Assembly Bill A10748

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   10748
 
                           I N  A S S E M B L Y
 
                              March 27, 2026
                                ___________
 
 Introduced  by  M.  of  A. SANTABARBARA -- read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance  law  and  the  social  services  law,  in
   relation  to  coverage  for  treatments  to  slow  the  progression of
   Alzheimer's disease and related dementias
 
   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 11-d to read as follows:
   (11-D) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE FOR ALL MEDICALLY
 NECESSARY DIAGNOSTIC TESTING AND UNITED STATES FOOD AND DRUG ADMINISTRA-
 TION-APPROVED TREATMENTS OR MEDICATIONS PRESCRIBED TO SLOW THE  PROGRES-
 SION  OF  ALZHEIMER'S DISEASE AND OTHER DEMENTIA, IN ACCORDANCE WITH THE
 UNITED STATES FOOD AND DRUG ADMINISTRATION LABEL,  AS  DETERMINED  BY  A
 PHYSICIAN LICENSED TO PRACTICE MEDICINE IN ALL ITS BRANCHES. COVERAGE OF
 UNITED  STATES FOOD AND DRUG ADMINISTRATION-APPROVED TREATMENTS OR MEDI-
 CATIONS PRESCRIBED TO SLOW THE PROGRESSION  OF  ALZHEIMER'S  DISEASE  OR
 ANOTHER RELATED DEMENTIA PURSUANT TO THIS PARAGRAPH SHALL NOT BE SUBJECT
 TO STEP THERAPY.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 11-d to read as follows:
   (11-D) EVERY INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSUING A
 GROUP  OR BLANKET POLICY FOR DELIVERY IN THIS STATE THAT PROVIDES COVER-
 AGE FOR MEDICAL, MAJOR MEDICAL, OR SIMILAR  COMPREHENSIVE-TYPE  COVERAGE
 SHALL  PROVIDE  COVERAGE  FOR ALL MEDICALLY NECESSARY DIAGNOSTIC TESTING
 AND UNITED STATES FOOD AND DRUG  ADMINISTRATION-APPROVED  TREATMENTS  OR
 MEDICATIONS  PRESCRIBED  TO  SLOW THE PROGRESSION OF ALZHEIMER'S DISEASE
 AND OTHER DEMENTIA, IN ACCORDANCE WITH THE UNITED STATES FOOD  AND  DRUG
 ADMINISTRATION  LABEL, AS DETERMINED BY A PHYSICIAN LICENSED TO PRACTICE
 MEDICINE IN ALL ITS BRANCHES. COVERAGE OF UNITED STATES  FOOD  AND  DRUG
 ADMINISTRATION-APPROVED TREATMENTS OR MEDICATIONS PRESCRIBED TO SLOW THE
 PROGRESSION  OF ALZHEIMER'S DISEASE OR ANOTHER RELATED DEMENTIA PURSUANT
 TO THIS PARAGRAPH SHALL NOT BE SUBJECT TO STEP THERAPY.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD15298-01-6
 A. 10748                            2
 
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (p-2) to read as follows:
   (P-2)  A  MEDICAL  EXPENSE  INDEMNITY  CORPORATION, A HOSPITAL SERVICE
 CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES  COVERAGE  FOR
 MEDICAL,  MAJOR  MEDICAL,  OR  SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL
 PROVIDE COVERAGE FOR ALL  MEDICALLY  NECESSARY  DIAGNOSTIC  TESTING  AND
 UNITED  STATES FOOD AND DRUG ADMINISTRATION-APPROVED TREATMENTS OR MEDI-
 CATIONS PRESCRIBED TO SLOW THE PROGRESSION OF  ALZHEIMER'S  DISEASE  AND
 OTHER  DEMENTIA,  IN  ACCORDANCE  WITH  THE  UNITED STATES FOOD AND DRUG
 ADMINISTRATION LABEL, AS DETERMINED BY A PHYSICIAN LICENSED TO  PRACTICE
 MEDICINE  IN  ALL  ITS BRANCHES. COVERAGE OF UNITED STATES FOOD AND DRUG
 ADMINISTRATION-APPROVED TREATMENTS OR MEDICATIONS PRESCRIBED TO SLOW THE
 PROGRESSION OF ALZHEIMER'S DISEASE OR ANOTHER RELATED DEMENTIA  PURSUANT
 TO THIS SUBSECTION SHALL NOT BE SUBJECT TO STEP THERAPY.
   §  4.  Subdivision  2  of  section 365-a of the social services law is
 amended by adding a new paragraph (mm-1) to read as follows:
   (MM-1) ALL MEDICALLY NECESSARY DIAGNOSTIC TESTING  AND  UNITED  STATES
 FOOD   AND   DRUG   ADMINISTRATION-APPROVED  TREATMENTS  OR  MEDICATIONS
 PRESCRIBED TO SLOW THE PROGRESSION  OF  ALZHEIMER'S  DISEASE  AND  OTHER
 DEMENTIA,  IN  ACCORDANCE  WITH THE UNITED STATES FOOD AND DRUG ADMINIS-
 TRATION LABEL, AS DETERMINED BY A PHYSICIAN LICENSED TO  PRACTICE  MEDI-
 CINE IN ALL ITS BRANCHES. COVERAGE OF UNITED STATES FOOD AND DRUG ADMIN-
 ISTRATION-APPROVED  TREATMENTS  OR  MEDICATIONS  PRESCRIBED  TO SLOW THE
 PROGRESSION OF ALZHEIMER'S DISEASE OR ANOTHER RELATED DEMENTIA  PURSUANT
 TO THIS PARAGRAPH SHALL NOT BE SUBJECT TO STEP THERAPY.
   §  5. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a law and shall apply to  all
 policies  and contracts issued, renewed, modified, altered or amended on
 or after such date.