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A01378 Summary:

BILL NOA01378
 
SAME ASSAME AS S03668
 
SPONSORCahill (MS)
 
COSPNSRSeawright, Rosenthal L, Glick, Jenne, Jaffee, Simotas, Gottfried, Barron, Blake, Barrett, Magnarelli, Bronson, Lavine, Mayer, Carroll, Galef, Otis, Sepulveda, Simon, Hyndman, Morelle, Ramos, D'Urso, Peoples-Stokes, Pichardo, Ortiz, Pellegrino, Woerner
 
MLTSPNSRBraunstein, Buchwald, Cook, Epstein, Hooper, Lifton, Lupardo, Mosley, Rozic, Thiele, Titus
 
Amd §§3221, 4303 & 3216, Ins L; amd §365-a, Soc Serv L; amd §§6527, 6807, 6909 & 6951, add §6832, Ed L; amd §207, Pub Health L
 
Enacts the "comprehensive contraception coverage act" to provide insurance coverage for FDA-approved contraceptive drugs, devices and products.
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A01378 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A1378
 
SPONSOR: Cahill (MS)
  TITLE OF BILL: An act to amend the insurance law, the social services law, the education law and the public health law, in relation to requir- ing health insurance policies to include coverage of all FDA-approved contraceptive drugs, devices, and products, as well as voluntary steri- lization procedures, contraceptive education and counseling, and related follow up services and prohibiting a health insurance policy from impos- ing any cost-sharing requirements or other restrictions or delays with respect to this coverage   PURPOSE: This legislation will help to reduce the number of unintended pregnan- cies, improve birth outcomes and improve the health and welfare of New Yorkers by ensuring that individuals have timely access to contraception and the information they need in order to plan their families and their future.   SUMMARY OF SPECIFIC PROVISIONS: Section 1. Provides that the act shall be known and may be cited as the Comprehensive Contraception Coverage Act. Section 2. Amends paragraph 16 of subsection (1) of section 3221 of the insurance law to require commercial group health insurance policies to cover all FDA-approved contraceptive drugs, devices and products when prescribed by a health care provider. When the FDA has approved one or more therapeutic and pharmaceutical equivalent versions of a contraceptive drug, device or product, coverage is not required for equivalent versions of the contraceptive drug unless the equivalent is not available or is medically inadvisable. Coverage shall: (i) include emergency contraception when prescribed through a prescription or a non-patient specific order; (ii) allow for dispensing of up to twelve months of contraception; (iii) include voluntary steri- lization procedures for women and men; (iv) include patient education and counseling about contraception; and (v) include any follow-up care related to the covered contraceptives including management of side-ef- fects, counseling and device insertion and removal. An insurer may not apply co-pays or deductibles when coverage for a contraceptive method is required. In addition, no restrictions, or delays in coverage can be applied when coverage for a contraceptive method is required. Coverage for an enrollee's covered spouse, domestic partner and covered dependents shall be the same as for the enrollee. "Conscience protections" in existing law remain untouched. Specif- ically; the bill does not amend existing law which allows a religious employer to request an insurance policy without coverage for FDA-ap- proved contraceptive methods that are contrary to the religious employ- er's religious tenets. Sections 3 and 4. Makes similar changes outlined in Section 2 to subsection (cc) of Section 4303 of the insurance law relating to nonpro- fit medical indemnity, or health and hospital service corporations and subparagraph (E) of paragraph 17 of subsection (i) of section 3216 of the insurance law relating to individual health insurance policies. Section 5. Amends paragraph (d) of subdivision 3 of section 365-a of the social services law to expand the definition of "medical services" to include 12 months of contraceptive supplies for eligible persons. Section 6. Amends subdivision six of section 6527 of the education law to authorize a registered professional nurse to administer or dispense emergency contraception to a patient and authorizes a pharmacist to dispense emergency contraception to be self-administered by the patient. Section 7. Amends subdivision 3 of section 6807 of the education law to add a licensed midwife to the list of practitioners who may prescribe or order a non-patient specific regimen. Also, adds a new subdivision to the education law providing that a licensed pharmacist may dispense a non-patient specific regimen of emergency contraception, to be self-ad- ministered by the patient, which was prescribed or ordered by a licensed physician, certified nurse practitioner, or licensed midwife. Section 8. Adds a new section 6832 to the education law to: (i) define the terms "emergency contraception" and "prescriber"; (ii) provide that this section does not apply to administering or dispensing emergency contraception when lawfully done without a prescription or non-patient specific regimen; (iii) require that the administering or dispensing of emergency contraception by a registered professional nurse or licensed pharmacist be done in accordance with professional standards of practice and in accordance with written procedures and protocols; and (iv) outline the contents of written material that must be provided to the patient when emergency contraception is administered or dispensed. Such written material shall be developed or approved by the commissioner in consultation with the Department of Health (DOH) and the American College of Obstetricians and Gynecologists (AGOG). Section 9. Amends subdivision 4 of Section 6909 of the education law to authorize a registered professional nurse to administer or dispense emergency contraception to a patient and a pharmacist to dispense emer- gency contraception to be self-administered by the patient. Section 10. Amends subdivision five of section 6909 of the education law by adding a licensed midwife to those practitioners who may prescribe and order a non-patient specific regimen of emergency contraception. Section 11. Adds a new subdivision 4 to section 6951 of the education law to authorize a licensed midwife to prescribe and order a non-patient specific regimen of emergency contraception to be administered or dispensed by a registered professional nurse or dispensed by a licensed pharmacist. Sections 10, 11, and 12. Amends three sections of the insurance law to mandate that under these sections any insurance policy that covers emer- gency contraception shall also cover emergency contraception when provided by a non-patient-specific prescription. Section 12. Adds a new paragraph (1) to subdivision one of section 207 of the public health law to broaden the NYS Department of Health's education and outreach program to include information on emergency contraception and its safety, efficacy, appropriate use and availabili- ty. Section 13. Provides that this act shall take effect on January 1, 2017, provided however that section six shall take effect on January 1, 2018.   JUSTIFICATION: Access to contraceptive services is essential to women's health and equality. New York has long recognized the central role that contracep- tion plays in women's health and lives and has led efforts to expand access to contraception. All New Yorkers, regardless of economic status, should have timely access to contraception and the information they need in order to protect their health, plan their families and their future. Time and time again, studies show that contraceptive access reduces rates of unintended pregnancy, plays a crucial role in improving public health outcomes, as well as improving the economic well-being of women and their families. * However, despite legal reform on the State and Federal level, lack of contraceptive insurance coverage and high co-pay- ments remain significant barriers to contraceptive access. The Contraceptive Equity Act would amend state insurance and social service laws to require health insurance policies to include coverage of all Food and Drug Administration (FDA)-approved contraceptive drugs, devices, and products, as well as voluntary sterilization procedures, contraceptive education and counseling, and related follow up services.** It would also prohibit a health insurance policy from impos- ing any cost-sharing requirements or other restriction or delays with respect to this coverage. In 2002, the New York State Legislature passed the Women's Health and Wellness Act, an important first step toward contraceptive equity that required insurance plans that cover prescriptions to include contracep- tion. Eight years later, the U.S. Congress passed the Affordable Care Act (ACA), which includes a contraceptive coverage guarantee as part of a broader requirement for health insurance plans to cover contraceptive services without cost-sharing for all women in the Health Insurance Marketplace. The contraceptive equity policy is one of the landmark achievements of the ACA, but a lack of clarity in the federal law has led to inconsist- ent implementation and enforcement. Insurers can take advantage of this confusion to limit coverage for the diverse array of contraceptive meth- ods available and, in some cases, can prevent individuals from accessing the method deemed most effective by their medical provider: Addi- tionally, many insurance companies do not typically cover male methods of contraception or require high cost-sharing despite the critical role men play in the prevention of unintended pregnancy. Building on existing state and federal law to promote gender equity and women's health, this Act would ensure broad contraceptive coverage and timely access to all federal FDA-approved methods of contraception for individuals covered under health insurance plans in New York.   PRIOR LEGISLATIVE HISTORY: 2015: A.8135-B of 2015-2016 (Cahill) Passed Assembly S.6013-A of 2015-2016 (Bonacic) Referred to Insurance   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None.   EFFECTIVE DATE: This act shall take effect on January 1, 2017. However, section five shall take effect on January 1, 2018. *Sonfield, Adam. "What Women Already Know: Documenting the Social and Economic Benefits of Family Planning." Guttmacher Institute. Winter 2013. http://www.guttmacher.org/pubs/gpr/16/1/gpr160108.html **For a full list of these devices, see the FDA Office of Women's Health's Birth Control Guide http://Wwm.fda.gov/downloads/ForConsumers/ByAudience/ ForWomen/FreePublications/UCM356451.pdf
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