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

S. 4721                             2

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
TAKE  INTO  CONSIDERATION EXISTING PRIOR AUTHORIZATION FORMS ESTABLISHED
BY  THE  DEPARTMENT  OF  HEALTH  PURSUANT  TO  SECTION   THREE   HUNDRED
SIXTY-FOUR-J OF THE SOCIAL SERVICES LAW.
  S 3. This act shall take effect immediately.