Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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Apr 12, 2019 |
signed chap.25 |
Apr 10, 2019 |
delivered to governor |
Jan 22, 2019 |
returned to senate passed assembly ordered to third reading cal.8 substituted for a585a referred to codes delivered to assembly passed senate ordered to third reading cal.34 reported and committed to rules |
Jan 11, 2019 |
print number 659a |
Jan 11, 2019 |
amend (t) and recommit to insurance |
Jan 09, 2019 |
referred to insurance |
Senate Bill S659
Signed By Governor2019-2020 Legislative Session
Enacts the "comprehensive contraception coverage act"
download bill text pdfSponsored By
(D, WF) 18th Senate District
Archive: Last Bill Status - Signed by Governor
- Introduced
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- In Committee Assembly
- In Committee Senate
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- On Floor Calendar Assembly
- On Floor Calendar Senate
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- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
Votes
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Floor Vote: Jan 22, 2019
aye (51)- Addabbo Jr.
- Akshar
- Bailey
- Benjamin
- Biaggi
- Boyle
- Breslin
- Brooks
- Carlucci
- Comrie
- Gaughran
- Gianaris
- Gounardes
- Griffo
- Harckham
- Hoylman-Sigal
- Jackson
- Jacobs
- Kaminsky
- Kaplan
- Kavanagh
- Kennedy
- Krueger
- LaValle
- Little
- Liu
- Martinez
- May
- Mayer
- Metzger
- Montgomery
- Myrie
- O'Mara
- Parker
- Persaud
- Ramos
- Rivera
- Robach
- Salazar
- Sanders Jr.
- Savino
- Sepúlveda
- Serino
- Serrano
- Seward
- Skoufis
- Stavisky
- Stewart-Cousins
- Tedisco
- Thomas
- Young
excused (1)
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Jan 22, 2019 - Rules Committee Vote
S65914Aye1Nay3Aye with Reservations0Absent1Excused0Abstained -
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Bill Amendments
co-Sponsors
(D, WF) Senate District
(D) 15th Senate District
(D) 36th Senate District
(D) Senate District
(D, WF) Senate District
(D, WF) 46th Senate District
(D) Senate District
(D) Senate District
(D) 14th Senate District
(D) Senate District
(D, WF) 12th Senate District
(D) 26th Senate District
(D, WF) 40th Senate District
(D, WF) 47th Senate District
(D, WF) 31st Senate District
(D) Senate District
(D, IP, WF) Senate District
(D) 27th Senate District
(D, WF) 63rd Senate District
(D, WF) 28th Senate District
(D) 16th Senate District
(D, WF) 4th Senate District
(D, WF) 48th Senate District
(D, WF) 37th Senate District
(D) Senate District
(D) 20th Senate District
(D, WF) 21st Senate District
(D) 19th Senate District
(D, WF) 13th Senate District
(D, WF) 33rd Senate District
(D) 10th Senate District
(D, IP) Senate District
(D) 32nd Senate District
(D, WF) 29th Senate District
(D) 42nd Senate District
(D) 11th Senate District
(D, WF) 35th Senate District
(D) 6th Senate District
2019-S659 - Details
2019-S659 - Sponsor Memo
BILL NUMBER: S659 SPONSOR: SALAZAR TITLE OF BILL: An act to amend the insurance law, the social services law, the education law and the public health law, in relation to requir- ing health insurance policies to include coverage of all FDA-approved contraceptive drugs, devices, and products, as well as voluntary steri- lization procedures, contraceptive education and counseling, and related follow up services and prohibiting a health insurance policy from impos- ing any cost-sharing requirements or other restrictions or delays with respect to this coverage PURPOSE OR GENERAL IDEA OF BILL: This legislation will help to reduce the number of unintended pregnan- cies, improve birth outcomes and improve the health and welfare of New Yorkers by ensuring that individuals have timely access to contraception and the information they need in order to plan their families and their future. SUMMARY OF PROVISIONS:
Section 1. Provides that the act shall be known and may be cited as the Comprehensive Contraception Coverage Act. Section 2. Amends paragraph 16 of subsection (1) of section 3221 of the insurance law to require commercial group health insurance policies to cover all FDA-approved contraceptive drugs, devices and products when prescribed by a health care provider. When the FDA has approved one or more therapeutic and pharmaceutical equivalent versions of a contraceptive drug, device or product, coverage is not required for equivalent versions of the contraceptive drug unless the equivalent is not available or is medically inadvisable. Coverage shall: (i) include emergency contraception when prescribed through a prescription or a non-patient specific order; (ii) allow for dispensing of up to twelve months of contraception; (iii) include voluntary steri- lization procedures for women and men; (iv) include patient education and counseling about contraception; and (v) include any follow-up care related to the covered contraceptives including management of side-ef- fects, counseling and device insertion and removal. An insurer may not apply co-pays or deductibles when coverage for a contraceptive method is required. In addition, no restrictions, or delays in coverage can be applied when coverage for a contraceptive method is required. Coverage for an enrollee's covered spouse, domestic partner and covered dependents shall be the same as for the enrollee. "Conscience protections" in existing law remain untouched. Specif- ically; the bill does not amend existing law which allows a religious employer to request an insurance policy without coverage for FDA-ap- proved contraceptive methods that are contrary to the religious employ- er's religious tenets. Sections 3 and 4. Makes similar changes outlined in Section 2 to subsection (cc) of Section 4303 of the insurance law relating to nonpro- fit medical indemnity, or health and hospital service corporations and subparagraph (E) of paragraph 17 of subsection (i) of section 3216 of the insurance law relating to individual health insurance policies. Section 5. Amends paragraph (d) of subdivision 3 of section 365-a of the social services law to expand the definition of "medical services" to include 12 months of contraceptive supplies for eligible persons. Section 6. Amends subdivision six of section 6527 of the education law to authorize a registered professional nurse to administer or dispense emergency contraception to a patient and authorizes a pharmacist to dispense emergency contraception to be self-administered by the patient. Section 7. Amends subdivision 3 of section 6807 of the education law to add a licensed midwife to the list of practitioners who may prescribe or order a non-patient specific regimen. Also, adds a new subdivision to the education law providing that a licensed pharmacist may dispense a non-patient specific regimen of emergency contraception, to be self-ad- ministered by the patient, which was prescribed or ordered by a licensed physician, certified nurse practitioner, or licensed midwife. Section 8. Adds a new section 6832 to the education law to: (i) define the terms "emergency contraception" and "prescriber"; (ii) provide that this section does not apply to administering or dispensing emergency contraception when lawfully done without a prescription or non-patient specific regimen; (iii) require that the administering or dispensing of emergency contraception.by a registered professional nurse or licensed pharmacist be done in accordance with professional standards of practice and in accordance with written procedures and protocols; and (iv) outline the contents of written material that must be provided to the patient when emergency contraception is administered or dispensed. Such written material shall be developed or approved by the commissioner in consultation with the Department of Health (DOH) and the American College of Obstetricians and Gynecologists (AGOG). Section 9. Amends subdivision 4 of Section 6909 of the education law to authorize a registered professional nurse to administer or dispense emergency contraception to a patient and a pharmacist to dispense emer- gency contraception to be self-administered by the patient. Section 10. Amends subdivision five of section 6909 of the education law by adding a licensed midwife to those practitioners who may prescribe and order a non-patient specific regimen of emergency contraception. Section 11. Adds a new subdivision 4 to section 6951 of the education law to authorize a licensed midwife to prescribe and order a non-patient specific regimen of emergency contraception to be administered or dispensed by a registered professional nurse or dispensed by a licensed pharmacist. Sections 10, 11, and 12. Amends three sections of the insurance law to mandate that under these sections any insurance policy that covers emer- gency contraception shall also cover emergency contraception when provided by a non-patient-specific prescription. Section 12. Adds a new paragraph (p) to subdivision one of section 207 of the public health law to broaden the NYS Department of Health's education and outreach program to include information on emergency contraception and its safety, efficacy, appropriate use and availabili- ty. Section 13. Contains a severability clause. Section 14. Provides that this act shall take effect on January 1, 2020, provided however that section six shall take effect on January 1, 2021. DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE): N/A JUSTIFICATION: Access to contraceptive services is essential to women's health and equality. New York has long recognized the central role that contracep- tion plays in women's health and lives and has led efforts to expand access to contraception. All New Yorkers, regardless of economic status, should have timely access to contraception and the information they need in order to protect their health, plan their families and their future. Time and time again, studies show that contraceptive access reduces rates of unintended pregnancy, plays a crucial role in improving public health outcomes, as well as improving the economic well-being of women and their families. * However, despite legal reform on the State and Federal level, lack of contraceptive insurance coverage and high co-pay- ments remain significant barriers to contraceptive access. The Contraceptive Equity Act would amend state insurance and social service laws to require health insurance policies to include coverage of all Food and Drug Administration (FDA)-approved contraceptive drugs, devices, and products, as well as voluntary sterilization procedures, contraceptive education and counseling, and related follow up services.** It would also prohibit a health insurance policy from impos- ing any cost-sharing requirements or other restriction or delays with respect to this coverage. In 2002, the New York State Legislature passed the Women's Health and Wellness Act, an important first step toward contraceptive equity that required insurance plans that cover prescriptions to include contracep- tion. Eight years later, the U.S. Congress passed the Affordable Care Act (ACA), which includes a contraceptive coverage guarantee as part of a broader requirement for health insurance plans to cover contraceptive services without cost-sharing for all women in the Health Insurance Marketplace. The contraceptive equity policy is one of the landmark achievements of the ACA, but a lack of clarity in the federal law has led to inconsist- ent implementation and enforcement. Insurers can take advantage of this confusion to limit coverage for the diverse array of contraceptive meth- ods available and, in some cases, can prevent individuals from accessing the method deemed most effective by their medical provider: Addi- tionally, many insurance companies do not typically cover male methods of contraception or require high cost-sharing despite the critical role men play in the prevention of unintended pregnancy. Building on existing state and federal law to promote gender equity and women's health, this Act would ensure broad contraceptive coverage and timely access to all federal FDA-approved methods of contraception for individuals covered under health insurance plans in New York. PRIOR LEGISLATIVE HISTORY: FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None EFFECTIVE DATE: This act shall take effect on January 1, 2020. However, section five shall take effect on January 1, 2021. *Bonfield, Adam. "What Women Already Know: Documenting the Social and Economic Benefits of Family Planning." Guttmacher Institute. Winter 2013. http://www.guttmacher.org/pubs/gpr/16/1/gpr160108.html **For a full list of these devices, see the FDA Office of Women's Health's Birth Control Guide http://Wwm.fda.gov/downloads/ForConsumers/ByAudience/ ForWomen/FreePublications/UCM356451.pdf
2019-S659 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ S. 659 A. 585 2019-2020 Regular Sessions S E N A T E - A S S E M B L Y (PREFILED) January 9, 2019 ___________ IN SENATE -- Introduced by Sens. SALAZAR, METZGER, ADDABBO, BAILEY, BENJAMIN, BIAGGI, BRESLIN, BROOKS, CARLUCCI, COMRIE, GAUGHRAN, GIANAR- IS, GOUNARDES, HARCKHAM, HOYLMAN, JACKSON, KAMINSKY, KAPLAN, KAVANAGH, KENNEDY, KRUEGER, LIU, MARTINEZ, MAY, MAYER, MONTGOMERY, MYRIE, PARK- ER, PERSAUD, RAMOS, RIVERA, SANDERS, SAVINO, SEPULVEDA, SERRANO, SKOUFIS, STAVISKY, STEWART-COUSINS, THOMAS -- read twice and ordered printed, and when printed to be committed to the Committee on Insur- ance IN ASSEMBLY -- Introduced by M. of A. CAHILL, SEAWRIGHT, HEASTIE, L. ROSENTHAL, GLICK, JAFFEE, SIMOTAS, GOTTFRIED, BARRON, BLAKE, BARRETT, MAGNARELLI, BRONSON, LAVINE, CARROLL, GALEF, OTIS, SIMON, HYNDMAN, RAMOS, D'URSO, PEOPLES-STOKES, PICHARDO, ORTIZ, WOERNER, BURKE, CRUZ, FALL, FRONTUS, GRIFFIN, JACOBSON, McMAHON, RAYNOR, ROMEO, REYES, SAYEGH -- Multi-Sponsored by -- M. of A. BRAUNSTEIN, BUCHWALD, COOK, EPSTEIN, LIFTON, LUPARDO, MOSLEY, ROZIC, THIELE, TITUS -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, the social services law, the educa- tion law and the public health law, in relation to requiring health insurance policies to include coverage of all FDA-approved contracep- tive drugs, devices, and products, as well as voluntary sterilization procedures, contraceptive education and counseling, and related follow up services and prohibiting a health insurance policy from imposing any cost-sharing requirements or other restrictions or delays with respect to this coverage THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. This act shall be known and may be cited as the "comprehen- sive contraception coverage act". EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
LBD06618-01-9 S. 659 2 A. 585 § 2. Paragraph 16 of subsection (l) of section 3221 of the insurance law, as added by chapter 554 of the laws of 2002, is amended to read as follows: (16) (A) Every group or blanket policy [which provides coverage for prescription drugs shall include coverage for the cost of contraceptive drugs or devices approved by the federal food and drug administration or generic equivalents approved as substitutes by such food and drug admin- istration under the prescription of a health care provider legally authorized to prescribe under title eight of the education law. The coverage required by this section shall be included in policies and certificates only through the addition of a rider. (A)] THAT IS ISSUED, AMENDED, RENEWED, EFFECTIVE OR DELIVERED ON OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY, SHALL PROVIDE COVERAGE FOR ALL OF THE FOLLOWING SERVICES AND CONTRACEPTIVE METHODS: (1) ALL FDA-APPROVED CONTRACEPTIVE DRUGS, DEVICES, AND OTHER PRODUCTS. THIS INCLUDES ALL FDA-APPROVED OVER-THE-COUNTER CONTRACEPTIVE DRUGS, DEVICES, AND PRODUCTS AS PRESCRIBED OR AS OTHERWISE AUTHORIZED UNDER STATE OR FEDERAL LAW. THE FOLLOWING APPLIES TO THIS COVERAGE: (A) WHERE THE FDA HAS APPROVED ONE OR MORE THERAPEUTIC AND PHARMACEU- TICAL EQUIVALENT, AS DEFINED BY THE FDA, VERSIONS OF A CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT, A GROUP OR BLANKET POLICY IS NOT REQUIRED TO INCLUDE ALL SUCH THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS IN ITS FORMULARY, SO LONG AS AT LEAST ONE IS INCLUDED AND COVERED WITHOUT COST-SHARING AND IN ACCORDANCE WITH THIS PARAGRAPH; (B) IF THE COVERED THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS OF A DRUG, DEVICE, OR PRODUCT ARE NOT AVAILABLE OR ARE DEEMED MEDICALLY INADVISABLE A GROUP OR BLANKET POLICY SHALL PROVIDE COVERAGE FOR AN ALTERNATE THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSION OF THE CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT WITHOUT COST-SHARING; (C) THIS COVERAGE SHALL INCLUDE EMERGENCY CONTRACEPTION WITHOUT COST- SHARING WHEN PROVIDED PURSUANT TO AN ORDINARY PRESCRIPTION, NON-PATIENT SPECIFIC REGIMEN ORDER, OR ORDER UNDER SECTION SIXTY-EIGHT HUNDRED THIR- TY-ONE OF THE EDUCATION LAW AND WHEN LAWFULLY PROVIDED OTHER THAN THROUGH A PRESCRIPTION OR ORDER; AND (D) THIS COVERAGE MUST ALLOW FOR THE DISPENSING OF TWELVE MONTHS WORTH OF A CONTRACEPTIVE AT ONE TIME; (2) VOLUNTARY STERILIZATION PROCEDURES; (3) PATIENT EDUCATION AND COUNSELING ON CONTRACEPTION; AND (4) FOLLOW-UP SERVICES RELATED TO THE DRUGS, DEVICES, PRODUCTS, AND PROCEDURES COVERED UNDER THIS PARAGRAPH, INCLUDING, BUT NOT LIMITED TO, MANAGEMENT OF SIDE EFFECTS, COUNSELING FOR CONTINUED ADHERENCE, AND DEVICE INSERTION AND REMOVAL. (B) A GROUP OR BLANKET POLICY SUBJECT TO THIS PARAGRAPH SHALL NOT IMPOSE A DEDUCTIBLE, COINSURANCE, COPAYMENT, OR ANY OTHER COST-SHARING REQUIREMENT ON THE COVERAGE PROVIDED PURSUANT TO THIS PARAGRAPH. (C) EXCEPT AS OTHERWISE AUTHORIZED UNDER THIS PARAGRAPH, A GROUP OR BLANKET POLICY SHALL NOT IMPOSE ANY RESTRICTIONS OR DELAYS ON THE COVER- AGE REQUIRED UNDER THIS PARAGRAPH. (D) BENEFITS FOR AN ENROLLEE UNDER THIS PARAGRAPH SHALL BE THE SAME FOR AN ENROLLEE'S COVERED SPOUSE OR DOMESTIC PARTNER AND COVERED NONSPOUSE DEPENDENTS. (E) Notwithstanding any other provision of this subsection, a reli- gious employer may request a contract without coverage for federal food and drug administration approved contraceptive methods that are contrary to the religious employer's religious tenets. If so requested, such contract shall be provided without coverage for contraceptive methods. S. 659 3 A. 585 This paragraph shall not be construed to deny an enrollee coverage of, and timely access to, contraceptive methods. (1) For purposes of this subsection, a "religious employer" is an entity for which each of the following is true: (a) The inculcation of religious values is the purpose of the entity. (b) The entity primarily employs persons who share the religious tenets of the entity. (c) The entity serves primarily persons who share the religious tenets of the entity. (d) The entity is a nonprofit organization as described in Section 6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended. (2) Every religious employer that invokes the exemption provided under this paragraph shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons. [(B) (i)] (F) (1) Where a group policyholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with subparagraph [(A)] (E) of this paragraph each certificateholder covered under the policy issued to that group policyholder shall have the right to directly purchase the rider required by this paragraph from the insurer which issued the group policy at the prevailing small group community rate for such rider whether or not the employee is part of a small group. [(ii)] (2) Where a group policyholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with subparagraph [(A)] (E) of this paragraph, the insurer that provides such coverage shall provide written notice to certificateholders upon enroll- ment with the insurer of their right to directly purchase a rider for coverage for the cost of contraceptive drugs or devices. The notice shall also advise the certificateholders of the additional premium for such coverage. [(C)] (G) Nothing in this paragraph shall be construed as authorizing a group or blanket policy which provides coverage for prescription drugs to exclude coverage for prescription drugs prescribed for reasons other than contraceptive purposes. [(D) Such coverage may be subject to reasonable annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other drugs or devices covered under the policy.] § 3. Subsection (cc) of section 4303 of the insurance law, as added by chapter 554 of the laws of 2002, is amended to read as follows: (cc) (1) Every contract [which provides coverage for prescription drugs shall include coverage for the cost of contraceptive drugs or devices approved by the federal food and drug administration or generic equivalents approved as substitutes by such food and drug administration under the prescription of a health care provider legally authorized to prescribe under title eight of the education law. The coverage required by this section shall be included in contracts and certificates only through the addition of a rider. (1)] THAT IS ISSUED, AMENDED, RENEWED, EFFECTIVE OR DELIVERED ON OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY, SHALL PROVIDE COVERAGE FOR ALL OF THE FOLLOWING SERVICES AND CONTRACEPTIVE METHODS: (A) ALL FDA-APPROVED CONTRACEPTIVE DRUGS, DEVICES, AND OTHER PRODUCTS. THIS INCLUDES ALL FDA-APPROVED OVER-THE-COUNTER CONTRACEPTIVE DRUGS, DEVICES, AND PRODUCTS AS PRESCRIBED OR AS OTHERWISE AUTHORIZED UNDER STATE OR FEDERAL LAW. THE FOLLOWING APPLIES TO THIS COVERAGE: S. 659 4 A. 585 (I) WHERE THE FDA HAS APPROVED ONE OR MORE THERAPEUTIC AND PHARMACEU- TICAL EQUIVALENT, AS DEFINED BY THE FDA, VERSIONS OF A CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT, A CONTRACT IS NOT REQUIRED TO INCLUDE ALL SUCH THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS IN ITS FORMULARY, SO LONG AS AT LEAST ONE IS INCLUDED AND COVERED WITHOUT COST-SHARING AND IN ACCORDANCE WITH THIS SUBSECTION; (II) IF THE COVERED THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS OF A DRUG, DEVICE, OR PRODUCT ARE NOT AVAILABLE OR ARE DEEMED MEDICALLY INADVISABLE A CONTRACT SHALL PROVIDE COVERAGE FOR AN ALTERNATE THERAPEU- TIC AND PHARMACEUTICAL EQUIVALENT VERSION OF THE CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT WITHOUT COST-SHARING; (III) THIS COVERAGE SHALL INCLUDE EMERGENCY CONTRACEPTION WITHOUT COST-SHARING WHEN PROVIDED PURSUANT TO AN ORDINARY PRESCRIPTION, NON-PA- TIENT SPECIFIC REGIMEN ORDER, OR ORDER UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-ONE OF THE EDUCATION LAW AND WHEN LAWFULLY PROVIDED OTHER THAN THROUGH A PRESCRIPTION OR ORDER; AND (IV) THIS COVERAGE MUST ALLOW FOR THE DISPENSING OF TWELVE MONTHS WORTH OF A CONTRACEPTIVE AT ONE TIME; (B) VOLUNTARY STERILIZATION PROCEDURES; (C) PATIENT EDUCATION AND COUNSELING ON CONTRACEPTION; AND (D) FOLLOW-UP SERVICES RELATED TO THE DRUGS, DEVICES, PRODUCTS, AND PROCEDURES COVERED UNDER THIS SUBSECTION, INCLUDING, BUT NOT LIMITED TO, MANAGEMENT OF SIDE EFFECTS, COUNSELING FOR CONTINUED ADHERENCE, AND DEVICE INSERTION AND REMOVAL. (2) A CONTRACT SUBJECT TO THIS SUBSECTION SHALL NOT IMPOSE A DEDUCT- IBLE, COINSURANCE, COPAYMENT, OR ANY OTHER COST-SHARING REQUIREMENT ON THE COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION. (3) EXCEPT AS OTHERWISE AUTHORIZED UNDER THIS SUBSECTION, A CONTRACT SHALL NOT IMPOSE ANY RESTRICTIONS OR DELAYS ON THE COVERAGE REQUIRED UNDER THIS SUBSECTION. (4) BENEFITS FOR AN ENROLLEE UNDER THIS SUBSECTION SHALL BE THE SAME FOR AN ENROLLEE'S COVERED SPOUSE OR DOMESTIC PARTNER AND COVERED NONSPOUSE DEPENDENTS. (5) Notwithstanding any other provision of this subsection, a reli- gious employer may request a contract without coverage for federal food and drug administration approved contraceptive methods that are contrary to the religious employer's religious tenets. If so requested, such contract shall be provided without coverage for contraceptive methods. This paragraph shall not be construed to deny an enrollee coverage of, and timely access to, contraceptive methods. (A) For purposes of this subsection, a "religious employer" is an entity for which each of the following is true: (i) The inculcation of religious values is the purpose of the entity. (ii) The entity primarily employs persons who share the religious tenets of the entity. (iii) The entity serves primarily persons who share the religious tenets of the entity. (iv) The entity is a nonprofit organization as described in Section 6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended. (B) Every religious employer that invokes the exemption provided under this paragraph shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons. [(2)](6) (A) Where a group contractholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with paragraph [one] FIVE of this subsection, each enrollee covered under the S. 659 5 A. 585 contract issued to that group contractholder shall have the right to directly purchase the rider required by this subsection from the insurer or health maintenance organization which issued the group contract at the prevailing small group community rate for such rider whether or not the employee is part of a small group. (B) Where a group contractholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with paragraph [one] FIVE of this subsection, the insurer or health maintenance organ- ization that provides such coverage shall provide written notice to enrollees upon enrollment with the insurer or health maintenance organ- ization of their right to directly purchase a rider for coverage for the cost of contraceptive drugs or devices. The notice shall also advise the enrollees of the additional premium for such coverage. [(3)](7) Nothing in this subsection shall be construed as authorizing a contract which provides coverage for prescription drugs to exclude coverage for prescription drugs prescribed for reasons other than contraceptive purposes. [(4) Such coverage may be subject to reasonable annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other drugs or devices covered under the policy.] § 4. Subparagraph (E) of paragraph 17 of subsection (i) of section 3216 of the insurance law is amended by adding a new clause (v) to read as follows: (V) ALL FDA-APPROVED CONTRACEPTIVE DRUGS, DEVICES, AND OTHER PRODUCTS, INCLUDING ALL OVER-THE-COUNTER CONTRACEPTIVE DRUGS, DEVICES, AND PRODUCTS AS PRESCRIBED OR AS OTHERWISE AUTHORIZED UNDER STATE OR FEDERAL LAW; VOLUNTARY STERILIZATION PROCEDURES; PATIENT EDUCATION AND COUN- SELING ON CONTRACEPTION; AND FOLLOW-UP SERVICES RELATED TO THE DRUGS, DEVICES, PRODUCTS, AND PROCEDURES COVERED UNDER THIS CLAUSE, INCLUDING, BUT NOT LIMITED TO, MANAGEMENT OF SIDE EFFECTS, COUNSELING FOR CONTINUED ADHERENCE, AND DEVICE INSERTION AND REMOVAL. EXCEPT AS OTHERWISE AUTHOR- IZED UNDER THIS CLAUSE, A CONTRACT SHALL NOT IMPOSE ANY RESTRICTIONS OR DELAYS ON THE COVERAGE REQUIRED UNDER THIS CLAUSE. HOWEVER, WHERE THE FDA HAS APPROVED ONE OR MORE THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT, AS DEFINED BY THE FDA, VERSIONS OF A CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT, A CONTRACT IS NOT REQUIRED TO INCLUDE ALL SUCH THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS IN ITS FORMULARY, SO LONG AS AT LEAST ONE IS INCLUDED AND COVERED WITHOUT COST-SHARING AND IN ACCORDANCE WITH THIS CLAUSE. IF THE COVERED THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS OF A DRUG, DEVICE, OR PRODUCT ARE NOT AVAILABLE OR ARE DEEMED MEDICALLY INADVISABLE A CONTRACT SHALL PROVIDE COVERAGE FOR AN ALTERNATE THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSION OF THE CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT WITHOUT COST-SHARING. THIS COVERAGE SHALL INCLUDE EMERGENCY CONTRACEPTION WITHOUT COST-SHARING WHEN PROVIDED PURSUANT TO AN ORDINARY PRESCRIPTION, NON-PATIENT SPECIFIC REGIMEN ORDER, OR ORDER UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-ONE OF THE EDUCATION LAW AND WHEN LAWFULLY PROVIDED OTHER THAN THROUGH A PRESCRIPTION OR ORDER; AND THIS COVERAGE MUST ALLOW FOR THE DISPENSING OF TWELVE MONTHS WORTH OF A CONTRACEPTIVE AT ONE TIME. § 5. Paragraph (d) of subdivision 3 of section 365-a of the social services law, as amended by chapter 909 of the laws of 1974 and as relettered by chapter 82 of the laws of 1995, is amended to read as follows: (d) family planning services and TWELVE MONTHS OF supplies for eligi- ble persons of childbearing age, including children under twenty-one S. 659 6 A. 585 years of age who can be considered sexually active, who desire such services and supplies, in accordance with the requirements of federal law and regulations and the regulations of the department. No person shall be compelled or coerced to accept such services or supplies. § 6. Subdivision 6 of section 6527 of the education law, as added by chapter 573 of the laws of 1999, paragraph (c) as amended by chapter 464 of the laws of 2015, paragraph (d) as added by chapter 429 of the laws of 2005, paragraph (e) as added by chapter 352 of the laws of 2014, paragraph (f) as added by section 6 of part V of chapter 57 of the laws of 2015 and paragraph (g) as added by chapter 502 of the laws of 2016, is amended to read as follows: 6. A licensed physician may prescribe and order a non-patient specific regimen [to a registered professional nurse], pursuant to regulations promulgated by the commissioner, and consistent with the public health law, [for] TO: (a) A REGISTERED PROFESSIONAL NURSE FOR: (I) administering immunizations[.]; [(b)] (II) the emergency treatment of anaphylaxis[.]; [(c)] (III) administering purified protein derivative (PPD) tests or other tests to detect or screen for tuberculosis infections[.]; [(d)] (IV) administering tests to determine the presence of the human immunodeficiency virus[.]; [(e)] (V) administering tests to determine the presence of the hepati- tis C virus[.]; [(f)] (VI) EMERGENCY CONTRACEPTION, TO BE ADMINISTERED TO OR DISPENSED TO BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-TWO OF THIS TITLE; (VII) the urgent or emergency treatment of opioid related overdose or suspected opioid related overdose[.]; OR [(g)] (VIII) screening of persons at increased risk of syphilis, gonorrhea and chlamydia. (B) A LICENSED PHARMACIST, FOR DISPENSING EMERGENCY CONTRACEPTION, TO BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-TWO OF THIS TITLE. § 7. Subdivision 3 of section 6807 of the education law, as added by chapter 573 of the laws of 1999, is amended and a new subdivision 4 is added to read as follows: 3. A pharmacist may dispense drugs and devices to a registered profes- sional nurse, and a registered professional nurse may possess and admin- ister, drugs and devices, pursuant to a non-patient specific regimen prescribed or ordered by a licensed physician, LICENSED MIDWIFE or certified nurse practitioner, pursuant to regulations promulgated by the commissioner and the public health law. 4. A PHARMACIST MAY DISPENSE A NON-PATIENT SPECIFIC REGIMEN OF EMER- GENCY CONTRACEPTION, TO BE SELF-ADMINISTERED BY THE PATIENT, PRESCRIBED OR ORDERED BY A LICENSED PHYSICIAN, CERTIFIED NURSE PRACTITIONER, OR LICENSED MIDWIFE, UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-TWO OF THIS ARTICLE. § 8. The education law is amended by adding a new section 6832 to read as follows: § 6832. EMERGENCY CONTRACEPTION; NON-PATIENT SPECIFIC PRESCRIPTION OR ORDER. 1. AS USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS, UNLESS THE CONTEXT REQUIRES OTHERWISE: (A) "EMERGENCY CONTRACEPTION" MEANS ONE OR MORE PRESCRIPTION OR NONPRESCRIPTION DRUGS, USED SEPARATELY OR IN COMBINATION, IN A DOSAGE AND MANNER FOR PREVENTING PREGNANCY WHEN USED AFTER INTERCOURSE, FOUND S. 659 7 A. 585 SAFE AND EFFECTIVE FOR THAT USE BY THE UNITED STATES FOOD AND DRUG ADMINISTRATION, AND DISPENSED OR ADMINISTERED FOR THAT PURPOSE. (B) "PRESCRIBER" MEANS A LICENSED PHYSICIAN, CERTIFIED NURSE PRACTI- TIONER OR LICENSED MIDWIFE. 2. THIS SECTION APPLIES TO THE ADMINISTERING OR DISPENSING OF EMERGEN- CY CONTRACEPTION BY A REGISTERED PROFESSIONAL NURSE OR THE DISPENSING OF EMERGENCY CONTRACEPTION BY A LICENSED PHARMACIST PURSUANT TO A PRESCRIPTION OR ORDER FOR A NON-PATIENT SPECIFIC REGIMEN MADE BY A PRES- CRIBER UNDER SECTION SIXTY-FIVE HUNDRED TWENTY-SEVEN, SIXTY-NINE HUNDRED NINE OR SIXTY-NINE HUNDRED FIFTY-ONE OF THIS TITLE. THIS SECTION DOES NOT APPLY TO ADMINISTERING OR DISPENSING EMERGENCY CONTRACEPTION WHEN LAWFULLY DONE WITHOUT SUCH A PRESCRIPTION OR ORDER. 3. THE ADMINISTERING OR DISPENSING OF EMERGENCY CONTRACEPTION BY A REGISTERED PROFESSIONAL NURSE OR THE DISPENSING OF EMERGENCY CONTRACEP- TION BY A LICENSED PHARMACIST SHALL BE DONE IN ACCORDANCE WITH PROFES- SIONAL STANDARDS OF PRACTICE AND IN ACCORDANCE WITH WRITTEN PROCEDURES AND PROTOCOLS AGREED TO BY THE REGISTERED PROFESSIONAL NURSE OR LICENSED PHARMACIST AND THE PRESCRIBER OR A HOSPITAL (LICENSED UNDER ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW) THAT PROVIDES GYNECOLOGICAL OR FAMILY PLANNING SERVICES. 4. WHEN EMERGENCY CONTRACEPTION IS ADMINISTERED OR DISPENSED, THE REGISTERED PROFESSIONAL NURSE OR LICENSED PHARMACIST SHALL PROVIDE TO THE PATIENT WRITTEN MATERIAL THAT INCLUDES: (I) THE CLINICAL CONSIDER- ATIONS AND RECOMMENDATIONS FOR USE OF THE DRUG; (II) THE APPROPRIATE METHOD FOR USING THE DRUG; (III) INFORMATION ON THE IMPORTANCE OF FOLLOW-UP HEALTH CARE; (IV) INFORMATION ON THE HEALTH RISKS AND OTHER DANGERS OF UNPROTECTED INTERCOURSE; AND (V) REFERRAL INFORMATION RELAT- ING TO HEALTH CARE AND SERVICES RELATING TO SEXUAL ABUSE AND DOMESTIC VIOLENCE. SUCH WRITTEN MATERIAL SHALL BE DEVELOPED OR APPROVED BY THE COMMISSIONER IN CONSULTATION WITH THE DEPARTMENT OF HEALTH AND THE AMER- ICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. § 9. Subdivision 4 of section 6909 of the education law, as added by chapter 573 of the laws of 1999, paragraph (a) as amended by chapter 221 of the laws of 2002, paragraph (c) as amended by chapter 464 of the laws of 2015, paragraph (d) as added by chapter 429 of the laws of 2005, paragraph (e) as added by chapter 352 of the laws of 2014, paragraph (f) as added by section 5 of part V of chapter 57 of the laws of 2015 and paragraph (g) as added by chapter 502 of the laws of 2016, is amended to read as follows: 4. A certified nurse practitioner may prescribe and order a non-pa- tient specific regimen [to a registered professional nurse], pursuant to regulations promulgated by the commissioner, consistent with subdivision three of section [six thousand nine] SIXTY-NINE hundred two of this article, and consistent with the public health law, for: (a) A REGISTERED PROFESSIONAL NURSE FOR: (I) administering immunizations[.]; [(b)] (II) the emergency treatment of anaphylaxis[.]; [(c)] (III) administering purified protein derivative (PPD) tests or other tests to detect or screen for tuberculosis infections[.]; [(d)] (IV) administering tests to determine the presence of the human immunodeficiency virus[.]; [(e)] (V) administering tests to determine the presence of the hepati- tis C virus[.]; [(f)] (VI) EMERGENCY CONTRACEPTION, TO BE ADMINISTERED TO OR DISPENSED TO BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-TWO OF THIS TITLE; S. 659 8 A. 585 (VII) the urgent or emergency treatment of opioid related overdose or suspected opioid related overdose[.]; OR [(g)] (VIII) screening of persons at increased risk for syphilis, gonorrhea and chlamydia. (B) A LICENSED PHARMACIST, FOR DISPENSING EMERGENCY CONTRACEPTION, TO BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-TWO OF THIS TITLE. § 10. Subdivision 5 of section 6909 of the education law, as added by chapter 573 of the laws of 1999, is amended to read as follows: 5. A registered professional nurse may execute a non-patient specific regimen prescribed or ordered by a licensed physician, LICENSED MIDWIFE or certified nurse practitioner, pursuant to regulations promulgated by the commissioner. § 11. Section 6951 of the education law is amended by adding a new subdivision 4 to read as follows: 4. A LICENSED MIDWIFE MAY PRESCRIBE AND ORDER A NON-PATIENT SPECIFIC REGIMEN PURSUANT TO REGULATIONS PROMULGATED BY THE COMMISSIONER, CONSISTENT WITH THIS SECTION AND THE PUBLIC HEALTH LAW, TO: (A) A REGISTERED PROFESSIONAL NURSE FOR EMERGENCY CONTRACEPTION, TO BE ADMINISTERED TO OR DISPENSED TO BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-TWO OF THIS TITLE; OR (B) A LICENSED PHARMACIST, FOR DISPENSING EMERGENCY CONTRACEPTION, TO BE SELF-ADMINISTERED BY THE PATIENT, UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-TWO OF THIS TITLE. § 12. Subdivision 1 of section 207 of the public health law is amended by adding a new paragraph (p) to read as follows: (P) EMERGENCY CONTRACEPTION, INCLUDING INFORMATION ABOUT ITS SAFETY, EFFICACY, APPROPRIATE USE AND AVAILABILITY. § 13. Severability clause. If any provision of this act or the appli- cation thereof is held invalid, such invalidity shall not affect other provisions or applications of this act which can be given effect without the invalid provision or application, and to this end the provisions of this act are declared to be severable. § 14. This act shall take effect January 1, 2020; provided that section six of this act shall take effect January 1, 2021; provided, however, that effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized and directed to be made and completed by the commissioner of education and the board of regents on or before such effective date.
co-Sponsors
(D, WF) Senate District
(D) 15th Senate District
(D) 36th Senate District
(D) Senate District
(D, WF) Senate District
(D, WF) 46th Senate District
(D) Senate District
(D) Senate District
(D) 14th Senate District
(D) Senate District
(D, WF) 12th Senate District
(D) 26th Senate District
(D, WF) 40th Senate District
(D, WF) 47th Senate District
(D, WF) 31st Senate District
(D) Senate District
(D, IP, WF) Senate District
(D) 27th Senate District
(D, WF) 63rd Senate District
(D, WF) 28th Senate District
(D) 16th Senate District
(D, WF) 4th Senate District
(D, WF) 48th Senate District
(D, WF) 37th Senate District
(D) Senate District
(D) 20th Senate District
(D, WF) 21st Senate District
(D) 19th Senate District
(D, WF) 13th Senate District
(D, WF) 33rd Senate District
(D) 10th Senate District
(D, IP) Senate District
(D) 32nd Senate District
(D, WF) 29th Senate District
(D) 42nd Senate District
(D) 11th Senate District
(D, WF) 35th Senate District
(D) 6th Senate District
2019-S659A (ACTIVE) - Details
2019-S659A (ACTIVE) - Sponsor Memo
BILL NUMBER: S659A SPONSOR: SALAZAR TITLE OF BILL: An act to amend the insurance law and the social services law, in relation to requiring health insurance policies to include coverage of all FDA-approved contraceptive drugs, devices, and products, as well as voluntary sterilization procedures, contraceptive education and counseling, and related follow up services and prohibiting a health insurance policy from imposing any cost-sharing requirements or other restrictions or delays with respect to this coverage PURPOSE OR GENERAL IDEA OF BILL: This legislation will help to reduce the number of unintended pregnan- cies, improve birth outcomes and improve the. health and welfare of New Yorkers by ensuring that individuals have timely access to contraception and the information they need in order to plan their families and their future. SUMMARY OF PROVISIONS:
Section 1. Provides that the act shall be known and may be cited as the . Comprehensive Contraception Coverage Act. Section 2. Amends paragraph 16 of subsection (1) of section 3221 of the insurance law to require commercial group health insurance policies to cover all FDA-approved contraceptive drugs, devices and products when prescribed by a health care provider. When the FDA has approved one or more therapeutic and pharmaceutical equivalent versions of a contraceptive drug, device or product, coverage is not required for equivalent versions of the contraceptive drug unless the equivalent is not available or is medically inadvisable. The Super- intendent of the Department of Financial Services shall promulgate regu- lations establishing a process, including guidelines for a form to be used by the insured or insured's health care provider to request cover- age of the contraceptive drug or product. Coverage shall: (i) include emergency contraception when prescribed, when available through Section 6831 of the Education law, or when lawfully provided over the counter; (ii) allow for dispensing of up to twelve months of contraception; (iii) include voluntary sterilization procedures for women and men; (iv) include patient education and coun- seling about contraception; and (v) include any follow-up care related to the covered contraceptives including management of side-effects, counseling and device insertion and removal. An insurer may not apply co-pays or deductibles when coverage for a contraceptive method is required. In addition, no restrictions or delays in coverage can be applied when coverage for a contraceptive method is required. Coverage for an enrollee's covered spouse, domestic partner and covered dependents shall be the same as for the enrollee. "Conscience protections" in existing law remain untouched. Specif- ically, the bill does not amend existing law which allows a religious employer to request an insurance policy without coverage for FDA-ap- proved contraceptive methods that are contrary to the religious employ- er's religious tenets. Sections 3 and 4. Makes similar changes outlined in Section 2 to subsection (cc) of Section 4303 of the insurance law relating to nonpro- fit medical indemnity, or health and hospital service corporations and subparagraph (E) of paragraph 17 of subsection (i) of section 3216 of the insurance law relating to individual health insurance policies. Section 5. Amends paragraph (d) of subdivision 3 of section 365-a of the social services law to expand the definition of "medical services" to include up to 12 months of contraceptive supplies for eligible persons. Section 6. Contains a severability clause. Section 7. Provides that this act shall take effect on January 1, 2020. JUSTIFICATION: Access to contraceptive services is essential to women's health and equality. New York has long recognized the central role that contracep- tion plays in women's health and lives and has led efforts to expand access to contraception. All New Yorkers, regardless of economic status, should have timely access to contraception and the information they need in order to protect their health, plan their families and their future. Time and time again, studies show that contraceptive access reduces rates of unintended pregnancy, plays a crucial role in improving public health outcomes, as well as improving the economic well-being of women and their families. * However, despite legal reform on the State and Federal level, lack of contraceptive insurance coverage and high co-pay- ments remain significant barriers to contraceptive access. The Comprehensive Contraception Coverage Act would amend state insurance and social service laws to require health insurance policies to include coverage of all Food and Drug Administration (FDA)-approved contracep- tive drugs, devices, and products, as well as voluntary sterilization procedures, contraceptive education and counseling, and related follow up services.** It would also prohibit a health insurance policy from imposing any cost-sharing requirements or other restriction or delays with respect to this coverage. In 2002, the New York State Legislature passed the Women's Health and Wellness Act, an important first step toward contraceptive equity that required insurance plans that cover prescriptions to include contracep- tion. Eight years later, the U.S. Congress passed the Affordable Care Act (ACA), which includes a contraceptive coverage guarantee as part of a broader requirement for health insurance plans to cover contraceptive services without cost-sharing for all women in the Health Insurance Marketplace. The contraceptive equity policy is one of the landmark achievements of the ACA, but a lack of clarity in the federal law has led to inconsist- ent implementation and enforcement. Insurers can take advantage of this confusion to limit coverage for the diverse array of contraceptive meth- ods available and, in some cases, can prevent individuals from accessing the method deemed most effective by their medical provider. Addi- tionally, many insurance companies do not typically cover male methods of contraception despite the critical role men play in the prevention of unintended pregnancy. Building on existing state and federal law to promote gender equity and women's health, this Act would ensure broad contraceptive coverage and timely access to all federal FDA-approved methods of contraception for individuals covered under health insurance plans in New York. PRIOR LEGISLATIVE HISTORY: 2017: A.1378 (Cahill) Passed Assembly; S.3668 (Bonacic) Referred to Insurance. 2016: A.8135-B (Cahill) Passed Assembly; S.6013-A (Bonacic) Referred to Insurance. FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None EFFECTIVE DATE: This act shall take effect on January 1, 2020. *Bonfield, Adam. "What Women Already Know: Documenting the Social and Economic Benefits of Family Planning." Guttmacher Institute. Winter 2013. http://www.guttmacher.org/pubs/gpr/16/1/gpr160108.html **For a full list of these devices, see the FDA Office of Women's Health's Birth Control Guide http://Wwm.fda.gov/downloads/ForConsumers/ByAudience/ ForWomen/FreePublications/UCM356451.pdf
2019-S659A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ S. 659--A A. 585--A 2019-2020 Regular Sessions S E N A T E - A S S E M B L Y (PREFILED) January 9, 2019 ___________ IN SENATE -- Introduced by Sens. SALAZAR, METZGER, ADDABBO, BAILEY, BENJAMIN, BIAGGI, BRESLIN, BROOKS, CARLUCCI, COMRIE, GAUGHRAN, GIANAR- IS, GOUNARDES, HARCKHAM, HOYLMAN, JACKSON, KAMINSKY, KAPLAN, KAVANAGH, KENNEDY, KRUEGER, LIU, MARTINEZ, MAY, MAYER, MONTGOMERY, MYRIE, PARK- ER, PERSAUD, RAMOS, RIVERA, SANDERS, SAVINO, SEPULVEDA, SERRANO, SKOUFIS, STAVISKY, STEWART-COUSINS, THOMAS -- 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 IN ASSEMBLY -- Introduced by M. of A. CAHILL, SEAWRIGHT, HEASTIE, L. ROSENTHAL, GLICK, JAFFEE, SIMOTAS, GOTTFRIED, BARRON, BLAKE, BARRETT, MAGNARELLI, BRONSON, LAVINE, CARROLL, GALEF, OTIS, SIMON, HYNDMAN, RAMOS, D'URSO, PEOPLES-STOKES, PICHARDO, ORTIZ, WOERNER, BURKE, CRUZ, FALL, FRONTUS, GRIFFIN, JACOBSON, McMAHON, RAYNOR, ROMEO, REYES, SAYEGH -- Multi-Sponsored by -- M. of A. BRAUNSTEIN, BUCHWALD, COOK, EPSTEIN, LIFTON, LUPARDO, MOSLEY, ROZIC, THIELE, TITUS -- 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 and the social services law, in relation to requiring health insurance policies to include coverage of all FDA-approved contraceptive drugs, devices, and products, as well as voluntary sterilization procedures, contraceptive education and counseling, and related follow up services and prohibiting a health insurance policy from imposing any cost-sharing requirements or other restrictions or delays with respect to this coverage THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06618-04-9
S. 659--A 2 A. 585--A Section 1. This act shall be known and may be cited as the "comprehen- sive contraception coverage act". § 2. Paragraph 16 of subsection (l) of section 3221 of the insurance law, as added by chapter 554 of the laws of 2002, is amended to read as follows: (16) (A) Every group or blanket policy [which provides coverage for prescription drugs shall include coverage for the cost of contraceptive drugs or devices approved by the federal food and drug administration or generic equivalents approved as substitutes by such food and drug admin- istration under the prescription of a health care provider legally authorized to prescribe under title eight of the education law. The coverage required by this section shall be included in policies and certificates only through the addition of a rider. (A)] THAT IS ISSUED, AMENDED, RENEWED, EFFECTIVE OR DELIVERED ON OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY, SHALL PROVIDE COVERAGE FOR ALL OF THE FOLLOWING SERVICES AND CONTRACEPTIVE METHODS: (1) ALL FDA-APPROVED CONTRACEPTIVE DRUGS, DEVICES, AND OTHER PRODUCTS. THIS INCLUDES ALL FDA-APPROVED OVER-THE-COUNTER CONTRACEPTIVE DRUGS, DEVICES, AND PRODUCTS AS PRESCRIBED OR AS OTHERWISE AUTHORIZED UNDER STATE OR FEDERAL LAW. THE FOLLOWING APPLIES TO THIS COVERAGE: (A) WHERE THE FDA HAS APPROVED ONE OR MORE THERAPEUTIC AND PHARMACEU- TICAL EQUIVALENT, AS DEFINED BY THE FDA, VERSIONS OF A CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT, A GROUP OR BLANKET POLICY IS NOT REQUIRED TO INCLUDE ALL SUCH THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS IN ITS FORMULARY, SO LONG AS AT LEAST ONE IS INCLUDED AND COVERED WITHOUT COST-SHARING AND IN ACCORDANCE WITH THIS PARAGRAPH; (B) IF THE COVERED THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS OF A DRUG, DEVICE, OR PRODUCT ARE NOT AVAILABLE OR ARE DEEMED MEDICALLY INADVISABLE A GROUP OR BLANKET POLICY SHALL PROVIDE COVERAGE FOR AN ALTERNATE THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSION OF THE CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT WITHOUT COST-SHARING. IF THE ATTENDING HEALTH CARE PROVIDER, IN HIS OR HER REASONABLE PROFESSIONAL JUDGMENT, DETERMINES THAT THE USE OF A NON-COVERED THERAPEUTIC OR PHAR- MACEUTICAL EQUIVALENT OF A DRUG, DEVICE, OR PRODUCT IS WARRANTED, THE HEALTH CARE PROVIDER'S DETERMINATION SHALL BE FINAL. THE SUPERINTENDENT SHALL PROMULGATE REGULATIONS ESTABLISHING A PROCESS, INCLUDING TIME- FRAMES, FOR AN INSURED, AN INSURED'S DESIGNEE OR AN INSURED'S HEALTH CARE PROVIDER TO REQUEST COVERAGE OF A NON-COVERED CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT. SUCH REGULATIONS SHALL INCLUDE A REQUIREMENT THAT INSURERS USE AN EXCEPTION FORM THAT SHALL MEET CRITERIA ESTABLISHED BY THE SUPERINTENDENT; (C) THIS COVERAGE SHALL INCLUDE EMERGENCY CONTRACEPTION WITHOUT COST- SHARING WHEN PROVIDED PURSUANT TO A PRESCRIPTION OR ORDER UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-ONE OF THE EDUCATION LAW OR WHEN LAWFULLY PROVIDED OVER THE COUNTER; AND (D) THIS COVERAGE MUST ALLOW FOR THE DISPENSING OF UP TO TWELVE MONTHS WORTH OF A CONTRACEPTIVE AT ONE TIME; (2) VOLUNTARY STERILIZATION PROCEDURES; (3) PATIENT EDUCATION AND COUNSELING ON CONTRACEPTION; AND (4) FOLLOW-UP SERVICES RELATED TO THE DRUGS, DEVICES, PRODUCTS, AND PROCEDURES COVERED UNDER THIS PARAGRAPH, INCLUDING, BUT NOT LIMITED TO, MANAGEMENT OF SIDE EFFECTS, COUNSELING FOR CONTINUED ADHERENCE, AND DEVICE INSERTION AND REMOVAL. (B) A GROUP OR BLANKET POLICY SUBJECT TO THIS PARAGRAPH SHALL NOT IMPOSE A DEDUCTIBLE, COINSURANCE, COPAYMENT, OR ANY OTHER COST-SHARING REQUIREMENT ON THE COVERAGE PROVIDED PURSUANT TO THIS PARAGRAPH. S. 659--A 3 A. 585--A (C) EXCEPT AS OTHERWISE AUTHORIZED UNDER THIS PARAGRAPH, A GROUP OR BLANKET POLICY SHALL NOT IMPOSE ANY RESTRICTIONS OR DELAYS ON THE COVER- AGE REQUIRED UNDER THIS PARAGRAPH. (D) BENEFITS FOR AN ENROLLEE UNDER THIS PARAGRAPH SHALL BE THE SAME FOR AN ENROLLEE'S COVERED SPOUSE OR DOMESTIC PARTNER AND COVERED NONSPOUSE DEPENDENTS. (E) Notwithstanding any other provision of this subsection, a reli- gious employer may request a contract without coverage for federal food and drug administration approved contraceptive methods that are contrary to the religious employer's religious tenets. If so requested, such contract shall be provided without coverage for contraceptive methods. This paragraph shall not be construed to deny an enrollee coverage of, and timely access to, contraceptive methods. (1) For purposes of this subsection, a "religious employer" is an entity for which each of the following is true: (a) The inculcation of religious values is the purpose of the entity. (b) The entity primarily employs persons who share the religious tenets of the entity. (c) The entity serves primarily persons who share the religious tenets of the entity. (d) The entity is a nonprofit organization as described in Section 6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended. (2) Every religious employer that invokes the exemption provided under this paragraph shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons. [(B) (i)] (F) (1) Where a group policyholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with subparagraph [(A)] (E) of this paragraph each certificateholder covered under the policy issued to that group policyholder shall have the right to directly purchase the rider required by this paragraph from the insurer which issued the group policy at the prevailing small group community rate for such rider whether or not the employee is part of a small group. [(ii)] (2) Where a group policyholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with subparagraph [(A)] (E) of this paragraph, the insurer that provides such coverage shall provide written notice to certificateholders upon enroll- ment with the insurer of their right to directly purchase a rider for coverage for the cost of contraceptive drugs or devices. The notice shall also advise the certificateholders of the additional premium for such coverage. [(C)] (G) Nothing in this paragraph shall be construed as authorizing a group or blanket policy which provides coverage for prescription drugs to exclude coverage for prescription drugs prescribed for reasons other than contraceptive purposes. [(D) Such coverage may be subject to reasonable annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other drugs or devices covered under the policy.] § 3. Subsection (cc) of section 4303 of the insurance law, as added by chapter 554 of the laws of 2002, is amended to read as follows: (cc) (1) Every contract [which provides coverage for prescription drugs shall include coverage for the cost of contraceptive drugs or devices approved by the federal food and drug administration or generic equivalents approved as substitutes by such food and drug administration S. 659--A 4 A. 585--A under the prescription of a health care provider legally authorized to prescribe under title eight of the education law. The coverage required by this section shall be included in contracts and certificates only through the addition of a rider. (1)] THAT IS ISSUED, AMENDED, RENEWED, EFFECTIVE OR DELIVERED ON OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY, SHALL PROVIDE COVERAGE FOR ALL OF THE FOLLOWING SERVICES AND CONTRACEPTIVE METHODS: (A) ALL FDA-APPROVED CONTRACEPTIVE DRUGS, DEVICES, AND OTHER PRODUCTS. THIS INCLUDES ALL FDA-APPROVED OVER-THE-COUNTER CONTRACEPTIVE DRUGS, DEVICES, AND PRODUCTS AS PRESCRIBED OR AS OTHERWISE AUTHORIZED UNDER STATE OR FEDERAL LAW. THE FOLLOWING APPLIES TO THIS COVERAGE: (I) WHERE THE FDA HAS APPROVED ONE OR MORE THERAPEUTIC AND PHARMACEU- TICAL EQUIVALENT, AS DEFINED BY THE FDA, VERSIONS OF A CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT, A CONTRACT IS NOT REQUIRED TO INCLUDE ALL SUCH THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS IN ITS FORMULARY, SO LONG AS AT LEAST ONE IS INCLUDED AND COVERED WITHOUT COST-SHARING AND IN ACCORDANCE WITH THIS SUBSECTION; (II) IF THE COVERED THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS OF A DRUG, DEVICE, OR PRODUCT ARE NOT AVAILABLE OR ARE DEEMED MEDICALLY INADVISABLE A CONTRACT SHALL PROVIDE COVERAGE FOR AN ALTERNATE THERAPEU- TIC AND PHARMACEUTICAL EQUIVALENT VERSION OF THE CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT WITHOUT COST-SHARING. IF THE ATTENDING HEALTH CARE PROVIDER, IN HIS OR HER REASONABLE PROFESSIONAL JUDGMENT, DETERMINES THAT THE USE OF A NON-COVERED THERAPEUTIC OR PHARMACEUTICAL EQUIVALENT OF A DRUG, DEVICE, OR PRODUCT IS WARRANTED, THE HEALTH CARE PROVIDER'S DETERMINATION SHALL BE FINAL. THE SUPERINTENDENT SHALL PROMULGATE REGU- LATIONS ESTABLISHING A PROCESS, INCLUDING TIMEFRAMES, FOR AN INSURED, AN INSURED'S DESIGNEE OR AN INSURED'S HEALTH CARE PROVIDER TO REQUEST COVERAGE OF A NON-COVERED CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT. SUCH REGULATIONS SHALL INCLUDE A REQUIREMENT THAT INSURERS USE AN EXCEPTION FORM THAT SHALL MEET CRITERIA ESTABLISHED BY THE SUPERINTENDENT; (III) THIS COVERAGE SHALL INCLUDE EMERGENCY CONTRACEPTION WITHOUT COST-SHARING WHEN PROVIDED PURSUANT TO A PRESCRIPTION OR ORDER UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-ONE OF THE EDUCATION LAW OR WHEN LAWFULLY PROVIDED OVER THE COUNTER; AND (IV) THIS COVERAGE MUST ALLOW FOR THE DISPENSING OF UP TO TWELVE MONTHS WORTH OF A CONTRACEPTIVE AT ONE TIME; (B) VOLUNTARY STERILIZATION PROCEDURES; (C) PATIENT EDUCATION AND COUNSELING ON CONTRACEPTION; AND (D) FOLLOW-UP SERVICES RELATED TO THE DRUGS, DEVICES, PRODUCTS, AND PROCEDURES COVERED UNDER THIS SUBSECTION, INCLUDING, BUT NOT LIMITED TO, MANAGEMENT OF SIDE EFFECTS, COUNSELING FOR CONTINUED ADHERENCE, AND DEVICE INSERTION AND REMOVAL. (2) A CONTRACT SUBJECT TO THIS SUBSECTION SHALL NOT IMPOSE A DEDUCT- IBLE, COINSURANCE, COPAYMENT, OR ANY OTHER COST-SHARING REQUIREMENT ON THE COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION. (3) EXCEPT AS OTHERWISE AUTHORIZED UNDER THIS SUBSECTION, A CONTRACT SHALL NOT IMPOSE ANY RESTRICTIONS OR DELAYS ON THE COVERAGE REQUIRED UNDER THIS SUBSECTION. (4) BENEFITS FOR AN ENROLLEE UNDER THIS SUBSECTION SHALL BE THE SAME FOR AN ENROLLEE'S COVERED SPOUSE OR DOMESTIC PARTNER AND COVERED NONSPOUSE DEPENDENTS. (5) Notwithstanding any other provision of this subsection, a reli- gious employer may request a contract without coverage for federal food and drug administration approved contraceptive methods that are contrary to the religious employer's religious tenets. If so requested, such S. 659--A 5 A. 585--A contract shall be provided without coverage for contraceptive methods. This paragraph shall not be construed to deny an enrollee coverage of, and timely access to, contraceptive methods. (A) For purposes of this subsection, a "religious employer" is an entity for which each of the following is true: (i) The inculcation of religious values is the purpose of the entity. (ii) The entity primarily employs persons who share the religious tenets of the entity. (iii) The entity serves primarily persons who share the religious tenets of the entity. (iv) The entity is a nonprofit organization as described in Section 6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended. (B) Every religious employer that invokes the exemption provided under this paragraph shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons. [(2)](6) (A) Where a group contractholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with paragraph [one] FIVE of this subsection, each enrollee covered under the contract issued to that group contractholder shall have the right to directly purchase the rider required by this subsection from the insurer or health maintenance organization which issued the group contract at the prevailing small group community rate for such rider whether or not the employee is part of a small group. (B) Where a group contractholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with paragraph [one] FIVE of this subsection, the insurer or health maintenance organ- ization that provides such coverage shall provide written notice to enrollees upon enrollment with the insurer or health maintenance organ- ization of their right to directly purchase a rider for coverage for the cost of contraceptive drugs or devices. The notice shall also advise the enrollees of the additional premium for such coverage. [(3)](7) Nothing in this subsection shall be construed as authorizing a contract which provides coverage for prescription drugs to exclude coverage for prescription drugs prescribed for reasons other than contraceptive purposes. [(4) Such coverage may be subject to reasonable annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other drugs or devices covered under the policy.] § 4. Subparagraph (E) of paragraph 17 of subsection (i) of section 3216 of the insurance law is amended by adding a new clause (v) to read as follows: (V) ALL FDA-APPROVED CONTRACEPTIVE DRUGS, DEVICES, AND OTHER PRODUCTS, INCLUDING ALL OVER-THE-COUNTER CONTRACEPTIVE DRUGS, DEVICES, AND PRODUCTS AS PRESCRIBED OR AS OTHERWISE AUTHORIZED UNDER STATE OR FEDERAL LAW; VOLUNTARY STERILIZATION PROCEDURES; PATIENT EDUCATION AND COUN- SELING ON CONTRACEPTION; AND FOLLOW-UP SERVICES RELATED TO THE DRUGS, DEVICES, PRODUCTS, AND PROCEDURES COVERED UNDER THIS CLAUSE, INCLUDING, BUT NOT LIMITED TO, MANAGEMENT OF SIDE EFFECTS, COUNSELING FOR CONTINUED ADHERENCE, AND DEVICE INSERTION AND REMOVAL. EXCEPT AS OTHERWISE AUTHOR- IZED UNDER THIS CLAUSE, A CONTRACT SHALL NOT IMPOSE ANY RESTRICTIONS OR DELAYS ON THE COVERAGE REQUIRED UNDER THIS CLAUSE. HOWEVER, WHERE THE FDA HAS APPROVED ONE OR MORE THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT, AS DEFINED BY THE FDA, VERSIONS OF A CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT, A CONTRACT IS NOT REQUIRED TO INCLUDE ALL SUCH THERAPEUTIC AND S. 659--A 6 A. 585--A PHARMACEUTICAL EQUIVALENT VERSIONS IN ITS FORMULARY, SO LONG AS AT LEAST ONE IS INCLUDED AND COVERED WITHOUT COST-SHARING AND IN ACCORDANCE WITH THIS CLAUSE. IF THE COVERED THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSIONS OF A DRUG, DEVICE, OR PRODUCT ARE NOT AVAILABLE OR ARE DEEMED MEDICALLY INADVISABLE A CONTRACT SHALL PROVIDE COVERAGE FOR AN ALTERNATE THERAPEUTIC AND PHARMACEUTICAL EQUIVALENT VERSION OF THE CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT WITHOUT COST-SHARING. (A) THIS COVERAGE SHALL INCLUDE EMERGENCY CONTRACEPTION WITHOUT COST SHARING WHEN PROVIDED PURSUANT TO A PRESCRIPTION, OR ORDER UNDER SECTION SIXTY-EIGHT HUNDRED THIRTY-ONE OF THE EDUCATION LAW OR WHEN LAWFULLY PROVIDED OVER-THE-COUN- TER. (B) IF THE ATTENDING HEALTH CARE PROVIDER, IN HIS OR HER REASON- ABLE PROFESSIONAL JUDGMENT, DETERMINES THAT THE USE OF A NON-COVERED THERAPEUTIC OR PHARMACEUTICAL EQUIVALENT OF A DRUG, DEVICE, OR PRODUCT IS WARRANTED, THE HEALTH CARE PROVIDER'S DETERMINATION SHALL BE FINAL. THE SUPERINTENDENT SHALL PROMULGATE REGULATIONS ESTABLISHING A PROCESS, INCLUDING TIMEFRAMES, FOR AN INSURED, AN INSURED'S DESIGNEE OR AN INSURED'S HEALTH CARE PROVIDER TO REQUEST COVERAGE OF A NON-COVERED CONTRACEPTIVE DRUG, DEVICE, OR PRODUCT. SUCH REGULATIONS SHALL INCLUDE A REQUIREMENT THAT INSURERS USE AN EXCEPTION FORM THAT SHALL MEET CRITERIA ESTABLISHED BY THE SUPERINTENDENT. (C) THIS COVERAGE MUST ALLOW FOR THE DISPENSING OF UP TO TWELVE MONTHS WORTH OF A CONTRACEPTIVE AT ONE TIME. § 5. Paragraph (d) of subdivision 3 of section 365-a of the social services law, as amended by chapter 909 of the laws of 1974 and as relettered by chapter 82 of the laws of 1995, is amended to read as follows: (d) family planning services and TWELVE MONTHS OF supplies for eligi- ble persons of childbearing age, including children under twenty-one years of age who can be considered sexually active, who desire such services and supplies, in accordance with the requirements of federal law and regulations and the regulations of the department. COVERAGE OF PRESCRIPTION CONTRACEPTIVES SHALL INCLUDE A TWELVE-MONTH SUPPLY THAT MAY BE DISPENSED AT ONE TIME OR UP TO TWELVE TIMES WITHIN ONE YEAR FROM THE DATE OF THE PRESCRIPTION. No person shall be compelled or coerced to accept such services or supplies. § 6. This act shall take effect January 1, 2020.
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