NY State Senate Bill 2023-S8367

Current 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

Please enter your contact information

First Name

Last Name

Email Address

A valid email address is required.

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.

Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 07, 2024	print number 8367a
Mar 07, 2024	amend (t) and recommit to insurance
Jan 23, 2024	referred to insurance

Bill Amendments

Original

A (Active)

2023-S8367 - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L

2023-S8367 - Summary

Requires insurance companies, medical expense indemnity corporations, hospital service corporations, health service corporations and medical assistance programs to provide coverage for prescribed antiviral therapeutics approved by the food and drug administration for the treatment of COVID-19 at no cost to the patient.

2023-S8367 - Sponsor Memo

                                 
BILL NUMBER: S8367

SPONSOR: HOYLMAN-SIGAL
 
TITLE OF BILL:

An act to amend the insurance law and the social services law, in
relation to capping cost sharing for oral antiviral COVID-19 therapeu-
tics

 
SUMMARY OF PROVISIONS:

Section one adds a new paragraph to section 3216 of the insurance law
requiring individual insurance policies that provide coverage for
prescription drugs to cover oral antiviral therapeutics approved by the
food and drug administration for the treatment of COVID-19 at no cost to
the insured.

Section two adds a new paragraph to section 3221 of the insurance law
requiring group insurance policies that provide coverage for
prescription drugs to cover oral antiviral therapeutics approved by the
food and drug administration for the treatment of COVID-19 at no cost to
the insured.

Section three adds a new paragraph to section 4303 of the insurance law
requiring hospital service corporations or health service corporations
insurance policies that provide coverage for prescription drugs to cover
oral antiviral therapeutics approved by the food and drug administration
for the treatment of COVID-19 at no cost to the insured.

Section four adds a new paragraph to section 365-a of the social
services law Medicaid in New York State to provide coverage for
prescription drugs to cover oral antiviral therapeutics approved by the
food and drug administration for the treatment of COVID-19 at no cost to
the insured.

 
JUSTIFICATION:

Oral antiviral therapeutics can save the life of someone with COVID-19,
having been shown to reduce the rate of serious illness and death from
COVID by as much as 89 percent. Yet a 2023 study of by the National
Institutes of Health found that only 9.7 percent of 1.3 million high-
risk patients eligible for an oral antiviral prescription had actually
received it (Hansen et al). These numbers can vary by demographic group,
with a December 2023 study by researchers at the City University of New
York finding that eligible Black and low-income patients take these
medications at even lower rates (Shen et al).

Many oral antiviral therapeutics have shifted into the commercial market
for distribution, at times costing more than $1,300 for a single
prescription. Though federal and private cost assistance programs prom-
ise to offset or eliminate the cost of a COVID-19 antiviral prescription
through 2024, many insured New Yorkers could still face out-of-pocket
costs that pose a barrier to uptake.

To ensure cost does not prohibit any New Yorker from taking life-saving
medication to treat COVID-l9, this bill would require private insurers
and Medicaid to cover the full cost of COVID-l9 oral antiviral therapeu-
tics for eligible New Yorkers with a prescription.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None to the state.

2023-S8367 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8367
 
                             I N  S E N A T E
 
                             January 23, 2024
                                ___________
 
 Introduced  by Sen. HOYLMAN-SIGAL -- 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  social  services  law,  in
   relation to capping cost sharing for oral antiviral COVID-19 therapeu-
   tics
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Subsection (i) of section 3216 of  the  insurance  law  is
 amended by adding a new paragraph 39 to read as follows:
   (39)  (A)  EVERY  POLICY THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS
 SHALL PROVIDE COVERAGE FOR ORAL ANTIVIRAL THERAPEUTICS APPROVED  BY  THE
 FOOD AND DRUG ADMINISTRATION FOR THE TREATMENT OF COVID-19.
   (B)  THE  COVERAGE REQUIRED PURSUANT TO SUBPARAGRAPH (A) OF THIS PARA-
 GRAPH SHALL NOT BE SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23) (A) EVERY POLICY THAT PROVIDES COVERAGE  FOR  PRESCRIPTION  DRUGS
 SHALL  PROVIDE  COVERAGE FOR ORAL ANTIVIRAL THERAPEUTICS APPROVED BY THE
 FOOD AND DRUG ADMINISTRATION FOR THE TREATMENT OF COVID-19.
   (B) THE COVERAGE REQUIRED PURSUANT TO SUBPARAGRAPH (A) OF  THIS  PARA-
 GRAPH SHALL NOT BE SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (vv) to read as follows:
   (VV) (1) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE  INDEMNITY  CORPO-
 RATION,  A  HOSPITAL SERVICE CORPORATION OR A HEALTH SERVICE CORPORATION
 FOR DELIVERY IN THIS STATE THAT PROVIDES MEDICAL, MAJOR MEDICAL OR SIMI-
 LAR COMPREHENSIVE-TYPE COVERAGE AND PROVIDES COVERAGE  FOR  PRESCRIPTION
 DRUGS  SHALL PROVIDE COVERAGE FOR PRESCRIBED ORAL ANTIVIRAL THERAPEUTICS
 APPROVED BY THE FOOD  AND  DRUG  ADMINISTRATION  FOR  THE  TREATMENT  OF
 COVID-19.
   (2)   SUCH  COVERAGE  REQUIRED  PURSUANT  TO  PARAGRAPH  ONE  OF  THIS
 SUBSECTION SHALL NOT BE SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE.
   § 4. Subdivision 2 of section 365-a of  the  social  services  law  is
 amended by adding a new paragraph (nn) to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD14144-01-4
 S. 8367                             2
 
   (NN)  PRESCRIBED  ORAL ANTIVIRAL THERAPEUTICS APPROVED BY THE FOOD AND
 DRUG ADMINISTRATION FOR THE TREATMENT  OF  COVID-19.  COVERAGE  REQUIRED
 PURSUANT TO THIS PARAGRAPH SHALL BE PROVIDED AT NO COST TO THE INSURED.
   §  5.  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, 2025.

2023-S8367A (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L

2023-S8367A (ACTIVE) - Summary

2023-S8367A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8367A

SPONSOR: HOYLMAN-SIGAL
 
TITLE OF BILL:

An act to amend the insurance law and the social services law, in
relation to capping cost sharing for antiviral COVID-19 therapeutics

 
SUMMARY OF PROVISIONS:

Section one adds a new paragraph to section 3216 of the insurance law
requiring individual insurance policies that provide coverage for
prescription drugs to cover antiviral therapeutics approved or author-
ized for temporary use by the food and drug administration for the
treatment of COVID19 at no cost to the insured.

Section two adds a new paragraph to section 3221 of the insurance law
requiring group insurance policies that provide coverage for
prescription drugs to cover antiviral therapeutics approved or author-
ized for temporary use by the food and drug administration for the
treatment of COVID-19 at no cost to the insured.

Section three adds a new paragraph to section 4303 of the insurance law

requiring hospital service corporations or health service corporations
insurance policies that provide coverage for prescription drugs to cover
antiviral therapeutics approved or authorized for temporary use by the
food and drug administration for the treatment of COVID-19 at no cost to
the insured.

Section four adds a new paragraph to section 365-a of the social
services law Medicaid in New York State to provide coverage for
prescription drugs to cover antiviral therapeutics approved or author-
ized for temporary use by the food and drug administration for the
treatment of COVID-19 at no cost to the insured.

 
JUSTIFICATION:

Oral antiviral therapeutics can save the life of someone with COVID-19,
having been shown to reduce the rate of serious illness and death from
COVID by as much as 89 percent. Yet a 2023 study by the National Insti-
tutes of Health found that only 9.7 percent of 1.3 million high-risk
patients eligible for an oral antiviral prescription had actually
received it (Hansen et al). These numbers can vary by demographic group,
with a December 2023 study by researchers at the City University of New
York finding that eligible Black and low-income patients take these
medications at even lower rates (Shen et al).

Many oral antiviral therapeutics have shifted into the commercial market
for distribution, at times costing more than $1,300 for a single
prescription. Though federal and private cost assistance programs prom-
ise to offset or eliminate the cost of a COVID-19 antiviral prescription
through 2024, many insured New Yorkers could still face out-of-pocket
costs that pose a barrier to uptake.

To ensure cost does not prohibit any New Yorker from taking life-saving
medication to treat COVID-19, this bill would require private insurers
and Medicaid to cover the full cost of COVID-19 antiviral therapeutics
for eligible New Yorkers with a prescription.  This bill would allow
insurers to require the insured to utilize existing manufacturer or
government programs offering free therapeutics, if the insured is eligi-
ble and able to obtain the therapeutic via such program.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

To be determined.

2023-S8367A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8367--A
 
                             I N  S E N A T E
 
                             January 23, 2024
                                ___________
 
 Introduced  by Sen. HOYLMAN-SIGAL -- read twice and ordered printed, and
   when printed to be committed to the Committee on Insurance --  commit-
   tee  discharged, bill amended, ordered reprinted as amended and recom-
   mitted to said committee
 
 AN ACT to amend the insurance  law  and  the  social  services  law,  in
   relation to capping cost sharing for antiviral COVID-19 therapeutics

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Subsection (i) of section 3216 of  the  insurance  law  is
 amended by adding a new paragraph 39 to read as follows:
   (39) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL OR
 MEDICAL  CARE OR PRESCRIPTION DRUGS SHALL PROVIDE COVERAGE FOR ANTIVIRAL
 THERAPEUTICS APPROVED OR GRANTED EMERGENCY USE AUTHORIZATION BY THE FOOD
 AND DRUG ADMINISTRATION FOR THE TREATMENT OF COVID-19 WHEN PRESCRIBED OR
 FURNISHED BY A LICENSED HEALTH CARE PROVIDER ACTING WITHIN  THEIR  SCOPE
 OF PRACTICE AND THE STANDARD OF CARE.
   (B)  THE  COVERAGE REQUIRED PURSUANT TO SUBPARAGRAPH (A) OF THIS PARA-
 GRAPH SHALL  NOT  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  OR  COINSURANCE,
 PROVIDED,  HOWEVER,  THAT  AN  INSURED  WHO  IS ELIGIBLE FOR AND ABLE TO
 OBTAIN FREE PRESCRIBED ANTIVIRAL THERAPEUTICS UNDER  A  MANUFACTURER  OR
 GOVERNMENT  PROGRAM  MAY  BE  REQUIRED  TO USE SUCH PROGRAM BEFORE USING
 COVERAGE REQUIRED PURSUANT TO THIS PARAGRAPH.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL OR
 MEDICAL CARE OR PRESCRIPTION DRUGS SHALL PROVIDE COVERAGE FOR  ANTIVIRAL
 THERAPEUTICS APPROVED OR GRANTED EMERGENCY USE AUTHORIZATION BY THE FOOD
 AND DRUG ADMINISTRATION FOR THE TREATMENT OF COVID-19 WHEN PRESCRIBED OR
 FURNISHED  BY  A LICENSED HEALTH CARE PROVIDER ACTING WITHIN THEIR SCOPE
 OF PRACTICE AND THE STANDARD OF CARE.
   (B) THE COVERAGE REQUIRED PURSUANT TO SUBPARAGRAPH (A) OF  THIS  PARA-
 GRAPH  SHALL  NOT  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  OR COINSURANCE,
 PROVIDED, HOWEVER, THAT AN INSURED WHO  IS  ELIGIBLE  FOR  AND  ABLE  TO
 OBTAIN  FREE  PRESCRIBED  ANTIVIRAL THERAPEUTICS UNDER A MANUFACTURER OR
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD14144-02-4
 S. 8367--A                          2
 
 GOVERNMENT PROGRAM MAY BE REQUIRED TO  USE  SUCH  PROGRAM  BEFORE  USING
 COVERAGE REQUIRED PURSUANT TO THIS PARAGRAPH.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (vv) to read as follows:
   (VV) (1) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE  INDEMNITY  CORPO-
 RATION,  A  HOSPITAL SERVICE CORPORATION OR A HEALTH SERVICE CORPORATION
 FOR DELIVERY IN THIS STATE THAT  PROVIDES  MEDICAL,  HOSPITAL,  SURGICAL
 CARE,  OR  MAJOR  MEDICAL  OR  SIMILAR  COMPREHENSIVE-TYPE  COVERAGE AND
 PROVIDES COVERAGE FOR PRESCRIPTION  DRUGS  SHALL  PROVIDE  COVERAGE  FOR
 ANTIVIRAL  THERAPEUTICS  APPROVED OR GRANTED EMERGENCY USE AUTHORIZATION
 BY THE FOOD AND DRUG ADMINISTRATION FOR THE TREATMENT OF  COVID-19  WHEN
 PRESCRIBED OR FURNISHED BY A LICENSED HEALTH CARE PROVIDER ACTING WITHIN
 THEIR SCOPE OF PRACTICE AND THE STANDARD OF CARE.
   (2)   SUCH  COVERAGE  REQUIRED  PURSUANT  TO  PARAGRAPH  ONE  OF  THIS
 SUBSECTION SHALL NOT BE SUBJECT TO ANNUAL  DEDUCTIBLES  OR  COINSURANCE,
 PROVIDED,  HOWEVER,  THAT  AN  INSURED  WHO  IS ELIGIBLE FOR AND ABLE TO
 OBTAIN FREE PRESCRIBED ANTIVIRAL THERAPEUTICS UNDER  A  MANUFACTURER  OR
 GOVERNMENT  PROGRAM  MAY  BE  REQUIRED  TO USE SUCH PROGRAM BEFORE USING
 COVERAGE REQUIRED PURSUANT TO THIS PARAGRAPH.
   § 4. Subdivision 2 of section 365-a of  the  social  services  law  is
 amended by adding a new paragraph (nn) to read as follows:
   (NN)  (I)  ANTIVIRAL  THERAPEUTICS  APPROVED  OR GRANTED EMERGENCY USE
 AUTHORIZATION BY THE FOOD AND DRUG ADMINISTRATION FOR THE  TREATMENT  OF
 COVID-19 WHEN PRESCRIBED OR FURNISHED BY A LICENSED HEALTH CARE PROVIDER
 ACTING WITHIN THEIR SCOPE OF PRACTICE AND THE STANDARD OF CARE.
   (II) COVERAGE REQUIRED PURSUANT TO THIS PARAGRAPH SHALL BE PROVIDED AT
 NO COST TO THE INSURED, PROVIDED, HOWEVER, THAT AN INSURED WHO IS ELIGI-
 BLE  FOR AND ABLE TO OBTAIN FREE PRESCRIBED ANTIVIRAL THERAPEUTICS UNDER
 A MANUFACTURER OR GOVERNMENT PROGRAM MAY BE REQUIRED TO USE SUCH PROGRAM
 BEFORE USING COVERAGE REQUIRED PURSUANT TO THIS PARAGRAPH.
   § 5. 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, 2025.

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.

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

Senate Bill S8367

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

Bill Amendments

2023-S8367 - Details

2023-S8367 - Summary

2023-S8367 - Sponsor Memo

2023-S8367 - Bill Text download pdf

2023-S8367A (ACTIVE) - Details

2023-S8367A (ACTIVE) - Summary

2023-S8367A (ACTIVE) - Sponsor Memo

2023-S8367A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S8367

Share this bill

Sponsored By

Brad Hoylman-Sigal

Current Bill Status - In Senate Committee Insurance Committee

Bill Amendments

2023-S8367 - Details

2023-S8367 - Summary

2023-S8367 - Sponsor Memo

2023-S8367 - Bill Text download pdf

2023-S8367A (ACTIVE) - Details

2023-S8367A (ACTIVE) - Summary

2023-S8367A (ACTIVE) - Sponsor Memo

2023-S8367A (ACTIVE) - Bill Text download pdf

Comments