A10461 Summary:
| BILL NO | A10461 |
| SAME AS | SAME AS S09842 |
| SPONSOR | Rules (Simone) |
| COSPNSR | |
| MLTSPNSR | |
| Amd §§3221 & 4303, Ins L | |
| Relates to copayments for pre-exposure or post-exposure prophylaxis as may be deemed appropriate by the superintendent. | |
A10461 Memo:
Go to topNEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
TITLE OF BILL: An act to amend the insurance law, in relation to copayments of pre-ex- posure or post-exposure prophylaxis PURPOSE OR GENERAL IDEA OF BILL: The purpose of this bill is to clarify under the insurance law that insurers cannot impose copayments on pre-exposure prophylaxis (PrEP) under certain circumstances. SUMMARY OF PROVISIONS: This bill would clarify that insurers cannot require copayments for PrEP so as long as it has in effect a rating of 'A' or `B' in the current recommendations of the United States Preventive Services Task Force. JUSTIFICATION: A copay is a fixed cost that an insurance policyholder pays for a specific service covered by their insurance. Coinsurance, on the other hand, is a percentage of the cost of a service. While these are two separate forms of cost-sharing, copayments are often considered to be a form of coinsurance under the insurance law. Currently, PrEP is not subject to annual deductibles and coinsurance because it has an 'A' rating with this USPSTF, however, the insurance law provides no explicit prohibition against the use of copayments. This bill would clarify that insurers may not impose copays on PrEP so as long as it has in effect a rating of `A' or 'B' in the current recommendations of the United States Preventive Services Task Force. PRIOR LEGISLATIVE HISTORY: New bill FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None.