NY State Senate Bill S504

Current Bill Status - Passed Senate

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

Your Voice

Please enter your contact information

First Name *

Last Name *

Email Address *

A valid email address is required.

Home address search or enter your address manually *

Home address is used to determine the senate district in which you reside. Your support or opposition to this bill is then shared immediately with the senator who represents you.

Optional services from the NY State Senate:

Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Include a custom message for your Senator? (Optional)

Enter a message to your senator. Many New Yorkers use this to share the reasoning behind their support or opposition to the bill. Others might share a personal anecdote about how the bill would affect them or people they care about.

Leave this field blank

Actions

view actions (6)

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 17, 2023	referred to insurance delivered to assembly passed senate ordered to third reading cal.73 reported and committed to rules
Jan 04, 2023	referred to insurance

Votes

view votes

Jan 17, 2023 - floor Vote

S504

floor

Aye

Nay

Absent

Excused

Abstained

Jan 17, 2023 - Insurance committee Vote

S504

committee

Aye

Nay

Aye with Reservations

Absent

Excused

Abstained

Jan 17, 2023 - Rules committee Vote

S504

committee

Aye

Nay

Aye with Reservations

Absent

Excused

Abstained

Co-Sponsors

S504 (ACTIVE) - Details

See Assembly Version of this Bill:: A4141
Current Committee:: Assembly Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S8255, A10821
2021-2022: S1413, A2383

S504 (ACTIVE) - Summary

Lowers the cost sharing cap for insulin from one hundred dollars per thirty-day supply to thirty dollars per calendar month.

S504 (ACTIVE) - Sponsor Memo

 
BILL NUMBER: S504

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the insurance law, in relation to capping cost sharing
for insulin

 
PURPOSE:

To reduce the cap on cost sharing for insulin from the current $100 per
insulin prescription per month to $30 per month, in aggregate, for all
insulin drugs.

 
SUMMARY OF PROVISIONS:

Sections 1 through 3 of the bill amend various sections of insurance law
which were amended as part DDD of Chapter 56 of the laws of 2020, the
adopted budget, to change the $100 limit on cost sharing for each insu-
lin prescription to a $30 limit per month on cost sharing for all insu-
lin prescriptions.

Section 4 of the bill provides for an effective date.

 
JUSTIFICATION:

An estimated 1.6 million New Yorkers have diabetes and many type 2
diabetics are insulin dependent. Each year there are thousands of hospi-
talizations in NY with a principal diagnosis of diabetes-related compli-
cations including diabetic ketoacidosis.

Type 1 and some Type 2 diabetics depend upon insulin for their very
survival. In 2016, the average person with type 1 diabetes incurred
annual insulin costs of $5,705.00. While some pay less, many others pay
many times this amount. When patients can't afford insulin, which can
cost thousands of dollars even for those who are insured, they resort to
rationing the little medication they can afford. In fact, one study
found that one in four people with type 1 diabetes admitted to not
taking their insulin as prescribed or rationing due to the cost. Compli-
cations from rationing insulin are extreme, leading to amputations,
Diabetic Ketoacidosis, also referred to as DKA, and even death.

As part of the adopted SFY 2020-21 state budget, a cap on cost sharing
was adopted (Part DDD, Chapter 56 of 2020). However, the budget language
capped cost sharing per prescription. Given many diabetics rely on two
or three different types of insulin, they may still have cost sharing of
$300 per month. This legislation changes the $100 cap per prescription
to an aggregate $30 cap on all insulin prescriptions for a given calen-
dar month.

A $30 cap on insulin is also in line with the caps other states are
pursuing and adopting to address access to affordable insulin. For exam-
ple, Utah recently adopted a $30 copay and states such as New Mexico,
Virginia, California, and Connecticut are all in various stages of pass-
ing and adopting copays that range from $25 to $50 per insulin. Addi-
tionally, President Biden signed the Inflation Reduction Act, which
includes a $35 per month out-of-pocket insulin cap for Medicare benefi-
ciaries, beginning January 2023. While New York's new law capping insu-
lin prescription cost sharing at $100 is an important first step, we
must truly make access to insulin affordable and reduce the copay to an
aggregate total of $30 a month.

 
PRIOR LEGISLATIVE HISTORY:

2022 - S1413 (Rivera) - Passed Senate

2021 - S1413 (Rivera) - Passed Senate

2020 - S8255 (Rivera) - Passed Senate

 
FISCAL IMPLICATIONS:

No cost to the state.

 
EFFECTIVE DATE:
Immediately and shall apply to any policy or contract written or renewed
on or after January 1, 2023.

S504 (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    504
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                              January 4, 2023
                                ___________
 
 Introduced  by  Sen.  RIVERA -- 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 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

 S. 504                              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.

Comments

Open Legislation is a forum for New York State legislation. All comments are subject to review and community moderation is encouraged.

Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity, hate or toxic speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Attempts to intimidate and silence contributors or deliberately deceive the public, including excessive or extraneous posting/posts, or coordinated activity, are prohibited and may result in the temporary or permanent banning of the user. Comment moderation is generally performed Monday through Friday. By contributing or voting you agree to the Terms of Participation and verify you are over 13.

The New York State Senate

senate Bill S504

Sponsored By

Current Bill Status - Passed Senate

Your Voice

Actions

Votes

Jan 17, 2023 - floor Vote

Floor Vote: Jan 17, 2023

Jan 17, 2023 - Insurance committee Vote

Insurance Committee Vote: Jan 17, 2023

Jan 17, 2023 - Rules committee Vote

Rules Committee Vote: Jan 17, 2023

Co-Sponsors

S504 (ACTIVE) - Details

S504 (ACTIVE) - Summary

S504 (ACTIVE) - Sponsor Memo

S504 (ACTIVE) - Bill Text download pdf

Comments

senate Bill S504

Share this bill

Sponsored By

Gustavo Rivera

Current Bill Status - Passed Senate

Your Voice

Actions

Votes

Jan 17, 2023 - floor Vote

Floor Vote: Jan 17, 2023

Jan 17, 2023 - Insurance committee Vote

Insurance Committee Vote: Jan 17, 2023

Jan 17, 2023 - Rules committee Vote

Rules Committee Vote: Jan 17, 2023

Co-Sponsors

Joseph P. Addabbo Jr

John C. Liu

Monica R. Martinez

S504 (ACTIVE) - Details

S504 (ACTIVE) - Summary

S504 (ACTIVE) - Sponsor Memo

S504 (ACTIVE) - Bill Text download pdf

Comments