Assembly Bill A9765

2013-2014 Legislative Session

Directs the commissioner of health and superintendent of financial services to establish a standard prior authorization request for a utilization review of prescription drug coverage

download bill text pdf

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Archive: Last Bill Status - On Floor Calendar

  • 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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2013-A9765 (ACTIVE) - Details

See Senate Version of this Bill:
S7369
Law Section:
Public Health Law
Laws Affected:
Amd §4903, Pub Health L; amd §4903, Ins L
Versions Introduced in 2015-2016 Legislative Session:
A6983, S4721

2013-A9765 (ACTIVE) - Summary

Directs the commissioner of health and superintendent of financial services to establish a standard prior authorization request for a utilization review of prescription drug coverage.

2013-A9765 (ACTIVE) - Bill Text download pdf 

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  9765

                          I N  A S S E M B L Y

                              May 21, 2014
                               ___________

Introduced by M. of A. McDONALD -- read once and referred to the Commit-
  tee on Health

AN ACT to amend the public health law and the insurance law, in relation
  to  a  standard  prior  authorization  request  form for a utilization
  review of prescription drug coverage

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Section 4903 of the public health law is amended by adding
a new subdivision 8 to read as follows:
  8. THE COMMISSIONER, IN CONJUNCTION WITH THE SUPERINTENDENT OF  FINAN-
CIAL SERVICES, SHALL DEVELOP A STANDARD PRIOR AUTHORIZATION REQUEST FORM
TO BE UTILIZED BY ALL HEALTH CARE PLANS FOR THE PURPOSES OF SUBMITTING A
REQUEST   FOR   A  UTILIZATION  REVIEW  DETERMINATION  FOR  COVERAGE  OF
PRESCRIPTION DRUG BENEFITS UNDER THIS ARTICLE. THE FORM SHALL BE IDENTI-
CAL TO THAT DEVELOPED PURSUANT TO SECTION  FOUR  THOUSAND  NINE  HUNDRED
THREE  OF THE INSURANCE LAW. EACH HEALTH CARE PLAN SHALL MAKE THE STAND-
ARD PRIOR AUTHORIZATION REQUEST FORM AVAILABLE TO, AND SHALL  ACCEPT  IT
FROM, PRESCRIBING PROVIDERS IN PAPER AND ELECTRONIC FORM. THE DEPARTMENT
AND  THE  DEPARTMENT OF FINANCIAL SERVICES, IN DEVELOPMENT OF THE STAND-
ARDIZED FORM, SHALL TAKE INTO CONSIDERATION EXISTING PRIOR AUTHORIZATION
FORMS ESTABLISHED BY THE DEPARTMENT PURSUANT TO  SECTION  THREE  HUNDRED
SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW.
  S  2.  Section  4903  of  the insurance law is amended by adding a new
subsection (h) to read as follows:
  (H) THE  SUPERINTENDENT,  IN  CONJUNCTION  WITH  THE  COMMISSIONER  OF
HEALTH,  SHALL DEVELOP A STANDARD PRIOR AUTHORIZATION REQUEST FORM TO BE
UTILIZED BY ALL HEALTH CARE PLANS  FOR  THE  PURPOSES  OF  SUBMITTING  A
REQUEST   FOR   A  UTILIZATION  REVIEW  DETERMINATION  FOR  COVERAGE  OF
PRESCRIPTION DRUG BENEFITS UNDER THIS ARTICLE. THE FORM SHALL BE IDENTI-
CAL TO THAT DEVELOPED PURSUANT TO SECTION FORTY-NINE  HUNDRED  THREE  OF
THE  PUBLIC  HEALTH  LAW.  EACH HEALTH CARE PLAN SHALL MAKE THE STANDARD
PRIOR AUTHORIZATION REQUEST FORM AVAILABLE TO, AND SHALL ACCEPT IT FROM,
PRESCRIBING PROVIDERS IN PAPER AND ELECTRONIC FORM. THE  DEPARTMENT  AND
THE DEPARTMENT OF HEALTH, IN DEVELOPMENT OF THE STANDARDIZED FORM, SHALL

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.

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