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A4899Assembly2017-2018 SessionSame asS7905

Cover Opioid Treatment Medications

Official title

“Requires insurers providing coverage of prescription drugs for opioid addiction, to provide coverage of such prescription drugs prescribed for the treatment of substance abuse disorder”

Sponsor Linda RosenthalAD-67+3 co-sponsorsAffects Legal
Status
Assembly Floor Calendar
Impact
8/10
Significant
Passage
0%

Bill progress

Step 3 of 7

Floor calendar · Jun 18

What's happening

This bill requires health insurers in New York to cover FDA-approved opioid addiction medications without prior authorization or step therapy.

Why it matters

  1. Reduces barriers to timely treatment. by eliminating prior authorization and step therapy, allowing patients with opioid addiction to access FDA-approved medications more quickly and with fewer administrative hurdles.

  2. Applies broadly across insurance types. , meaning both individual and group health policies, as well as health maintenance organization (HMO) contracts, must comply—impacting a wide range of insured New Yorkers.

  3. Supports evidence-based care. by mandating coverage for all FDA-approved medications for opioid use disorder, not just a subset, thereby enabling clinicians and patients to choose the most appropriate treatment.

  4. May still involve out-of-pocket costs. , as the bill allows insurers to apply annual deductibles and co-insurance, though these must be consistent with those applied to other benefits within the same policy or contract.

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Who cares

Headline styles

Cover Opioid Treatment Medications

Plain English, a few words. Used as the page title.

Sponsors

Primary sponsor
Linda Rosenthal

Assembly Member · Assembly District 67

History

  1. Ordered to third reading rules cal.296
  2. Rules report cal.296
  3. Reported
  4. Reported referred to rules
  5. Print number 4899c
  6. Amend and recommit to ways and means
  7. Reported referred to ways and means
  8. Reported referred to codes
  9. Print number 4899b
  10. Amend (t) and recommit to insurance
  11. Print number 4899a
  12. Amend and recommit to insurance
Show 2 earlier actions
  1. Referred to insurance
  2. 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.

S7905Senate

Cover Opioid Addiction Medication

In Senate Committee · Insurance · Sponsor Joseph A. Griffo

Impact 7 · Significant0% to pass

Full text

2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗

STATE OF NEW YORK

4899--C

2017-2018 Regular Sessions

IN ASSEMBLY

February 6, 2017

Introduced by M. of A. L. ROSENTHAL, BRINDISI, HUNTER, GALEF -- read once and referred to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -committee discharged, bill amended, ordered reprinted… Show all

Introduced by M. of A. L. ROSENTHAL, BRINDISI, HUNTER, GALEF -- read once and referred to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- again reported from said committee with amendments, ordered reprinted as amended and recommitted to said committee -- reported and referred to the Committee on Codes -reported and referred to the Committee on Ways and Means -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee

AN ACT to amend the insurance law, in relation to requiring health insurers to provide coverage of opioid addiction prescription drugs prescribed for the treatment of substance abuse disorder

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) Every policy that provides medical, major medical or similar comprehensive-type coverage, or coverage for prescription drugs must provide coverage, without prior authorization or step therapy, for an initial or renewal prescription for prescription drugs prescribed for the treatment of substance abuse disorder suffered by a covered person with an addiction to opioids.

(B) 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.

(C) For the purposes of this paragraph, "prescription drugs prescribed for the treatment of substance abuse disorder" shall mean medications and prescription drugs approved by the food and drug administration for the detoxification or maintenance treatment of substance use disorder.

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD05152-05-8

A. 4899--C 2

§ 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) Every policy that provides medical, major medical or similar comprehensive-type coverage, or coverage for prescription drugs must provide coverage, without prior authorization or step therapy, for an initial or renewal prescription for prescription drugs prescribed for the treatment of substance abuse disorder suffered by a covered person with an addiction to opioids.

(B) 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.

(C) For the purposes of this paragraph, "prescription drugs prescribed for the treatment of substance abuse disorder" shall mean medications and prescription drugs approved by the food and drug administration for the detoxification or maintenance treatment of substance use disorder.

§ 3. Section 4303 of the insurance law is amended by adding a new subsection (l-3) to read as follows:

(l-3) Every contract that provides medical, major medical or similar comprehensive-type coverage, or coverage for prescription drugs must provide coverage, without prior authorization or step therapy, for an initial or renewal prescription for prescription drugs prescribed for the treatment of substance abuse disorder suffered by a covered person with an addiction to opioids. 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 contract. For the purposes of this subsection, "prescription drugs prescribed for the treatment of substance abuse disorder" shall mean medications and prescription drugs approved by the food and drug administration for the detoxification or maintenance treatment of substance use disorder.

§ 4. This act shall take effect immediately.

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.