What's happening
This bill prohibits health insurers in New York from requiring prior authorization for HIV prevention medication (pre-exposure prophylaxis).
Why it matters
Removes a major administrative barrier. By eliminating prior authorization requirements for HIV prevention medication, the bill aims to reduce delays and bureaucratic obstacles, making it faster and easier for people to access life-saving PrEP drugs.
Could help curb new HIV infections. Easier and more immediate access to pre-exposure prophylaxis (PrEP) is associated with higher usage rates, which public health experts believe is crucial in reducing the spread of HIV, especially among high-risk populations.
Insurers retain cost-control measures. While prior authorization is removed, insurers can still deny coverage if the medication is later deemed not medically necessary, balancing patient access with safeguards against inappropriate use.
Signals a shift toward preventive healthcare. The bill reflects broader efforts to prioritize prevention in healthcare policy, potentially setting a precedent for removing access barriers to other preventive treatments in the future.
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Who cares
Headline styles
End PrEP Authorization Delays
Plain English, a few words. Used as the page title.
Sponsors
30 Co-sponsors
- Carmen E. Arroyo
- Harry B. Bronson
- William Colton
- Vivian Cook
- Catalina Cruz
- Carmen De La Rosa
- Deborah Glick
- Aileen Gunther
- Judy Griffin
- Andrew Hevesi
- Ellen C. Jaffee
- David McDonough
- Yuh-Line Niou
- Felix Ortiz
- Karines Reyes
- Nader Sayegh
- Colin Schmitt
- Rebecca Seawright
- Jo Anne Simon
- Aravella Simotas
- Al Taylor
- Fred Thiele
- Carrie Woerner
- Tremaine Wright
- William Magnarelli
- Nathalia Fernandez
- Daniel Rosenthal
- Jonathan Jacobson
- John T. McDonald III
- Pamela J. Hunter
3 Multi-sponsors
History
- Print number 7281a
- Amend and recommit to insurance
- Referred to insurance
- 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.
End PreP Insurance Hurdles
In Senate Committee · Rules · Sponsor Brad Hoylman-Sigal
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
7281--A
2019-2020 Regular Sessions
IN ASSEMBLY
April 18, 2019
Introduced by M. of A. GOTTFRIED, ARROYO, BRONSON, COLTON, COOK, CRUZ, DE LA ROSA, GLICK, GUNTHER, GRIFFIN, HEVESI, JAFFEE, McDONOUGH, NIOU, ORTIZ, REYES, SAYEGH, SCHMITT, SEAWRIGHT, SIMON, SIMOTAS, TAYLOR, THIELE, WOERNER, WRIGHT, MAGNARELLI, FERNANDEZ, D. ROSENTHAL -- Multi-Sponsored by -- M. of A. GALEF, LENTOL, NOLAN -- 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
AN ACT to amend the public health law and the insurance law, in relation to prohibiting health insurers from requiring prior authorization for pre-exposure prophylaxis used to prevent HIV infection
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 4406-c of the public health law is amended by adding a new subdivision 11 to read as follows:
11. A health care plan which provides prescription drug coverage shall not require a prior authorization determination for pre-exposure prophylaxis used to prevent HIV infection. Nothing in this subdivision shall prohibit a health care plan from denying a claim for such services if the services are subsequently determined not medically necessary.
§ 2. Section 3217-b of the insurance law is amended by adding a new subsection (m) to read as follows:
(m) An insurer which provides prescription drug coverage shall not require a prior authorization determination for pre-exposure prophylaxis used to prevent HIV infection. Nothing in this subsection shall prohibit an insurer from denying a claim for such services if the services are subsequently determined not medically necessary.
§ 3. Section 4325 of the insurance law is amended by adding a new subsection (n) to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD08766-04-0
A. 7281--A 2
(n) A corporation organized under this article which provides prescription drug coverage shall not require a prior authorization determination for pre-exposure prophylaxis used to prevent HIV infection. Nothing in this subsection shall prohibit a corporation organized under this article from denying a claim for such services if the services are subsequently determined not medically necessary.
§ 4. This act shall take effect on the one hundred eightieth 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.