Senate Bill S4721

Signed By Governor
2015-2016 Legislative Session

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

download bill text pdf

Sponsored By

Archive: Last Bill Status - Signed by Governor

  • 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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Bill Amendments

co-Sponsors

2015-S4721 - Details

Law Section:
Public Health Law
Laws Affected:
Amd §4903, Pub Health L; amd §4903, Ins L
Versions Introduced in 2013-2014 Legislative Session:
S7369

2015-S4721 - 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.

2015-S4721 - Sponsor Memo

2015-S4721 - Bill Text download pdf 

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

                                  4721

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             April 10, 2015
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee 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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04038-01-5

co-Sponsors

2015-S4721A (ACTIVE) - Details

Law Section:
Public Health Law
Laws Affected:
Amd §4903, Pub Health L; amd §4903, Ins L
Versions Introduced in 2013-2014 Legislative Session:
S7369

2015-S4721A (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.

2015-S4721A (ACTIVE) - Sponsor Memo

2015-S4721A (ACTIVE) - Bill Text download pdf 

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

                                 4721--A
    Cal. No. 1059

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             April 10, 2015
                               ___________

Introduced  by  Sens.  HANNON, LARKIN -- read twice and ordered printed,
  and when printed to  be  committed  to  the  Committee  on  Health  --
  reported  favorably  from  said  committee,  ordered  to first report,
  amended on first report,  ordered  to  a  second  report  and  ordered
  reprinted, retaining its place in the order of second report

AN ACT to amend the public health law and the insurance law, in relation
  to standards for prior authorization requests 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 STANDARDS FOR PRIOR AUTHORIZATION  REQUESTS
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 DEPARTMENT  AND  THE
DEPARTMENT OF FINANCIAL SERVICES, IN DEVELOPMENT OF THE STANDARDS, SHALL
TAKE  INTO  CONSIDERATION EXISTING ELECTRONIC PRIOR AUTHORIZATION STAND-
ARDS INCLUDING NATIONAL COUNCIL FOR PRESCRIPTION DRUG  PROGRAMS  (NCPDP)
ELECTRONIC PRIOR AUTHORIZATION STANDARD TRANSACTIONS.
  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 STANDARDS FOR PRIOR AUTHORIZATION REQUESTS 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 DEPARTMENT  AND  THE
DEPARTMENT  OF  HEALTH, IN DEVELOPMENT OF THE STANDARDS, SHALL TAKE INTO
CONSIDERATION EXISTING ELECTRONIC PRIOR AUTHORIZATION STANDARDS  INCLUD-
ING  NATIONAL  COUNCIL FOR PRESCRIPTION DRUG PROGRAMS (NCPDP) ELECTRONIC
PRIOR AUTHORIZATION STANDARD TRANSACTIONS.
  S 3. This act shall take effect immediately.

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