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A00582 Summary:

BILL NOA00582
 
SAME ASSAME AS S02682
 
SPONSORMcDonald
 
COSPNSRSteck
 
MLTSPNSR
 
Amd §4902, Ins L; amd §4902, Pub Health L
 
Ensures that step therapy shall not apply to medically necessary prescription drugs in the dermatologic, hematology, ophthalmologic, rheumatic, gastrointestinal, neurology, and oncology therapeutic classes, including non-formulary drugs.
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A00582 Actions:

BILL NOA00582
 
01/09/2023referred to insurance
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A00582 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A582
 
SPONSOR: McDonald
  TITLE OF BILL: An act to amend the insurance law and the public health law, in relation to protecting certain therapeutic classes from step therapy   PURPOSE OR GENERAL IDEA OF BILL: The purpose of this bill is to prevent plans from implementing step therapy policies for certain progressive diseases.   SUMMARY OF PROVISIONS: Section one amends section 4902 of the insurance law to prohibit a utilization review agent from applying a step therapy protocol to medically necessary prescription drugs in dermatologic, hematology, ophthalmologic, rheumatic, gastrointestinal, neurology, and oncology therapeutic classes, including non-formulary drugs. Section two amends section 4902 of the public health law to reflect the same requirement as section one. Section three requires that this act shall take effect immediately.   JUSTIFICATION: Step therapy interferes with the prescriber-patient relationship and delays access to necessary care, which can negatively impact patients' health. This is especially true for those with progressive diseases who require timely access to their prescribed treatment to avoid advancing the condition and potentially causing irreversible harm.   PRIOR LEGISLATIVE HISTORY: 2021-2022: A.9250   FISCAL IMPLICATIONS: None   EFFECTIVE DATE: This act shall take effect immediately.
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A00582 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                           582
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                     January 9, 2023
                                       ___________
 
        Introduced  by M. of A. McDONALD, STECK -- read once and referred to the
          Committee on Insurance
 
        AN ACT to amend the insurance law and the public health law, in relation
          to protecting certain therapeutic classes from step therapy
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.    Subsection  (a) of section 4902 of the insurance law is
     2  amended by adding a new paragraph 14 to read as follows:
     3    (14) When establishing a step therapy protocol, a  utilization  review
     4  agent  shall  ensure  that  such  protocol  shall not apply to medically
     5  necessary prescription drugs in the dermatologic, hematology, ophthalmo-
     6  logic, rheumatic, gastrointestinal, neurology, and oncology  therapeutic
     7  classes, including non-formulary drugs.
     8    §  2. Section 4902 of the public health law is amended by adding a new
     9  subdivision 5 to read as follows:
    10    5. When establishing a step therapy  protocol,  a  utilization  review
    11  agent  shall  ensure  that  such  protocol  shall not apply to medically
    12  necessary prescription drugs in the dermatologic, hematology, ophthalmo-
    13  logic, rheumatic, gastrointestinal, neurology, and oncology  therapeutic
    14  classes, including non-formulary drugs.
    15    § 3. This act shall take effect immediately.
 
 
 
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02499-01-3
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