BILL NUMBER: S8174

SPONSOR: JACKSON
 
TITLE OF BILL:

An act to amend the insurance law and the education law, in relation to
providing for coverage of a one hundred twenty-day supply of a
prescription without prior authorization during a state disaster emer-
gency

 
PURPOSE:

The purpose of this legislation is to ensure that individuals have
enough of a supply of their medications for when a state disaster emer-
gency is declared and that they are not denied the ability to get such
medications because insurance companies require prior authorization.

 
SUMMARY OF PROVISIONS:

Section 1 adds a new subsection (c) to Section 3242 of the Insurance Law
that requires every insurance policy to include a provision that allows
              

individuals to obtain a 120-day supply of any current prescription drug
without prior authorization from insurance companies when a state disas-
ter emergency, as defined by Section 20 of the Executive Law, is
declared. Any insurance company that violates this provision will be
subject to a civil penalty of $100 per dose of the prescription when
coverage is denied for lack of prior authorization.

Section 2 adds a new subsection (c) to Section 4329 of the Insurance Law
that requires every insurance policy to include a provision that allows
individuals to obtain a 120-day supply of any current prescription drug
without prior authorization from insurance companies when a state disas-
ter emergency, as defined by Section 20 of the Executive Law, is
declared. Any insurance company that violates this provision will be
subject to a civil penalty of $100 per dose of the prescription when
coverage is denied for lack of prior authorization.

Section 3 adds a new subdivision 16 to Section 6810 of the Education Law
that requires pharmacies to dispense a 120-day supply of a prescription
to patients, or persons authorized to make the requests on behalf of
patients, at no cost to patients or persons authorized to make such
requests if insurance coverage of the prescription is denied due to a
lack of prior authorization during a state disaster emergency, as
defined by Section 20 of the Executive Law. Pharmacies shall have a
cause of action against the insurance company for the cost of the
prescription dispensed pursuant to this subdivision.

 
JUSTIFICATION:

COVID-19, the novel coronavirus, has forever changed the world as we
know it. At a time when governments across the global are ordering their
populations to quarantine themselves at home, people are bulk buying
household supplies and food in anticipation of staying in their homes
for weeks and months. Unfortunately for many New Yorkers, no such oppor-
tunity exists for their medications. New Yorkers need to be able to have
several months of medications in stock when they need to stay in their
homes for weeks and months at a time with no opportunity to leave their
homes. New Yorkers need their medications, whether they are normal main-
tenance medications or life saving ones.  No New Yorker should be denied
their ability to stock up on medications during a state disaster emer-
gency because their insurance company requires prior authorization.
People's lives are more important than insurance industry profits or
their internal protocols. When our medical capacities are being
stretched to the breaking point, and when we are asking retired doctors
and nurses and medical and nursing students to aid in medical emergen-
cies, requiring patients and doctors to ascertain prior authorization in
order for patients to receive their medications is ludicrous.

 
LEGISLATIVE HISTORY:

New bill.

 
STATE AND LOCAL FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This  act  shall take effect immediately and shall apply to all policies
and contracts issued, renewed, modified, altered or amended on or  after
such date.