BILL NUMBER:S5528

TITLE OF BILL:

An act to amend the insurance law, in relation to requiring insurance
coverage for pre-exposure prophylaxis and post-exposure prophylaxis to
prevent HIV infection

PURPOSE:

The purpose of this legislation is to require that any insurance policy
which provides coverage for prescription drugs shall include coverage
for the cost of pre and post-exposure prophylaxis for the purposes of
HIV prevention.

SUMMARY OF PROVISIONS:

Section 1 of the bill adds a new paragraph 32 to section 3216 of the
insurance law to require that any policy which provides coverage for
prescription drugs shall include coverage for the cost of pre-exposure
prophylaxis for the prevention of HIV and post-exposure prophylaxis to
prevent HIV infection.

Section 2 of the bill adds a new paragraph 19 to section 3221 of the
insurance law to do the same as above.

              

Section 3 of the bill adds a new subsection (pp) to section 4303 of the
insurance law to require that every contract issued by a hospital
services corporation or a health service corporation which provides
coverage for prescription drugs shall include coverage for the cost of
pre-exposure prophylaxis for the prevention of HIV and post-exposure
prophylaxis to prevent HIV infection.

Section 4 of the bill provides the effective date.

JUSTIFICATION:

Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are
two important tools for preventing the spread of HIV. According to the
Centers for Disease Control, PrEP has been shown to reduce the risk of
HIV infection in people at high risk of contracting HIV by up to 92%
when taken consistently. Postexposure prophylaxis (PEP) regimens are
antiretroviral drugs taken to stop the spread of HIV after a single
high-risk event. PEP can be used to treat health care workers who have
been exposed to the blood or body fluids of HIV-positive patients, as
well as people who have been exposed to HIV through unprotected sex,
needle sharing, or sexual assault.

Allowing access to PrEP and PEP is an important part of the fight to end
the AIDS epidemic in New York. This legislation would ensure that insur-
ance policies covering prescription drugs include coverage for PrEP and
PEP.

PRIOR LEGISLATIVE HISTORY:

None, new bill.

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

This act shall take effect immediately.