR  COVERAGE  OF
PRESCRIPTION DRUG BENEFITS UNDER THIS ARTICLE. THE FORM SHALL BE IDENTI-
CAL TO THAT DEVELOPED PURSUANT TO SECTION  FOUR  THOUSAND  NINE  HUNDRED
THREE  OF THE INSURANCE LAW. EACH HEALTH CARE PLAN SHALL MAKE THE STAND-
ARD PRIOR AUTHORIZATION REQUEST FORM AVAILABLE TO, AND SHALL  ACCEPT  IT
FROM, PRESCRIBING PROVIDERS IN PAPER AND ELECTRONIC FORM. THE DEPARTMENT
AND  THE  DEPARTMENT OF FINANCIAL SERVICES, IN DEVELOPMENT OF THE STAND-
ARDIZED FORM, SHALL TAKE INTO CONSIDERATION EXISTING PRIOR AUTHORIZATION
FORMS ESTABLISHED BY THE DEPARTMENT PURSUANT TO  SECTION  THREE  HUNDRED
SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW.
  S  2.  Section  4903  of  the insurance law is amended by adding a new
subsection (h) to read as follows:
  (H) THE  SUPERINTENDENT,  IN  CONJUNCTION  WITH  THE  COMMISSIONER  OF
HEALTH,  SHALL DEVELOP A STANDARD PRIOR AUTHORIZATION REQUEST FORM TO BE
UTILIZED BY ALL HEALTH CARE PLANS  FOR  THE  PURPOSES  OF  SUBMITTING  A
REQUEST   FOR   A  UTILIZATION  REVIEW  DETERMINATION  FOR  COVERAGE  OF
PRESCRIPTION DRUG BENEFITS UNDER THIS ARTICLE. THE FORM SHALL BE IDENTI-
CAL TO THAT DEVELOPED PURSUANT TO SECTION FORTY-NINE  HUNDRED  THREE  OF
THE  PUBLIC  HEALTH  LAW.  EACH HEALTH CARE PLAN SHALL MAKE THE STANDARD

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04038-01-5

2015-A6983A (ACTIVE) - Details

See Senate Version of this Bill:
S4721
Law Section:
Public Health Law
Laws Affected:
Amd §4903, Pub Health L; amd §4903, Ins L
Versions Introduced in 2013-2014 Legislative Session:
A9765, S7369

2015-A6983A (ACTIVE) - Summary

Directs the commissioner of health and superintendent of financial services to establish a standard prior authorization request for a utilization review of prescription drug coverage.

2015-A6983A (ACTIVE) - Bill Text download pdf 

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

                                 6983--A
                                                        Cal. No. 333

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                             April 16, 2015
                               ___________

Introduced by M. of A. McDONALD -- read once and referred to the Commit-
  tee on Health -- reported from committee, advanced to a third reading,
  amended  and  ordered  reprinted,  retaining its place on the order of
  third reading

AN ACT to amend the public health law and the insurance law, in relation
  to standards for prior authorization requests for a utilization review
  of prescription drug coverage

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

  Section  1. Section 4903 of the public health law is amended by adding
a new subdivision 8 to read as follows:
  8. THE COMMISSIONER, IN CONJUNCTION WITH THE SUPERINTENDENT OF  FINAN-
CIAL  SERVICES, SHALL DEVELOP STANDARDS FOR PRIOR AUTHORIZATION REQUESTS
TO BE UTILIZED BY ALL HEALTH CARE PLANS FOR THE PURPOSES OF SUBMITTING A
REQUEST  FOR  A  UTILIZATION  REVIEW  DETERMINATION  FOR   COVERAGE   OF
PRESCRIPTION  DRUG  BENEFITS UNDER THIS ARTICLE.  THE DEPARTMENT AND THE
DEPARTMENT OF FINANCIAL SERVICES, IN DEVELOPMENT OF THE STANDARDS, SHALL
TAKE INTO CONSIDERATION EXISTING ELECTRONIC PRIOR  AUTHORIZATION  STAND-
ARDS  INCLUDING  NATIONAL COUNCIL FOR PRESCRIPTION DRUG PROGRAMS (NCPDP)
ELECTRONIC PRIOR AUTHORIZATION STANDARD TRANSACTIONS.
  S 2. Section 4903 of the insurance law is  amended  by  adding  a  new
subsection (h) to read as follows:
  (H)  THE  SUPERINTENDENT,  IN  CONJUNCTION  WITH  THE  COMMISSIONER OF
HEALTH, SHALL DEVELOP STANDARDS FOR PRIOR AUTHORIZATION REQUESTS  TO  BE
UTILIZED  BY  ALL  HEALTH  CARE  PLANS  FOR THE PURPOSES OF SUBMITTING A
REQUEST  FOR  A  UTILIZATION  REVIEW  DETERMINATION  FOR   COVERAGE   OF
PRESCRIPTION  DRUG  BENEFITS UNDER THIS ARTICLE.  THE DEPARTMENT AND THE
DEPARTMENT OF HEALTH, IN DEVELOPMENT OF THE STANDARDS, SHALL  TAKE  INTO
CONSIDERATION  EXISTING ELECTRONIC PRIOR AUTHORIZATION STANDARDS INCLUD-
ING NATIONAL COUNCIL FOR PRESCRIPTION DRUG PROGRAMS  (NCPDP)  ELECTRONIC
PRIOR AUTHORIZATION STANDARD TRANSACTIONS.

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

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