Senate Bill S8798

2021-2022 Legislative Session

Relates to reporting information regarding step therapy override requests and determinations; repealer

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2021-S8798 (ACTIVE) - Details

See Assembly Version of this Bill:
A9206
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§4903 & 4408, rpld §4408 sub 2 ¶(j), Pub Health L; rpld §3217-a sub§ (b) ¶10, §4324 sub§ (b) ¶10, amd §§3217-a, 4903 & 4324, Ins L
Versions Introduced in 2023-2024 Legislative Session:
S2800, A1384

2021-S8798 (ACTIVE) - Summary

Requires disclosure, in such form as the superintendent shall require, of non-confidential information regarding step therapy override requests and determinations on a website that is readily accessible to the public.

2021-S8798 (ACTIVE) - Sponsor Memo

2021-S8798 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8798
 
                             I N  S E N A T E
 
                              April 18, 2022
                                ___________
 
 Introduced  by  Sen. BRESLIN -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law and the public health law, in relation
   to enhanced disclosure of step therapy override requests and  determi-
   nations; and to repeal certain provisions of such laws relating there-
   to

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4903 of the insurance law is amended by adding  two
 new subsections (j) and (k) to read as follows:
   (J) EACH HEALTH CARE PLAN AND UTILIZATION REVIEW AGENT SHALL ANNUALLY,
 IN  SUCH FORM AS THE SUPERINTENDENT SHALL REQUIRE, REPORT INFORMATION TO
 THE DEPARTMENT REGARDING STEP THERAPY  OVERRIDE  REQUESTS  AND  DETERMI-
 NATIONS. SUCH REPORTS SHALL, AMONG OTHER THINGS, SEPARATELY IDENTIFY THE
 FOLLOWING  INFORMATION, ORGANIZED BY INDIVIDUAL DRUG NAME AND DRUG CATE-
 GORY AND CLASS:
   (1)  THE  NUMBER  OF  STEP  THERAPY  OVERRIDE  DETERMINATION  REQUESTS
 RECEIVED;
   (2)  THE  TYPE  OF HEALTH CARE PROVIDERS OR THE MEDICAL SPECIALTIES OF
 THE HEALTH CARE PROVIDERS SUBMITTING REQUESTS;
   (3) THE NUMBER OF STEP THERAPY OVERRIDE  DETERMINATION  REQUESTS  THAT
 WERE INITIALLY DENIED AND THE REASONS FOR SUCH DENIALS;
   (4)  THE  NUMBER  OF STEP THERAPY OVERRIDE DETERMINATION REQUESTS THAT
 WERE INITIALLY APPROVED; AND
   (5) THE NUMBER OF STEP THERAPY OVERRIDE  DETERMINATION  REQUESTS  THAT
 WERE REVERSED ON INTERNAL APPEAL.
   (K) EACH HEALTH CARE PLAN AND UTILIZATION REVIEW AGENT SHALL DISCLOSE,
 IN  SUCH  FORM  AS  THE  SUPERINTENDENT  SHALL REQUIRE, NON-CONFIDENTIAL
 INFORMATION REGARDING STEP THERAPY OVERRIDE REQUESTS AND  DETERMINATIONS
 ON A WEBSITE OR WEB-BASED TOOL THAT IS READILY ACCESSIBLE TO THE PUBLIC.
 SUCH  DISCLOSURE  SHALL,  AMONG  OTHER  THINGS,  SEPARATELY IDENTIFY THE
 FOLLOWING INFORMATION, ORGANIZED BY INDIVIDUAL DRUG NAME AND DRUG  CATE-
 GORY AND CLASS:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD14461-01-2
              

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