Assembly Bill A5354

2025-2026 Legislative Session

Requires health insurers to provide coverage without cost-sharing for opioid antagonists and devices

download bill text pdf

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Current Bill Status - In Assembly 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

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2025-A5354 (ACTIVE) - Details

Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L

2025-A5354 (ACTIVE) - Summary

Requires health insurers to provide coverage without cost-sharing for opioid antagonists and devices; provides that no prior authorization of premedical review for coverage of such opioid antagonist is required.

2025-A5354 (ACTIVE) - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5354
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 13, 2025
                                ___________
 
 Introduced  by M. of A. STECK -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the insurance  law,  in  relation  to  requiring  health
   insurers  to  provide  coverage without cost-sharing for opioid antag-
   onists and devices
 
   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 40 to read as follows:
   (40) (A) (I) EVERY POLICY WHICH  PROVIDES  COVERAGE  FOR  PRESCRIPTION
 DRUGS  SHALL  INCLUDE  COVERAGE  FOR  AT LEAST ONE OPIOID ANTAGONIST AND
 DEVICE.  NO PRIOR AUTHORIZATION OR PREMEDICAL REVIEW FOR COVERAGE OF  AN
 OPIOID ANTAGONIST IS REQUIRED.
   (II)  AS USED IN THIS PARAGRAPH "OPIOID ANTAGONIST AND DEVICE" MEANS A
 DRUG APPROVED BY THE FOOD AND DRUG ADMINISTRATION  THAT,  WHEN  ADMINIS-
 TERED,  NEGATES  OR  NEUTRALIZES IN WHOLE OR IN PART THE PHARMACOLOGICAL
 EFFECTS OF AN OPIOID IN THE BODY. "OPIOID ANTAGONIST" SHALL  BE  LIMITED
 TO MEDICATIONS APPROVED BY THE DEPARTMENT OF HEALTH FOR SUCH PURPOSE.
   (B)  THE  COVERAGE  MANDATED  BY  THIS  PARAGRAPH SHALL INCLUDE OPIOID
 ANTAGONISTS PRESCRIBED OR DISPENSED VIA STANDING ORDER OR  COLLABORATIVE
 PRACTICE AGREEMENT INTENDED FOR USE ON PATIENTS OTHER THAN THE INSURED.
   (C)  A POLICY SHALL NOT IMPOSE A DEDUCTIBLE, CO-INSURANCE, CO-PAYMENT,
 OR ANY OTHER COST-SHARING REQUIREMENT ON SUCH COVERAGE PROVIDED PURSUANT
 TO THIS PARAGRAPH.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 7-c to read as follows:
   (7-C) (A) (I) EVERY POLICY WHICH PROVIDES  COVERAGE  FOR  PRESCRIPTION
 DRUGS  SHALL  INCLUDE  COVERAGE  FOR  AT LEAST ONE OPIOID ANTAGONIST AND
 DEVICE.  NO PRIOR AUTHORIZATION OR PREMEDICAL REVIEW FOR COVERAGE OF  AN
 OPIOID ANTAGONIST IS REQUIRED.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07388-02-5
 A. 5354                             2

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