Senate Bill S7905A

2017-2018 Legislative Session

Requires insurers providing coverage of prescription drugs for opioid addiction, to provide coverage of such prescription drugs prescribed for the treatment of substance abuse disorder

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Archive: Last Bill Status - In Senate Committee Insurance Committee

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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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 15, 2018	print number 7905a
Jun 15, 2018	amend (t) and recommit to insurance
Mar 08, 2018	referred to insurance

Bill Amendments

Original

A (Active)

co-Sponsors

2017-S7905 - Details

See Assembly Version of this Bill:: A4899
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2015-2016: A10237
2019-2020: S5535, A294

2017-S7905 - Summary

Requires insurers providing coverage of prescription drugs for opioid addiction, to provide coverage of such prescription drugs prescribed for the treatment of substance abuse disorder.

2017-S7905 - Sponsor Memo

                                
 
BILL NUMBER: S7905

SPONSOR: GRIFFO
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring health
insurers to provide coverage of opioid addiction medications during the
entire period such medications are prescribed

 
PURPOSE:

To ensure that patients suffering from drug and alcohol dependency
receive appropriate care, by requiring, without prior authorization or
step therapy, that health insurers provide coverage of opioid addiction
medications during the entire period such medications are prescribed.

 
SUMMARY OF PROVISIONS:

Section one amends subsection (i) of section 3216 of the insurance law
by adding a new paragraph 34 that requires health insurance policies to
provide coverage, without prior authorization or step therapy, of medi-

cations and prescription drugs to treat substance abuse disorder for a
covered person with an addition to opioids.

Section two amends subsection (1) of section 3221 of the insurance law
by adding a new paragraph 7-c that requires health insurance policies to
provide coverage, without prior authorization or step therapy, of medi-
cations and prescription drugs to treat substance abuse disorder for a
covered person with an addition to opioids.

Section three amends section 4303 of the insurance law by adding a new
subsection (1-3) that requires health insurance contracts to provide
coverage, without prior authorization or step therapy, of medications
and prescription drugs to treat substance abuse disorder for a covered
person with an addition to opioids.

Section four sets forth the effective date.

 
JUSTIFICATION:

In recent years, opioid use in New York State has risen to epidemic
levels. There is significant need for accessible treatment options for
individuals seeking medical treatment for addiction that insurance
companies are failing to provide. In some cases, insurance companies
have denied or sought to deny continued coverage for medications
prescribed to treat opioid addiction; or an insurer may technically
"cover" the medication but still require patients to jump through hoops
like step therapy or require prior authorization. Insurance companies
should not deny coverage for treatment options for opioid addiction
recovery as prescribed by a doctor treating a patient in recovery, nor
should they dictate to any doctor or patient a specified amount of time
that a patient can or should remain on such medication.

This legislation ensures that patients suffering from drug and alcohol
dependency receive appropriate care by requiring every insurer to
provide coverage for addiction treatment medications without prior
authorization or step therapy, and for the duration that they are
prescribed.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
Immediate.

2017-S7905 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7905
 
                             I N  S E N A T E
 
                               March 8, 2018
                                ___________
 
 Introduced  by  Sen.  GRIFFO -- 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  requiring  health
   insurers  to  provide  coverage of opioid addiction medications during
   the entire period such medications are prescribed
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 34 to read as follows:
   (34)(A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL  OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE,  OR  COVERAGE  FOR PRESCRIPTION DRUGS MUST
 PROVIDE COVERAGE, WITHOUT PRIOR AUTHORIZATION OR STEP THERAPY, OF  MEDI-
 CATIONS AND PRESCRIPTION DRUGS PRESCRIBED FOR THE TREATMENT OF SUBSTANCE
 ABUSE  DISORDER  SUFFERED  BY  A  COVERED  PERSON  WITH  AN ADDICTION TO
 OPIOIDS. SUCH COVERAGE OF MEDICATIONS AND DRUGS  SHALL  CONTINUE  TO  BE
 PROVIDED  DURING THE ENTIRE PERIOD OF TIME THE MEDICATIONS AND DRUGS ARE
 PRESCRIBED FOR SUCH TREATMENT BY AN AUTHORIZED PRESCRIBER.
   (B) COVERAGE PROVIDED UNDER THIS PARAGRAPH MAY BE  SUBJECT  TO  ANNUAL
 DEDUCTIBLES AND CO-INSURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT
 AND  THAT  ARE  CONSISTENT WITH THOSE IMPOSED ON OTHER BENEFITS WITHIN A
 GIVEN POLICY.
   § 2. Subsection (1) of section 3221 of the insurance law is amended by
 adding a new paragraph 7-c to read as follows:
   (7-C)(A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE,  OR  COVERAGE  FOR PRESCRIPTION DRUGS MUST
 PROVIDE COVERAGE, WITHOUT PRIOR AUTHORIZATION OR STEP THERAPY, OF  MEDI-
 CATIONS AND PRESCRIPTION DRUGS PRESCRIBED FOR THE TREATMENT OF SUBSTANCE
 ABUSE  DISORDER  SUFFERED  BY  A  COVERED  PERSON  WITH  AN ADDICTION TO
 OPIOIDS. SUCH COVERAGE OF MEDICATIONS AND DRUGS  SHALL  CONTINUE  TO  BE
 PROVIDED  DURING THE ENTIRE PERIOD OF TIME THE MEDICATIONS AND DRUGS ARE
 PRESCRIBED FOR SUCH TREATMENT BY AN AUTHORIZED PRESCRIBER.
   (B) COVERAGE PROVIDED UNDER THIS PARAGRAPH MAY BE  SUBJECT  TO  ANNUAL
 DEDUCTIBLES AND CO-INSURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD14969-01-8

 S. 7905                             2
 
 AND  THAT  ARE  CONSISTENT WITH THOSE IMPOSED ON OTHER BENEFITS WITHIN A
 GIVEN POLICY.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (l-3) to read as follows:
   (L-3) EVERY CONTRACT THAT PROVIDES MEDICAL, MAJOR MEDICAL  OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE,  OR  COVERAGE  FOR PRESCRIPTION DRUGS MUST
 PROVIDE COVERAGE, WITHOUT PRIOR AUTHORIZATION OR STEP THERAPY, OF  MEDI-
 CATIONS AND PRESCRIPTION DRUGS PRESCRIBED FOR THE TREATMENT OF SUBSTANCE
 ABUSE  DISORDER  SUFFERED  BY  A  COVERED  PERSON  WITH  AN ADDICTION TO
 OPIOIDS. SUCH COVERAGE OF MEDICATIONS AND DRUGS  SHALL  CONTINUE  TO  BE
 PROVIDED  DURING THE ENTIRE PERIOD OF TIME THE MEDICATIONS AND DRUGS ARE
 PRESCRIBED FOR SUCH TREATMENT BY AN AUTHORIZED PRESCRIBER.
   § 4. This act shall take effect immediately.

co-Sponsors

2017-S7905A (ACTIVE) - Details

See Assembly Version of this Bill:: A4899
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2015-2016: A10237
2019-2020: S5535, A294

2017-S7905A (ACTIVE) - Summary

Requires insurers providing coverage of prescription drugs for opioid addiction, to provide coverage of such prescription drugs prescribed for the treatment of substance abuse disorder.

2017-S7905A (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S7905A

SPONSOR: GRIFFO
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring health
insurers to provide coverage of opioid addiction prescription drugs
prescribed for the treatment of substance abuse disorder

 
PURPOSE:

This bill ensures that patients suffering from drug and alcohol depend-
ency receive appropriate care, by requiring that health insurers to
provide overage, without prior authorization, for an initial or renewal
prescription for drugs prescribed for the treatment of substance abuse
disorder.

 
SUMMARY OF PROVISIONS:

Section one amends subsection (i) of section 3216 of the insurance law
to provide that every policy providing medical, major medical or similar

comprehensive-type coverage, or coverage for prescription drugs must
provide coverage, without prior authorization, for an initial or renewal
prescription for prescription drugs prescribed for the treatment of
substance use disorder.

Section two amends subsection (1) of section 3221 of the insurance law
to provide that every policy providing medical, major medical or similar
comprehensive-type coverage, or coverage for prescription drugs must
provide coverage, without prior authorization, for an initial or renewal
prescription for prescription drugs prescribed for the treatment of
substance use disorder.

Section three adds a new subsection to section 4303 of the insurance Law
to provide that every contract that provides medical, major medical or
similar comprehensive-type coverage, or coverage for prescription drugs
must provide coverage, without prior authorization, for an initial or
renewal prescription for prescription drugs prescribed for the treatment
of substance use disorder.

Section four sets forth the effective date.

 
JUSTIFICATION:

Opioid use has grown by epidemic proportions in recent years. There is
significant need for accessible treatment options for individuals seek-
ing medical treatment for addiction. However, in some reported
instances, insurance companies have denied or sought to deny continued
coverage for buprenorphine and other medications prescribed to treat
opiate addiction. Insurance companies should not deny coverage for
treatment options for opioid addiction recovery as prescribed by a
doctor treating a patient in recovery.

This legislation would ensure that patients suffering from drug and
alcohol dependency receive appropriate care by prohibiting insurance
companies from denying coverage of medication for treatment of substance
use disorder for an initial or renewal prescription for prescription
drugs prescribed for the treatment of substance use disorder.

 
LEGISLATIVE HISTORY:

New in Senate.

 
FISCAL IMPLICATIONS:

Undetermined.

 
EFFECTIVE DATE:
Immediate.

2017-S7905A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7905--A
 
                             I N  S E N A T E
 
                               March 8, 2018
                                ___________
 
 Introduced  by  Sens. GRIFFO, GOLDEN, HAMILTON -- read twice and ordered
   printed, and when printed to be committed to the Committee  on  Insur-
   ance  --  committee  discharged,  bill  amended,  ordered reprinted as
   amended and recommitted to said committee
 
 AN ACT to amend the insurance  law,  in  relation  to  requiring  health
   insurers  to  provide  coverage of opioid addiction prescription drugs
   prescribed for the treatment of substance abuse disorder
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 35 to read as follows:
   (35)(A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL  OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE,  OR  COVERAGE  FOR PRESCRIPTION DRUGS MUST
 PROVIDE COVERAGE, WITHOUT PRIOR AUTHORIZATION OR STEP  THERAPY,  FOR  AN
 INITIAL  OR  RENEWAL  PRESCRIPTION FOR PRESCRIPTION DRUGS PRESCRIBED FOR
 THE TREATMENT OF SUBSTANCE ABUSE DISORDER SUFFERED BY A  COVERED  PERSON
 WITH AN ADDICTION TO OPIOIDS.
   (B)  COVERAGE  PROVIDED  UNDER THIS PARAGRAPH MAY BE SUBJECT TO ANNUAL
 DEDUCTIBLES AND CO-INSURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT
 AND THAT ARE CONSISTENT WITH THOSE IMPOSED ON OTHER  BENEFITS  WITHIN  A
 GIVEN POLICY.
   (C) FOR THE PURPOSES OF THIS PARAGRAPH, "PRESCRIPTION DRUGS PRESCRIBED
 FOR  THE  TREATMENT  OF SUBSTANCE ABUSE DISORDER" SHALL MEAN MEDICATIONS
 AND PRESCRIPTION DRUGS APPROVED BY THE FOOD AND DRUG ADMINISTRATION  FOR
 THE DETOXIFICATION OR MAINTENANCE TREATMENT OF SUBSTANCE USE DISORDER.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 7-c to read as follows:
   (7-C)(A)  EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR
 COMPREHENSIVE-TYPE COVERAGE, OR COVERAGE  FOR  PRESCRIPTION  DRUGS  MUST
 PROVIDE  COVERAGE,  WITHOUT  PRIOR AUTHORIZATION OR STEP THERAPY, FOR AN
 INITIAL OR RENEWAL PRESCRIPTION FOR PRESCRIPTION  DRUGS  PRESCRIBED  FOR
 THE  TREATMENT  OF SUBSTANCE ABUSE DISORDER SUFFERED BY A COVERED PERSON
 WITH AN ADDICTION TO OPIOIDS.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD14969-04-8

 S. 7905--A                          2
 
   (B) COVERAGE PROVIDED UNDER THIS PARAGRAPH MAY BE  SUBJECT  TO  ANNUAL
 DEDUCTIBLES AND CO-INSURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT
 AND  THAT  ARE  CONSISTENT WITH THOSE IMPOSED ON OTHER BENEFITS WITHIN A
 GIVEN POLICY.
   (C) FOR THE PURPOSES OF THIS PARAGRAPH, "PRESCRIPTION DRUGS PRESCRIBED
 FOR  THE  TREATMENT  OF SUBSTANCE ABUSE DISORDER" SHALL MEAN MEDICATIONS
 AND PRESCRIPTION DRUGS APPROVED BY THE FOOD AND DRUG ADMINISTRATION  FOR
 THE DETOXIFICATION OR MAINTENANCE TREATMENT OF SUBSTANCE USE DISORDER.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (l-3) to read as follows:
   (L-3) EVERY CONTRACT THAT PROVIDES MEDICAL, MAJOR MEDICAL  OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE,  OR  COVERAGE  FOR PRESCRIPTION DRUGS MUST
 PROVIDE COVERAGE, WITHOUT PRIOR AUTHORIZATION OR STEP  THERAPY,  FOR  AN
 INITIAL  OR  RENEWAL  PRESCRIPTION FOR PRESCRIPTION DRUGS PRESCRIBED FOR
 THE TREATMENT OF SUBSTANCE ABUSE DISORDER SUFFERED BY A  COVERED  PERSON
 WITH  AN  ADDICTION  TO OPIOIDS. COVERAGE PROVIDED UNDER THIS SUBSECTION
 MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND CO-INSURANCE AS  DEEMED  APPRO-
 PRIATE  BY THE SUPERINTENDENT AND THAT ARE CONSISTENT WITH THOSE IMPOSED
 ON OTHER BENEFITS WITHIN A GIVEN CONTRACT.  FOR  THE  PURPOSES  OF  THIS
 SUBSECTION,   "PRESCRIPTION   DRUGS  PRESCRIBED  FOR  THE  TREATMENT  OF
 SUBSTANCE ABUSE DISORDER" SHALL MEAN MEDICATIONS AND PRESCRIPTION  DRUGS
 APPROVED  BY  THE FOOD AND DRUG ADMINISTRATION FOR THE DETOXIFICATION OR
 MAINTENANCE TREATMENT OF SUBSTANCE USE DISORDER.
   § 4. This act shall take effect immediately.

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Senate Bill S7905A

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

Actions

Bill Amendments

co-Sponsors

2017-S7905 - Details

2017-S7905 - Summary

2017-S7905 - Sponsor Memo

2017-S7905 - Bill Text download pdf

co-Sponsors

2017-S7905A (ACTIVE) - Details

2017-S7905A (ACTIVE) - Summary

2017-S7905A (ACTIVE) - Sponsor Memo

2017-S7905A (ACTIVE) - Bill Text download pdf

Comments

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Sponsored By

Joseph A. Griffo

Archive: Last Bill Status - In Senate Committee Insurance Committee

Actions

Bill Amendments

co-Sponsors

Martin J. Golden

Jesse Hamilton

2017-S7905 - Details

2017-S7905 - Summary

2017-S7905 - Sponsor Memo

2017-S7905 - Bill Text download pdf

co-Sponsors

Martin J. Golden

Jesse Hamilton

2017-S7905A (ACTIVE) - Details

2017-S7905A (ACTIVE) - Summary

2017-S7905A (ACTIVE) - Sponsor Memo

2017-S7905A (ACTIVE) - Bill Text download pdf

Comments