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A06983 Summary:

BILL NOA06983A
 
SAME ASSAME AS S04721-A
 
SPONSORMcDonald
 
COSPNSR
 
MLTSPNSR
 
Amd S4903, Pub Health L; amd S4903, Ins L
 
Directs the commissioner of health and superintendent of financial services to establish a standard prior authorization request for a utilization review of prescription drug coverage.
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A06983 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         6983--A
                                                                Cal. No. 333
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                     April 16, 2015
                                       ___________
 
        Introduced by M. of A. McDONALD -- read once and referred to the Commit-
          tee on Health -- reported from committee, advanced to a third reading,
          amended  and  ordered  reprinted,  retaining its place on the order of
          third reading
 
        AN ACT to amend the public health law and the insurance law, in relation
          to standards for prior authorization requests for a utilization review
          of prescription drug coverage
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. Section 4903 of the public health law is amended by adding
     2  a new subdivision 8 to read as follows:
     3    8. The commissioner, in conjunction with the superintendent of  finan-
     4  cial  services, shall develop standards for prior authorization requests
     5  to be utilized by all health care plans for the purposes of submitting a
     6  request  for  a  utilization  review  determination  for   coverage   of
     7  prescription  drug  benefits under this article.  The department and the
     8  department of financial services, in development of the standards, shall
     9  take into consideration existing electronic prior  authorization  stand-
    10  ards  including  National Council for Prescription Drug Programs (NCPDP)
    11  electronic prior authorization standard transactions.
    12    § 2. Section 4903 of the insurance law is  amended  by  adding  a  new
    13  subsection (h) to read as follows:
    14    (h)  The  superintendent,  in  conjunction  with  the  commissioner of
    15  health, shall develop standards for prior authorization requests  to  be
    16  utilized  by  all  health  care  plans  for the purposes of submitting a
    17  request  for  a  utilization  review  determination  for   coverage   of
    18  prescription  drug  benefits under this article.  The department and the
    19  department of health, in development of the standards, shall  take  into
    20  consideration  existing electronic prior authorization standards includ-
    21  ing National Council for Prescription Drug Programs  (NCPDP)  electronic
    22  prior authorization standard transactions.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04038-02-5

        A. 6983--A                          2
 
     1    § 3. This act shall take effect immediately.
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