NY State Senate Bill 2017-S6674

Senate Bill S6674

2017-2018 Legislative Session

Prohibits certain insurance policies from requiring prior authorization for certain medications used in the treatment of substance use disorders; repealer

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Archive: Last Bill Status - In Senate Committee Insurance 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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2018	referred to insurance
Jun 12, 2017	referred to rules

co-Sponsors

2017-S6674 (ACTIVE) - Details

See Assembly Version of this Bill:: A7979
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, rpld §3216 sub§ (i) ¶31-a, §3221 sub§ (l) ¶¶7-a & 7-b, §4303 sub§§ (l-1) & (l-2), Ins L
Versions Introduced in 2019-2020 Legislative Session:: S4808, A2904

2017-S6674 (ACTIVE) - Summary

Prohibits certain insurance policies from requiring prior authorization for buprenorphine products, methadone and long acting injectable naltrexone for detoxification or maintenance treatment of substance use disorders.

2017-S6674 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S6674

 TITLE OF BILL :  An act to amend the insurance law, in relation to
prohibiting certain insurance policies from requiring prior
authorization for certain medications used in the treatment of
substance use disorders; and to repeal certain provisions of such law
relating thereto

 PURPOSE :

To ensure uniformity across all health insurance plan policies
regarding reasonable patient access to medication assisted treatment
for substance abuse disorders.

 SUMMARY OF PROVISIONS :

Section 1 repeals subdivision 31-a of section 3216 of the insurance
law and replaces it with a new subdivision to require health insurers
to provide patient access, without prior authorization requirements,
for initial and renewal prescriptions for buprenorphine, methadone or
long acting injectable naltrexone for the treatment of substance abuse
disorders.

Section 2 repeals paragraphs 7-a and 7-b of subsection (1) of section
3221 of the insurance law and adds a new paragraph 7-a to require
health insurers to provide patient access, without prior authorization

requirements, for initial and renewal prescriptions for buprenorphine,
methadone or long acting injectable naltrexone for the treatment of
substance abuse disorders.

Section 3 repeals subsections (1-1) and (1-2) of section 4303 of the
insurance law and adds a new subsection (1-1) to require health
insurers to provide patient access, without prior authorization
requirements, for initial and renewal prescriptions for buprenorphine,
methadone or long acting injectable naltrexone for the treatment of
substance abuse disorders.

Section 4 provides that this act will take effect on the 60th day
after enactment.

 JUSTIFICATION :

New York is experiencing an unprecedented heroin and opioid epidemic
that is ravaging communities across the state. According to the New
York State Comptroller's Office, New York has experienced an increase
in death rates due to opioid and heroin addiction that outpaces almost
any other state where data is available.

This bill builds upon measures enacted in 2016 to improve access to
health insurance coverage for substance abuse treatment, including
medication-assisted treatment. In 2016, prior authorization
requirements were removed for buprenorphine and long acting injectable
naltrexone in the Medicaid program. The purpose of this bill is to
establish parity for all consumers by ensuring that addicted persons
with commercial insurance coverage can access medication assisted
treatment as prescribed by their health care providers without
unnecessary barriers.

 LEGISLATIVE HISTORY :

New bill.

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
Sixty days after enactment.

2017-S6674 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6674
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                               June 12, 2017
                                ___________
 
 Introduced  by  Sen. AMEDORE -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the insurance law, in relation  to  prohibiting  certain
   insurance  policies  from  requiring  prior  authorization for certain
   medications used in the treatment of substance use disorders;  and  to
   repeal certain provisions of such law relating thereto
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph 31-a of subsection (i) of  section  3216  of  the
 insurance  law  is REPEALED and a new paragraph 31-a is added to read as
 follows:
   (31-A) (A) NO POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL  OR  SIMILAR
 COMPREHENSIVE-TYPE COVERAGE AND PROVIDES COVERAGE FOR PRESCRIPTION DRUGS
 FOR  MEDICATION  FOR  THE  TREATMENT  OF  A SUBSTANCE USE DISORDER SHALL
 REQUIRE PRIOR AUTHORIZATION FOR AN INITIAL OR RENEWAL  PRESCRIPTION  FOR
 ALL BUPRENORPHINE PRODUCTS, METHADONE OR LONG ACTING INJECTABLE NALTREX-
 ONE  FOR  DETOXIFICATION  OR  MAINTENANCE  TREATMENT  OF A SUBSTANCE USE
 DISORDER EXCEPT WHERE OTHERWISE PROHIBITED BY LAW.
   (B) COVERAGE PROVIDED UNDER THIS PARAGRAPH MAY BE  SUBJECT  TO  COPAY-
 MENTS,  COINSURANCE,  AND  ANNUAL  DEDUCTIBLES  THAT ARE CONSISTENT WITH
 THOSE IMPOSED ON OTHER BENEFITS WITHIN THE POLICY.
   § 2. Paragraphs 7-a and 7-b of subsection (l) of section 3221  of  the
 insurance  law  are REPEALED and a new paragraph 7-a is added to read as
 follows:
   (7-A) (A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR
 COMPREHENSIVE-TYPE LARGE GROUP COVERAGE SHALL PROVIDE IMMEDIATE COVERAGE
 FOR ALL BUPRENORPHINE PRODUCTS,  METHADONE  OR  LONG  ACTING  INJECTABLE
 NALTREXONE WITHOUT PRIOR AUTHORIZATION FOR THE DETOXIFICATION OR MAINTE-
 NANCE TREATMENT OF A SUBSTANCE USE DISORDER.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11793-03-7

 S. 6674                             2
 
   (B)  COVERAGE  PROVIDED  UNDER THIS PARAGRAPH MAY BE SUBJECT TO COPAY-
 MENTS, COINSURANCE, AND ANNUAL  DEDUCTIBLES  THAT  ARE  CONSISTENT  WITH
 THOSE IMPOSED ON OTHER BENEFITS WITHIN THE POLICY.
   §  3. Subsections (l-1) and (l-2) of section 4303 of the insurance law
 are REPEALED and a new subsection (l-1) is added to read as follows:
   (L-1) (A) EVERY CONTRACT THAT  PROVIDES  MEDICAL,  MAJOR  MEDICAL,  OR
 SIMILAR  COMPREHENSIVE-TYPE LARGE GROUP COVERAGE SHALL PROVIDE IMMEDIATE
 COVERAGE FOR  ALL  BUPRENORPHINE  PRODUCTS,  METHADONE  OR  LONG  ACTING
 INJECTABLE NALTREXONE WITHOUT PRIOR AUTHORIZATION FOR THE DETOXIFICATION
 OR MAINTENANCE TREATMENT OF A SUBSTANCE USE DISORDER.
   (B)  COVERAGE  PROVIDED  UNDER THIS PARAGRAPH MAY BE SUBJECT TO COPAY-
 MENTS, COINSURANCE, AND ANNUAL  DEDUCTIBLES  THAT  ARE  CONSISTENT  WITH
 THOSE IMPOSED ON OTHER BENEFITS WITHIN THE POLICY.
   §  4.  This  act  shall take effect on the sixtieth day after it shall
 have become a law.

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Senate Bill S6674

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Sponsored By

George Amedore