NY State Senate Bill S8255

Archive: Last Bill Status - Passed Senate

Introduced
In Committee
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- Passed Assembly
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Actions

view actions (6)

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jul 22, 2020	referred to insurance delivered to assembly passed senate ordered to third reading cal.990
Jul 20, 2020	reported and committed to rules
Apr 29, 2020	referred to insurance

Votes

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Jul 22, 2020 - floor Vote

S8255

floor

Aye

Nay

Absent

Excused

Abstained

Jul 22, 2020 - Rules committee Vote

S8255

committee

Aye

Nay

Aye with Reservations

Absent

Excused

Abstained

Jul 20, 2020 - Insurance committee Vote

S8255

committee

Aye

Nay

Aye with Reservations

Absent

Excused

Abstained

Co-Sponsors

view additional co-sponsors

S8255 (ACTIVE) - Details

See Assembly Version of this Bill:: A10821
Current Committee:: Assembly Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2021-2022: S1413, A2383
2023-2024: S504, A4141

S8255 (ACTIVE) - Summary

Lowers the cost sharing cap for insulin from one hundred dollars to thirty dollars.

S8255 (ACTIVE) - Sponsor Memo

 
BILL NUMBER: S8255

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the insurance law, in relation to capping cost sharing
for insulin

 
PURPOSE:

To reduce the cap on cost sharing for insulin from the current $100 per
insulin per month to $30 per insulin per month.

 
SUMMARY OF PROVISIONS:

Sections 1 through 3 of the bill amend various sections of insurance law
which were amended as part DDD of Chapter 56 of the laws of 2020, the
adopted budget, to change the $100 limit on cost sharing for insulin to
a $30 limit on cost sharing for insulin.

Section 4 of the bill provides for an effective date.

 
JUSTIFICATION:

2.1 million New Yorkers have diabetes and 30% of type two diabetics are
insulin dependent. There are 20,000 hospitalizations in NY each year
with a principal diagnosis of diabetes related complications including
diabetic ketoacidosis.

Type 1 and some Type 2 diabetics depend upon insulin for their very
survival. In 2016 the average person with type 1 diabetes incurred annu-
al insulin costs of $ 5,705.00. While some pay less, many others pay
many times this amount. When patients can't afford insulins, which can
cost thousands of dollars even for those who are insured, they resort to
rationing the little medication they can afford. In fact, one study
found one in four people with type 1 diabetics admitted to not taking
their insulin as prescribed, or rationing, due to the cost. Compli-
cations from rationing insulin are extreme leading to amputations,
Diabetic KETOACIDOSIS, also referred to as DKA, and even death.

As part of the adopted 2020-21 state budget a cap on cost sharing was
adopted (Part DDD, Chapter 56 of 2020). However, unlike the legislation
which passed the Senate in 2019 (S 6497A) capping the cost of all insu-
lins a person needs per month at $100, the budget language capped cost
sharing per prescription. Given many diabetics rely on two or three
different types of insulin they may still have cost sharing of $300 per
month. This legislation changes the $100 cap to a $30 cap on each insu-
lin per month more in line with our original legislation.

A $30 cap on insulin is also in line with the caps other states are
pursuing and adopting to address access to affordable insulin. For exam-
ple, Utah recently adopted a $30 copay and states such as New Mexico,
Virginia, California, and Connecticut are all in various stages of pass-
ing and adopting copays that range from $25 to $50 per insulin. While
New York's new law capping insulin is an important first step, we must
truly make access to insulin affordable and reduce the copay to $30 per
insulin per month.

 
PRIOR LEGISLATIVE HISTORY:
New bill

 
FISCAL IMPLICATIONS:

No cost to the state

 
EFFECTIVE DATE:
Immediately and shall apply to any policy or contract written or renewed
on or after January 1, 2021.

S8255 (ACTIVE) - Bill Text download pdf


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

                                  8255

                            I N  S E N A T E

                             April 29, 2020
                               ___________

Introduced  by Sens. RIVERA, HOYLMAN, KAMINSKY, KRUEGER, SALAZAR -- 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 capping cost sharing
  for insulin

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

  Section  1.  Subparagraph  (B)  of paragraph 15-a of subsection (i) of
section 3216 of the insurance law, as amended by section 1 of  part  DDD
of chapter 56 of the laws of 2020, is amended to read as follows:
  (B) Such coverage may be subject to annual deductibles and coinsurance
as may be deemed appropriate by the superintendent and as are consistent
with  those  established  for  other  benefits  within  a  given policy;
provided however, the total amount that a covered person is required  to
pay out of pocket for covered prescription insulin drugs shall be capped
at  an  amount not to exceed [one hundred] THIRTY dollars per thirty-day
supply, regardless of the amount or type of insulin needed to fill  such
covered  person's  prescription  and regardless of the insured's deduct-
ible, copayment, coinsurance or any other cost sharing requirement.
  § 2. Subparagraph (B) of paragraph 7 of subsection (k) of section 3221
of the insurance law, as amended by section 2 of part DDD of chapter  56
of the laws of 2020, is amended to read as follows:
  (B) Such coverage may be subject to annual deductibles and coinsurance
as may be deemed appropriate by the superintendent and as are consistent
with  those  established  for  other  benefits  within  a  given policy;
provided however, the total amount that a covered person is required  to
pay out of pocket for covered prescription insulin drugs shall be capped
at  an  amount not to exceed [one hundred] THIRTY dollars per thirty-day
supply, regardless of the amount or type of insulin needed to fill  such
covered  person's  prescription  and regardless of the insured's deduct-
ible, copayment, coinsurance or any other cost sharing requirement.
  § 3. Paragraph 2 of subsection (u) of section 4303  of  the  insurance
law,  as  amended  by section 3 of part DDD of chapter 56 of the laws of
2020, is amended to read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                      [ ] is old law to be omitted.
                                                           LBD16178-01-0

S. 8255                             2

  (2) Such coverage may be subject to annual deductibles and coinsurance
as may be deemed appropriate by the superintendent and as are consistent
with those  established  for  other  benefits  within  a  given  policy;
provided  however, the total amount that a covered person is required to
pay out of pocket for covered prescription insulin drugs shall be capped
at  an  amount not to exceed [one hundred] THIRTY dollars per thirty-day
supply, regardless of the amount or type of insulin needed to fill  such
covered  person's  prescription  and regardless of the insured's deduct-
ible, copayment, coinsurance or any other cost sharing requirement.
  § 4. This act shall take effect immediately and  shall  apply  to  any
policy or contract issued or renewed on or after January 1, 2021.

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The New York State Senate

senate Bill S8255

Sponsored By

Archive: Last Bill Status - Passed Senate

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Votes

Jul 22, 2020 - floor Vote

Floor Vote: Jul 22, 2020

Jul 22, 2020 - Rules committee Vote

Rules Committee Vote: Jul 22, 2020

Jul 20, 2020 - Insurance committee Vote

Insurance Committee Vote: Jul 20, 2020

Co-Sponsors

S8255 (ACTIVE) - Details

S8255 (ACTIVE) - Summary

S8255 (ACTIVE) - Sponsor Memo

S8255 (ACTIVE) - Bill Text download pdf

Comments

senate Bill S8255

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Archive: Last Bill Status - Passed Senate

Your Voice

Actions

Votes

Jul 22, 2020 - floor Vote

Floor Vote: Jul 22, 2020

Jul 22, 2020 - Rules committee Vote

Rules Committee Vote: Jul 22, 2020

Jul 20, 2020 - Insurance committee Vote

Insurance Committee Vote: Jul 20, 2020

Co-Sponsors

S8255 (ACTIVE) - Details

S8255 (ACTIVE) - Summary

S8255 (ACTIVE) - Sponsor Memo

S8255 (ACTIVE) - Bill Text download pdf

Comments