What's happening
This bill requires health insurance policies in New York to cover FDA-approved smoking cessation medications and counseling, with limits on annual quit attempts and no cost-sharing.
Why it matters
Expands access to smoking cessation. By mandating insurance coverage for both FDA-approved medications and recommended counseling, the bill removes financial barriers that often prevent people from seeking help to quit smoking.
Limits and structure on coverage. The bill allows for up to two quit attempts per year, with each attempt including 90 days of medication and four counseling sessions, aiming to balance support with cost control and prevent misuse.
No cost-sharing or prior authorization. Prohibiting copays and prior authorization for these services means individuals can access help without administrative delays or out-of-pocket expenses, leading to faster and potentially more successful quit attempts.
Exemptions and continuity of benefits. The bill exempts multi-state employer plans and protects existing coverage, ensuring that current benefits aren’t reduced or eliminated and minimizing disruption for those already receiving cessation support.
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Who cares
People seeking to quit smoking
Covered policies would pay for physician-ordered FDA-approved cessation medications and recommended counseling, with coverage allowed to be limited to two quit attempts per year.
Health insurers and health service corporations
Affected policies would have to cover ninety days of medication and four counseling sessions per quit attempt without cost-sharing or prior authorization, though the health service corporation provision also allows certain deductibles and coinsurance.
Physicians and smoking cessation counselors
The bill would require coverage for physician-ordered medications and recommended counseling, expanding covered treatment options for their patients.
Multistate employers and unions
The hospital and health service corporation mandate would exempt specified contracts covering employees in more than one state, including contracts whose benefit structure was collectively bargained for those workers.
Headline styles
Require Smoking Cessation Coverage
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
556
2025-2026 Regular Sessions
IN SENATE (Prefiled)
January 8, 2025
Introduced by Sen. KRUEGER -- 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 coverage for treatment of smoking cessation
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 4303 of the insurance law is amended by adding a new subsection (ww) to read as follows:
(ww) A hospital service corporation or a health service corporation which provides group, group remittance or school blanket coverage for inpatient hospital care shall provide coverage for costs of any FDA approved smoking cessation medication and recommended counseling that is ordered by a physician. Such coverage may be limited to two quit attempts per year. Each quit attempt will include ninety days of any FDA approved cessation medications and four counseling sessions without cost-sharing or prior authorization. This provision shall not apply to a contract issued pursuant to section four thousand three hundred five of this article which covers persons employed in more than one state or the benefit structure of which was the subject of collective bargaining affecting persons who are employed in more than one state. Such coverage may be subject to annual deductibles and co-insurance as may be deemed appropriate by the superintendent and are consistent with those imposed on other benefits within a given policy. Such coverage shall not replace, restrict or eliminate existing coverage provided by the policy.
§ 2. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 40 to read as follows:
(40) Every policy shall provide coverage for costs of any FDA approved smoking cessation medication and recommended counseling that is ordered by a physician. Such coverage may be limited to two quit attempts per year. Each quit attempt will include ninety days of any FDA approved
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01728-01-5
cessation medications and four counseling sessions without cost-sharing or prior authorization.
§ 3. Subsection (1) of section 3221 of the insurance law is amended by adding a new paragraph 23 to read as follows:
(23) Every group or blanket policy delivered or issued for delivery in this state which provides hospital, surgical or medical coverage shall provide coverage for costs of any FDA approved smoking cessation medication and recommended counseling that is ordered by a physician. Such coverage may be limited to two quit attempts per year. Each quit attempt will include ninety days of any FDA approved cessation medications and four counseling sessions without cost-sharing or prior authorization.
§ 4. This act shall take effect on the one hundred eightieth day after it shall have become a law and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such date. 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 date.
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 coverage for treatment of smoking cessation
Purpose
To extend health insurance coverage to individuals for whom a physician prescribes or orders smoking cessation treatment.
Summary of provisions
Section 1 amends Section 4303 of the Insurance Law by adding a new subsection (oo) requiring hospital or health service corporations to provide coverage for costs of any FDA-approved smoking cessation medica- tion and recommended counseling that is ordered by a physician. Such coverage may be limited to two quit attempts per year. Each quit attempt will include ninety days of any FDA-approved cessation medications and four counseling sessions without cost-sharing or prior authorization.
Section 2 amends subsection (i) of Section 3216 of the Insurance Law by adding a new paragraph (34) which requires insurance policies to provide coverage for costs of any FDA-approved smoking cessation medication and recommended counseling that is ordered by a physician. Such coverage may be limited to two quit attempts per year. Each quit attempt will include ninety days of any FDA-approved cessation medications and four counseling sessions without cost-sharing or prior authorization.
Section 3 amends subsection (1) of Section 3221 of the Insurance Law by adding a new paragraph 20 requiring every group or blanket policy in New York State providing hospital, surgical or medical coverage to include coverage for costs of any FDA-approved smoking cessation medication and recommended counseling that is ordered by a physician. Such coverage may be limited to two quit attempts per year. Each quit attempt will include ninety days of any FDA-approved cessation medications and four counseling sessions without cost-sharing or prior authorization.
Justification
Tobacco addiction is one of the costliest and most easily avoidable public health problems, requiring Americans and their families to spend millions of dollars every year for the illnesses that are caused by smoking. Smoking cessation programs are currently covered by health insurance under Affordable Care Act (ACA) law, but the future of the ACA is uncertain. As the cost of cigarettes continues to rise, more New Yorkers will want to stop smoking. This legislation will ensure that New Yorkers who wish to quit smoking now and in the future will be able to afford to participate in a smoking cessation program. Making smoking cessation programs accessible will make it easier for people to stop smoking, improve public health, and reduce health care e4erls0 associ- ated with treating smoking-related illnesses.
Prior legislative history
2023-2024: S.137 died in the Insurance Committee
2021-2022: S.507 died in the Insurance Committee.
2019-2020: S.6022 died in the Insurance Committee.
2017-2018: S.4002 died in the Insurance Committee.
2015-2016: S.2884-A died in the Insurance Committee.
2013-2014: S.3132 died in the Insurance Committee; A.3778 died in the Insurance Committee.
2011-2012: S.1792-A died in the Rules Committee; A.2620-A died in the Insurance Committee.
Fiscal implications
It is expected that there will be no additional cost, as health insur- ance providers are already required to cover the cost of smoking cessa- tion programs.
Effective date
This act shall take effect on the 180th day after it shall become a law and shall apply to all policies and contracts issued, renewed, modified or amended after such date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.