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.
STATE OF NEW YORK
________________________________________________________________________
2682
2023-2024 Regular Sessions
IN SENATE
January 24, 2023
___________
Introduced by Sen. BRESLIN -- read twice and ordered printed, and when
printed to be committed 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