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Senate Bill S5535

2019-2020 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

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

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2019-S5535 (ACTIVE) - Details

See Assembly Version of this Bill:
A294
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
2017-2018: S7905, A4899

2019-S5535 (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.

2019-S5535 (ACTIVE) - Sponsor Memo

2019-S5535 (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5535
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                                May 6, 2019
                                ___________
 
 Introduced  by Sen. HARCKHAM -- 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 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 36 to read as follows:
   (36)(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.

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