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


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

view actions (2)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 08, 2020 referred to insurance
May 06, 2019 referred to insurance

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

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.

S5535 (ACTIVE) - Sponsor Memo

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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