The New York State Senate

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

                                 7979--A

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                              May 23, 2017
                               ___________

Introduced  by M. of A. QUART -- 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 prohibiting certain
  insurance policies from  requiring  prior  authorization  for  certain
  medications  used  in the treatment of substance use disorders; and to
  repeal certain provisions of such law relating thereto

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

  Section  1.  Paragraph  31-a  of subsection (i) of section 3216 of the
insurance law is REPEALED and a new paragraph 31-a is added to  read  as
follows:
  (31-A)  (A)  NO POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE AND PROVIDES COVERAGE FOR PRESCRIPTION DRUGS
FOR MEDICATION FOR THE TREATMENT  OF  A  SUBSTANCE  USE  DISORDER  SHALL
REQUIRE  PRIOR  AUTHORIZATION FOR AN INITIAL OR RENEWAL PRESCRIPTION FOR
ALL BUPRENORPHINE PRODUCTS, METHADONE OR LONG ACTING INJECTABLE NALTREX-
ONE FOR DETOXIFICATION OR  MAINTENANCE  TREATMENT  OF  A  SUBSTANCE  USE
DISORDER EXCEPT WHERE OTHERWISE PROHIBITED BY LAW.
  (B)  COVERAGE  PROVIDED  UNDER THIS PARAGRAPH MAY BE SUBJECT TO COPAY-
MENTS, COINSURANCE, AND ANNUAL  DEDUCTIBLES  THAT  ARE  CONSISTENT  WITH
THOSE IMPOSED ON OTHER BENEFITS WITHIN THE POLICY.
  §  2.  Paragraphs 7-a and 7-b of subsection (l) of section 3221 of the
insurance law are REPEALED and a new paragraph 7-a is added to  read  as
follows:
  (7-A) (A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR
COMPREHENSIVE-TYPE LARGE GROUP COVERAGE SHALL PROVIDE IMMEDIATE COVERAGE
FOR  ALL  BUPRENORPHINE  PRODUCTS,  METHADONE  OR LONG ACTING INJECTABLE
NALTREXONE WITHOUT PRIOR AUTHORIZATION FOR THE DETOXIFICATION OR MAINTE-
NANCE TREATMENT OF A SUBSTANCE USE DISORDER.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11793-02-7

A. 7979--A                          2

  (B) COVERAGE PROVIDED UNDER THIS PARAGRAPH MAY BE  SUBJECT  TO  COPAY-
MENTS,  COINSURANCE,  AND  ANNUAL  DEDUCTIBLES  THAT ARE CONSISTENT WITH
THOSE IMPOSED ON OTHER BENEFITS WITHIN THE POLICY.
  §  3. Subsections (l-1) and (l-2) of section 4303 of the insurance law
are REPEALED and a new subsection (l-1) is added to read as follows:
  (L-1) (A) EVERY CONTRACT THAT  PROVIDES  MEDICAL,  MAJOR  MEDICAL,  OR
SIMILAR  COMPREHENSIVE-TYPE LARGE GROUP COVERAGE SHALL PROVIDE IMMEDIATE
COVERAGE FOR  ALL  BUPRENORPHINE  PRODUCTS,  METHADONE  OR  LONG  ACTING
INJECTABLE NALTREXONE WITHOUT PRIOR AUTHORIZATION FOR THE DETOXIFICATION
OR MAINTENANCE TREATMENT OF A SUBSTANCE USE DISORDER.
  (B)  COVERAGE  PROVIDED  UNDER THIS PARAGRAPH MAY BE SUBJECT TO COPAY-
MENTS, COINSURANCE, AND ANNUAL  DEDUCTIBLES  THAT  ARE  CONSISTENT  WITH
THOSE IMPOSED ON OTHER BENEFITS WITHIN THE POLICY.
  §  4.  This  act  shall take effect on the sixtieth day after it shall
have become a law.