S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1619
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2023
                                ___________
 
 Introduced  by  M.  of  A. L. ROSENTHAL -- read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the public health law, in relation  to  prohibiting  the
   preferred  drug  program  from  restricting  or imposing delays in the
   distribution of antiretroviral prescription drugs to certain  persons;
   to  amend  the social services law, in relation to prohibiting managed
   care programs from restricting or imposing delays in the  distribution
   of  antiretroviral prescription drugs to certain persons; and to amend
   the insurance law, in relation to prohibiting insurers from  restrict-
   ing   or   imposing  delays  in  the  distribution  of  antiretroviral
   prescription drugs to certain persons
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 273 of the public health law is amended by adding a
 new subdivision 11 to read as follows:
   11.  NO  PRIOR AUTHORIZATION, STEP THERAPY, OR ANY OTHER PROTOCOL THAT
 COULD RESTRICT OR DELAY THE DISPENSING OF THE DRUG SHALL BE REQUIRED FOR
 ANTIRETROVIRAL PRESCRIPTION DRUGS PRESCRIBED TO  A  PERSON  IN  A  STATE
 PUBLIC  HEALTH PLAN FOR THE TREATMENT OR PREVENTION OF THE HUMAN IMMUNO-
 DEFICIENCY VIRUS (HIV) OR ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS).
   § 2. Section 364-j of the social services law is amended by  adding  a
 new subdivision 26-d to read as follows:
   26-D.  MANAGED  CARE  PROVIDERS  SHALL  NOT  SUBJECT AN ANTIRETROVIRAL
 PRESCRIPTION DRUG PRESCRIBED TO A PERSON FOR THE TREATMENT OR PREVENTION
 OF THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) OR  ACQUIRED  IMMUNODEFICIENCY
 SYNDROME  (AIDS)  TO A PRIOR AUTHORIZATION REQUIREMENT, STEP THERAPY, OR
 ANY OTHER PROTOCOL THAT COULD RESTRICT OR DELAY THE  DISPENSING  OF  THE
 DRUG.
   § 3. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 39 to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04099-01-3
 A. 1619                             2
              

 
   (39)  NO POLICY THAT PROVIDES COVERAGE FOR ANTIRETROVIRAL PRESCRIPTION
 DRUGS PRESCRIBED FOR THE TREATMENT OR PREVENTION OF THE HUMAN  IMMUNODE-
 FICIENCY  VIRUS (HIV) OR ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) SHALL
 SUBJECT SUCH DRUGS TO PRIOR AUTHORIZATION REQUIREMENT, STEP THERAPY,  OR
 ANY  OTHER  PROTOCOL  THAT COULD RESTRICT OR DELAY THE DISPENSING OF THE
 DRUG.
   § 4. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
 THIS STATE THAT PROVIDES COVERAGE FOR ANTIRETROVIRAL PRESCRIPTION  DRUGS
 FOR  THE  TREATMENT  OR  PREVENTION  OF THE HUMAN IMMUNODEFICIENCY VIRUS
 (HIV) OR ACQUIRED IMMUNODEFICIENCY SYNDROME  (AIDS)  SHALL  NOT  SUBJECT
 SUCH  DRUG  TO  A  PRIOR AUTHORIZATION REQUIREMENT, STEP THERAPY, OR ANY
 OTHER PROTOCOL THAT COULD RESTRICT OR DELAY THE DISPENSING OF THE DRUG.
   § 5. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (uu) to read as follows:
   (UU) ANY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION, A
 HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH  SERVICES CORPORATION THAT
 PROVIDES COVERAGE FOR ANTIRETROVIRAL PRESCRIPTION DRUGS FOR  THE  TREAT-
 MENT OR PREVENTION OF THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) OR ACQUIRED
 IMMUNODEFICIENCY  SYNDROME (AIDS) SHALL NOT SUBJECT SUCH DRUG TO A PRIOR
 AUTHORIZATION REQUIREMENT, STEP THERAPY,  OR  ANY  OTHER  PROTOCOL  THAT
 COULD RESTRICT OR DELAY THE DISPENSING OF THE DRUG.
   §  6. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become  a  law;  provided,  however,
 that sections three, four and five of this act shall apply to all cover-
 age,  contracts or policies issued, reissued, renewed, modified, altered
 or amended on or after such effective date; and provided further, howev-
 er, that the amendments to section 364-j of the social services law made
 by section two of this act, shall not affect the repeal of such  section
 and  shall  be  deemed  repealed therewith.   Effective immediately, the
 addition, amendment and/or repeal of any rule  or  regulation  necessary
 for  the implementation of this act on its effective date are authorized
 to be made and completed on or before such effective date.