What's happening
This bill requires health insurers in New York to cover at least one FDA-approved opioid antagonist, such as naloxone, and related devices.
Why it matters
Expands access to life-saving overdose treatments. By mandating insurance coverage for at least one FDA-approved opioid antagonist (like naloxone) and related devices, the bill ensures more New Yorkers can obtain these vital drugs, potentially reducing opioid overdose deaths.
Supports broader community preparedness. The bill requires that coverage includes opioid antagonists prescribed or dispensed via standing orders or collaborative practice agreements, meaning organizations or individuals (not just the insured person) can obtain naloxone for emergency use on others—a key tool for community response.
Balances access with insurance cost controls. While mandating coverage, the bill allows insurers to require prior authorization for non-generic (brand name) versions and maintains the ability to apply standard deductibles and co-insurance, seeking to balance affordability with access.
Aligns with evolving public health policy. By broadening the definition of opioid antagonists to include future FDA-approved medications as authorized by the state Department of Health, the law aims to keep pace with advancements in overdose treatment options.
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Who cares
Headline styles
Require Insurance for Opioid 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.
Cover Opioid Overdose Antidotes
In Assembly Committee · Insurance · Sponsor Linda Rosenthal
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8891
IN SENATE
June 1, 2018
Introduced by Sen. JACOBS -- read twice and ordered printed, and when printed to be committed 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
S. 8891 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.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to requiring health insurers to provide coverage for opioid antagonists and devices
Purpose
This bill requires health insurers to provide coverage for opioid antag- onists and devices.
Summary of provisions
Section one amends section 3216 of the insurance law by adding a new paragraph 34.
Section two amends subsection 1 of section 3221 of the insurance law by adding a new paragraph 7-c. Section three amends section 4303 of the insurance law is amended by adding a new subsection rr. Section four sets forth the effective date.
Justification
The rate of opioid overdose deaths in New York State rose 32% from 2015 to 2016, and there is little to indicate that the severity of that trend has abated. The most immediate concern with addressing this public health crisis is saving lives, and to do that we need to ensure that any New Yorker who wants to equip themselves with a lifesaving opioid antag- onist, either for themselves or for someone else, can do that. Currently though, under threat of audit from insurance companies, pharmacies are often only selling opioid antagonists to individuals who are purchasing an opioid antagonist for personal use. The deadly consequence of this crackdown is that New Yorkers are often prevented from saving the life of another.
This legislation will require that every policy that provides coverage for prescription drugs shall include coverage for at least one opioid antagonist and device. Critically, the coverage must include opioid antagonists intended for use on patients other than the insured. This bill empowers those seeking to be proactive in protecting the life of someone they believe to be at risk, and helps expand New York State's overdose prevention network.
Legislative history
This is a new bill.
Fiscal implications
Undetermined.
Effective date
This act shall take effect immediately after it shall have become a law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.