New York State Assembly

 
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A02904 Summary:

A02904 Actions:

A02904 Committee Votes:

Committee:INSURANCE   Chair:Cahill      
DATE:03/12/2019AYE/NAY:23/0  Action: Favorable refer to committee Codes        
Cahill
Aye
Garbarino
Aye
Cook
Aye
Hawley
Aye
Pretlow
Aye
Blankenbush
Aye
Rivera
Aye
Finch
Excused
Cymbrowitz
Aye
Raia
Aye
Lavine
Aye
Palmesano
Aye
Steck
Aye
Byrne
Aye
Dilan
Aye
Hunter
Aye
Simotas
Aye
Walker
Aye
Niou
Aye
Rosenthal
Aye
Stern
Aye
McDonald
Aye
Romeo
Aye
Jacobson
Aye

Committee:CODES   Chair:Lentol      
DATE:03/18/2019AYE/NAY:21/0  Action: Favorable         
Lentol
Aye
Ra
Aye
Schimminger
Aye
Giglio
Aye
Pretlow
Aye
Montesano
Aye
Cook
Aye
Morinello
Aye
Cymbrowitz
Aye
Palumbo
Aye
O'Donnell
Absent
Garbarino
Aye
Lavine
Aye
Perry
Aye
Zebrowski
Aye
Abinanti
Aye
Weprin
Aye
Mosley
Aye
Hevesi
Aye
Fahy
Aye
Seawright
Aye
Rosenthal
Aye

A02904 Floor Votes:

A02904 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A2904
 
SPONSOR: Quart

 
TITLE OF BILL:
 
An act to amend the insurance law, in relation to prohibiting certain
insurance policies from requiring prior authorization for certain medi-
cations used in the treatment of substance use disorders; and to repeal
certain provisions of such law relating thereto
 
 
PURPOSE OR GENERAL IDEA OF BILL:
 
To ensure uniformity across all health insurance plan policies regarding
reasonable patient access to medication assisted treatment for substance
abuse disorders
 
 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 repeals subdivision 31-a of section 3216 of the insurance law
and replaces it with a new subdivision to require health insurers to
provide patient access, without prior authorization requirements, for
initial and renewal prescriptions for buprenorphine and long-acting
injectable naltrexone for the treatment of substance abuse disorders.
 
Section 2 repeals paragraphs 7-a and 7-b of subsection (1) of section
3221 of the insurance law and adds a new paragraph 7-a to require health
insurers to provide patient access, without prior authorization require-
ments, for initial and renewal prescriptions for buprenorphine and long-
acting injectable naltrexone for the treatment of substance abuse disor-
ders.
 
Section 3 repeals subsections (1-1) and (1-2) of section 4303 of the
insurance law and adds a new subsection (1-1) to require health insurers
to provide patient access, without prior authorization requirements, for
initial and renewal prescriptions for buprenorphine and long-acting
injectable naltrexone for the treatment of substance abuse disorders.
 
Section 4 provides that this act will take effect on the 60th day after
enactment.
 
 
JUSTIFICATION:
 
New York is experiencing an unprecedented heroin and opioid epidemic
that is ravaging communities across the state. According to the New York
State Comptroller's Office, New York has experienced an increase in
death rates due to opioid and heroin addiction that outpaces almost any
other state where data is available.
 
This bill builds upon measures enacted in 2016 to improve access to
health insurance coverage for substance abuse treatment, including medi-
cation assisted treatment. In 2016, prior authorization requirements
were removed for buprenorphine and long- acting injectable naltrexone in
the Medicaid program. The purpose of this bill is to establish parity
for all consumers by ensuring that addicted persons with commercial
insurance coverage can access medication assisted treatment as
prescribed by their health care providers without unnecessary barriers.
 
 
PRIOR LEGISLATIVE HISTORY:
 
2017-2018: A7979 passed Assembly
 
 
FISCAL IMPLICATIONS:
 
None
 
 
EFFECTIVE DATE:
Sixty days after enactment

A02904 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2904
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 28, 2019
                                       ___________
 
        Introduced  by M. of A. QUART -- read once and referred to the Committee
          on Insurance
 
        AN ACT to amend the insurance law, in relation  to  prohibiting  certain
          insurance  policies  from  requiring  prior  authorization for certain
          medications used in the treatment of substance use disorders;  and  to
          repeal certain provisions of such law relating thereto
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph 31-a of subsection (i) of  section  3216  of  the
     2  insurance  law  is REPEALED and a new paragraph 31-a is added to read as
     3  follows:
     4    (31-a) (A) No policy that provides medical, major medical  or  similar
     5  comprehensive-type coverage and provides coverage for prescription drugs
     6  for  medication  for  the  treatment  of  a substance use disorder shall
     7  require prior authorization for an initial or renewal  prescription  for
     8  all buprenorphine products, methadone or long acting injectable naltrex-
     9  one  for  detoxification  or  maintenance  treatment  of a substance use
    10  disorder except where otherwise prohibited by law.
    11    (B) Coverage provided under this paragraph may be  subject  to  copay-
    12  ments,  coinsurance,  and  annual  deductibles  that are consistent with
    13  those imposed on other benefits within the policy.
    14    § 2. Paragraphs 7-a and 7-b of subsection (l) of section 3221  of  the
    15  insurance  law  are REPEALED and a new paragraph 7-a is added to read as
    16  follows:
    17    (7-a) (A) Every policy that provides medical, major medical or similar
    18  comprehensive-type large group coverage shall provide immediate coverage
    19  for all buprenorphine products,  methadone  or  long  acting  injectable
    20  naltrexone without prior authorization for the detoxification or mainte-
    21  nance treatment of a substance use disorder.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01428-01-9
        A. 2904                             2
 
     1    (B)  Coverage  provided  under this paragraph may be subject to copay-
     2  ments, coinsurance, and annual  deductibles  that  are  consistent  with
     3  those imposed on other benefits within the policy.
     4    §  3. Subsections (l-1) and (l-2) of section 4303 of the insurance law
     5  are REPEALED and a new subsection (l-1) is added to read as follows:
     6    (l-1) (A) Every contract that  provides  medical,  major  medical,  or
     7  similar  comprehensive-type large group coverage shall provide immediate
     8  coverage for  all  buprenorphine  products,  methadone  or  long  acting
     9  injectable naltrexone without prior authorization for the detoxification
    10  or maintenance treatment of a substance use disorder.
    11    (B)  Coverage  provided  under this paragraph may be subject to copay-
    12  ments, coinsurance, and annual  deductibles  that  are  consistent  with
    13  those imposed on other benefits within the policy.
    14    §  4.  This  act  shall take effect on the sixtieth day after it shall
    15  have become a law.

A02904 LFIN:

 
NO LFIN

A02904 Chamber Video/Transcript: