The New York State Senate

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4141
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 10, 2023
                                ___________
 
 Introduced  by M. of A. FORREST -- read once and referred to the Commit-
   tee 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] AN INSURED is
 required  to  pay  out  of pocket for covered prescription insulin drugs
 shall be capped IN AGGREGATE, INCLUDING SITUATIONS WHERE THE INSURED  IS
 PRESCRIBED  MORE  THAN ONE INSULIN DRUG, at an amount not to exceed [one
 hundred] THIRTY dollars per [thirty-day supply] CALENDAR MONTH,  regard-
 less  of  the  amount  or  type  of insulin needed to fill such [covered
 person's] INSURED'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] AN INSURED is
 required to pay out of pocket for  covered  prescription  insulin  drugs
 shall  be capped IN AGGREGATE, INCLUDING SITUATIONS WHERE THE INSURED IS
 PRESCRIBED MORE THAN ONE INSULIN DRUG, at an amount not to  exceed  [one
 hundred]  THIRTY dollars per [thirty-day supply] CALENDAR MONTH, regard-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02649-02-3

 A. 4141                             2
 
 less of the amount or type of  insulin  needed  to  fill  such  [covered
 person's] INSURED'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:
   (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]  AN  ENROLLEE
 is  required to pay out of pocket for covered prescription insulin drugs
 shall be capped IN AGGREGATE, INCLUDING SITUATIONS WHERE THE ENROLLEE IS
 PRESCRIBED MORE THAN ONE INSULIN DRUG, at an amount not to  exceed  [one
 hundred]  THIRTY dollars per [thirty-day supply] CALENDAR MONTH, regard-
 less of the amount or type of  insulin  needed  to  fill  such  [covered
 person's]  ENROLLEE'S  prescription  and  regardless  of the [insured's]
 ENROLLEE'S deductible, copayment, coinsurance or any other cost  sharing
 requirement.
   §  4.  This  act  shall take effect immediately and shall apply to any
 policy or contract issued, renewed, modified, altered, or amended on  or
 after January 1, 2024.