What's happening
This bill requires health insurance policies in New York to cover at least one opioid antagonist and device, such as naloxone.
Why it matters
Increases access to lifesaving overdose medication. By requiring insurance coverage for at least one opioid antagonist and device (such as naloxone), the bill aims to make it easier and more affordable for individuals and families to obtain emergency treatments that can reverse opioid overdoses.
Supports public health efforts to prevent overdose deaths. Including coverage for opioid antagonists prescribed through standing orders or collaborative practice agreements (allowing access for use on others, not just the insured) enables broader community distribution—important for schools, libraries, first responders, and families of those at risk.
Limits cost barriers while allowing standard insurance practices. The bill permits insurers to require prior authorization for non-generic versions and allows deductibles and coinsurance consistent with other prescription drug benefits, balancing consumer protection with insurer flexibility.
Aligns with evolving standards of care. By tying the definition of covered opioid antagonists to FDA approval and Department of Health recommendations, the bill ensures that insurance coverage will adapt as new overdose-reversal drugs or devices become available.
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Who cares
Headline styles
Cover Opioid Overdose Antidotes
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Require Insurance for Opioid Antidotes
In Senate Committee · Insurance · Sponsor Chris Jacobs
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
10622
IN ASSEMBLY
May 9, 2018
Introduced by M. of A. L. ROSENTHAL -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health insurers to provide coverage for opioid antagonists and devices
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 35 to read as follows:
(35) (A) (i) Every policy which provides coverage for prescription drugs shall include coverage for at least one opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid antagonists and devices.
(ii) As used in this paragraph "opioid antagonist and device" means a drug approved by the Food and Drug Administration that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid in the body. "Opioid antagonist" shall be limited to naloxone and other medications approved by the department of health for such purpose.
(B) The coverage mandated by this paragraph shall include opioid antagonists prescribed or dispensed via standing order or collaborative practice agreement intended for use on patients other than the insured.
(C) Coverage provided under this paragraph may be subject to annual deductibles and co-insurance as deemed appropriate by the superintendent and that are consistent with those imposed on other benefits within a given policy.
§ 2. Subsection (l) of section 3221 of the insurance law is amended by adding a new paragraph 7-c to read as follows:
(7-c) (A) (i) Every policy which provides coverage for prescription drugs shall include coverage for at least one opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid antagonists and devices.
(ii) As used in this paragraph "opioid antagonist and device" means a drug approved by the Food and Drug Administration that, when administered, negates or neutralizes in whole or in part the pharmacological
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15406-03-8
A. 10622 2
effects of an opioid in the body. "Opioid antagonist" shall be limited to naloxone and other medications approved by the department of health for such purpose.
(B) The coverage mandated by this paragraph shall include opioid antagonists prescribed or dispensed via standing order or collaborative practice agreement intended for use on patients other than the insured.
(C) Coverage provided under this paragraph may be subject to annual deductibles and co-insurance as deemed appropriate by the superintendent and that are consistent with those imposed on other benefits within a given policy.
§ 3. Section 4303 of the insurance law is amended by adding a new subsection (ss) to read as follows:
(ss) (1) (A) Every policy which provides coverage for prescription drugs shall include coverage for at least one opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid antagonists and devices.
(B) As used in this subsection "opioid antagonist and device" means a drug approved by the Food and Drug Administration that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid in the body. "Opioid antagonist" shall be limited to naloxone and other medications approved by the department of health for such purpose.
(2) Coverage provided under this subsection may be subject to annual deductibles and co-insurance as deemed appropriate by the superintendent and that are consistent with those imposed on other benefits within a given policy.
§ 4. This act shall take effect on the thirtieth day after it shall have become a law.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.