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Assembly Bill A6059C

2023-2024 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 Assembly Committee

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Bill Amendments

co-Sponsors

2023-A6059 - Details

Current Committee:
Assembly Insurance
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: A7281
2021-2022: A1732

2023-A6059 - Summary

Prohibits health insurers, health care plans and HMOs from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection, provided that the health insurer, health care plan or HMO can confirm that the insured prescribed pre-exposure prophylaxis has tested negative for HIV within the previous one hundred and twenty days.

2023-A6059 - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6059
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              March 31, 2023
                                ___________
 
 Introduced  by  M.  of  A.  SIMONE,  BRONSON, COLTON, COOK, CRUZ, GLICK,
   GUNTHER, HEVESI, McDONOUGH, REYES, SAYEGH, SEAWRIGHT,  SIMON,  TAYLOR,
   THIELE,  WOERNER,  MAGNARELLI,  D. ROSENTHAL, JACOBSON, HUNTER -- read
   once and referred to the Committee on Insurance
 
 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 13 to read as follows:
   13. 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 (p) to read as follows:
   (P) 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 (p) to read as follows:
   (P)   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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

co-Sponsors

2023-A6059A - Details

Current Committee:
Assembly Insurance
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: A7281
2021-2022: A1732

2023-A6059A - Summary

Prohibits health insurers, health care plans and HMOs from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection, provided that the health insurer, health care plan or HMO can confirm that the insured prescribed pre-exposure prophylaxis has tested negative for HIV within the previous one hundred and twenty days.

2023-A6059A - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6059--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              March 31, 2023
                                ___________
 
 Introduced  by  M.  of  A.  SIMONE,  BRONSON, COLTON, COOK, CRUZ, GLICK,
   GUNTHER, HEVESI, McDONOUGH, REYES, SAYEGH, SEAWRIGHT,  SIMON,  TAYLOR,
   THIELE, WOERNER, MAGNARELLI, JACOBSON, HUNTER, GONZALEZ-ROJAS, EPSTEIN
   -- read once and referred to the Committee on Insurance -- recommitted
   to the Committee on Insurance in accordance with Assembly Rule 3, sec.
   2  -- committee discharged, bill amended, ordered reprinted as amended
   and recommitted to said committee
 
 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 14 to read as follows:
   14. 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 (p) to read as follows:
   (P) 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 (p) to read as follows:
   (P)   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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07908-03-4

co-Sponsors

2023-A6059B - Details

Current Committee:
Assembly Insurance
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: A7281
2021-2022: A1732

2023-A6059B - Summary

Prohibits health insurers, health care plans and HMOs from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection, provided that the health insurer, health care plan or HMO can confirm that the insured prescribed pre-exposure prophylaxis has tested negative for HIV within the previous one hundred and twenty days.

2023-A6059B - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6059--B
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              March 31, 2023
                                ___________
 
 Introduced  by  M.  of  A.  SIMONE,  BRONSON, COLTON, COOK, CRUZ, GLICK,
   GUNTHER, HEVESI, McDONOUGH, REYES, SAYEGH, SEAWRIGHT,  SIMON,  TAYLOR,
   THIELE,   WOERNER,   MAGNARELLI,   JACOBSON,  HUNTER,  GONZALEZ-ROJAS,
   EPSTEIN, DAVILA, BURDICK, RAGA, BORES -- read once and referred to the
   Committee on Insurance -- recommitted to the Committee on Insurance in
   accordance with Assembly Rule 3, sec. 2 -- committee discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee -- again reported from said  committee  with  amendments,  ordered
   reprinted as amended and recommitted to said committee
 
 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 14 to read as follows:
   14. 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, PROVIDED THAT THE HEALTH CARE  PLAN
 CAN  CONFIRM THAT THE SUBSCRIBER PRESCRIBED PRE-EXPOSURE PROPHYLAXIS HAS
 TESTED NEGATIVE FOR HIV WITHIN THE PREVIOUS  ONE  HUNDRED  TWENTY  DAYS.
 NOTHING IN THIS SUBDIVISION SHALL PROHIBIT A HEALTH CARE PLAN FROM DENY-
 ING  A  CLAIM  FOR SUCH SERVICES IF THE SERVICES ARE SUBSEQUENTLY DETER-
 MINED NOT MEDICALLY NECESSARY.
   § 2. Section 3217-b of the insurance law is amended by  adding  a  new
 subsection (p) to read as follows:
   (P)  AN  INSURER  WHICH  PROVIDES PRESCRIPTION DRUG COVERAGE SHALL NOT
 REQUIRE A PRIOR AUTHORIZATION DETERMINATION FOR PRE-EXPOSURE PROPHYLAXIS
 USED TO PREVENT HIV INFECTION, PROVIDED THAT  THE  INSURER  CAN  CONFIRM
 THAT THE INSURED PRESCRIBED PRE-EXPOSURE PROPHYLAXIS HAS TESTED NEGATIVE
 FOR  HIV  WITHIN  THE  PREVIOUS ONE HUNDRED TWENTY DAYS. NOTHING IN THIS
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07908-04-4

co-Sponsors

2023-A6059C (ACTIVE) - Details

Current Committee:
Assembly Insurance
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: A7281
2021-2022: A1732

2023-A6059C (ACTIVE) - Summary

Prohibits health insurers, health care plans and HMOs from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection, provided that the health insurer, health care plan or HMO can confirm that the insured prescribed pre-exposure prophylaxis has tested negative for HIV within the previous one hundred and twenty days.

2023-A6059C (ACTIVE) - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6059--C
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              March 31, 2023
                                ___________
 
 Introduced  by  M.  of  A.  SIMONE,  BRONSON, COLTON, COOK, CRUZ, GLICK,
   GUNTHER, HEVESI, McDONOUGH, REYES, SAYEGH, SEAWRIGHT,  SIMON,  TAYLOR,
   THIELE,   WOERNER,   MAGNARELLI,   JACOBSON,  HUNTER,  GONZALEZ-ROJAS,
   EPSTEIN, DAVILA, BURDICK, RAGA, BORES -- read once and referred to the
   Committee on Insurance -- recommitted to the Committee on Insurance in
   accordance with Assembly Rule 3, sec. 2 -- committee discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee -- again reported from said  committee  with  amendments,  ordered
   reprinted  as  amended  and  recommitted  to  said  committee -- again
   reported from said committee with  amendments,  ordered  reprinted  as
   amended and recommitted to said committee
 
 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 14 to read as follows:
   14. 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, PROVIDED THAT THE HEALTH CARE  PLAN
 CAN  CONFIRM THAT THE SUBSCRIBER PRESCRIBED PRE-EXPOSURE PROPHYLAXIS HAS
 TESTED NEGATIVE FOR HIV WITHIN THE PREVIOUS  ONE  HUNDRED  TWENTY  DAYS.
 NOTHING  IN  THIS  SUBDIVISION  SHALL  PROHIBIT  A HEALTH CARE PLAN FROM
 REQUIRING A SUBSCRIBER UNDERGO A STEP THERAPY PROTOCOL SUBJECT TO  ARTI-
 CLE  FORTY-NINE  OF  THIS  CHAPTER  BEFORE  PROVIDING  COVERAGE  OF  THE
 PRESCRIBED DRUG OR DENYING A CLAIM FOR SUCH SERVICES IF THE SERVICES ARE
 SUBSEQUENTLY DETERMINED NOT TO BE MEDICALLY NECESSARY.
   § 2. Section 3217-b of the insurance law is amended by  adding  a  new
 subsection (p) to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07908-06-4
 A. 6059--C                          2

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