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Senate Bill S836

2021-2022 Legislative Session

Relates to prohibiting health insurers from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection

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Archive: Last Bill Status - In Senate Committee Health Committee

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2021-S836 (ACTIVE) - Details

See Assembly Version of this Bill:
A1732
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Amd §4406-c, Pub Health L; amd §§3217-b & 4325, Ins L
Versions Introduced in Other Legislative Sessions:
2019-2020: S6779, A7281
2023-2024: S3227, A6059

2021-S836 (ACTIVE) - Summary

Prohibits health insurers, health care plans and HMOs from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection.

2021-S836 (ACTIVE) - Sponsor Memo

2021-S836 (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    836
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sens. HOYLMAN, JACKSON, RIVERA -- read twice and ordered
   printed, and when printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law and the insurance law, in relation
   to prohibiting health insurers from requiring prior authorization  for
   pre-exposure prophylaxis used to prevent HIV infection
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4406-c of the  public  health  law  is  amended  by
 adding a new subdivision 11 to read as follows:
   11. A HEALTH CARE PLAN WHICH PROVIDES PRESCRIPTION DRUG COVERAGE SHALL
 NOT REQUIRE A PRIOR AUTHORIZATION DETERMINATION FOR PRE-EXPOSURE PROPHY-
 LAXIS  USED  TO PREVENT HIV INFECTION. NOTHING IN THIS SUBDIVISION SHALL
 PROHIBIT A HEALTH CARE PLAN FROM DENYING A CLAIM FOR  SUCH  SERVICES  IF
 THE SERVICES ARE SUBSEQUENTLY DETERMINED NOT MEDICALLY NECESSARY.
   §  2.  Section  3217-b of the insurance law is amended by adding a new
 subsection (m) to read as follows:
   (M) AN INSURER WHICH PROVIDES PRESCRIPTION  DRUG  COVERAGE  SHALL  NOT
 REQUIRE A PRIOR AUTHORIZATION DETERMINATION FOR PRE-EXPOSURE PROPHYLAXIS
 USED TO PREVENT HIV INFECTION. NOTHING IN THIS SUBSECTION SHALL PROHIBIT
 AN  INSURER  FROM  DENYING A CLAIM FOR SUCH SERVICES IF THE SERVICES ARE
 SUBSEQUENTLY DETERMINED NOT MEDICALLY NECESSARY.
   § 3. Section 4325 of the insurance law is  amended  by  adding  a  new
 subsection (n) to read as follows:
   (N)   A  CORPORATION  ORGANIZED  UNDER  THIS  ARTICLE  WHICH  PROVIDES
 PRESCRIPTION DRUG COVERAGE  SHALL  NOT  REQUIRE  A  PRIOR  AUTHORIZATION
 DETERMINATION   FOR   PRE-EXPOSURE   PROPHYLAXIS  USED  TO  PREVENT  HIV
 INFECTION. NOTHING IN  THIS  SUBSECTION  SHALL  PROHIBIT  A  CORPORATION
 ORGANIZED  UNDER  THIS ARTICLE FROM DENYING A CLAIM FOR SUCH SERVICES IF
 THE SERVICES ARE SUBSEQUENTLY DETERMINED NOT MEDICALLY NECESSARY.
   § 4. This act shall take effect on the one hundred eightieth day after
 it shall have become a law.

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