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S06962 Summary:

Add 3216-a, Ins L
Provides for patient access to FDA approved abuse-deterrent technology to help combat opioid abuse.
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S06962 Text:

                STATE OF NEW YORK
                    IN SENATE
                                     March 10, 2016
        Introduced  by  Sens.  HANNON,  AKSHAR,  AMEDORE,  BOYLE, CROCI, GOLDEN,
          LARKIN, LATIMER, MARTINS, MURPHY,  ORTT  --  read  twice  and  ordered
          printed,  and  when printed to be committed to the Committee on Health
          -- committee discharged, bill amended, ordered  reprinted  as  amended
          and recommitted to said committee
        AN  ACT to amend the insurance law, in relation to the use of abuse-det-
          errent technology for opioids as a mechanism for  reducing  abuse  and
          diversion of opioid drugs
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. The insurance law is amended by adding a new section 3216-a
     2  to read as follows:
     3    § 3216-a.  Access to abuse-deterrent opioid medications. (a) An insur-
     4  ance carrier or health plan shall provide  coverage  on  its  formulary,
     5  drug  list  or  other lists of similar construct for at least one abuse-
     6  deterrent opioid analgesic drug  product  per  opioid  analgesic  active
     7  ingredient.
     8    (1)  Cost-sharing for brand name abuse-deterrent opioid analgesic drug
     9  products covered pursuant to this section shall not  exceed  the  lowest
    10  cost-sharing  level  applied  to  brand  name non-abuse deterrent opioid
    11  drugs covered under the applicable health plan or policy.
    12    (2) Cost-sharing for generic  abuse-deterrent  opioid  analgesic  drug
    13  products  covered  pursuant  to this section shall not exceed the lowest
    14  cost-sharing level applied to generic non-abuse deterrent  opioid  drugs
    15  covered under the applicable health plan or policy.
    16    (3)  An increase in patient cost-sharing or disincentives for prescri-
    17  bers or dispensers shall not be allowed to achieve compliance with  this
    18  section.
    19    (b)  Any  prior-authorization requirements or other utilization review
    20  measures for opioid analgesics, and any service  denials  made  pursuant
    21  thereto, shall not require use of opioid analgesic drug products without
    22  abuse-deterrent  properties  in  order  to access abuse-deterrent opioid
    23  analgesic drug products.
    24    (c) Definitions. As used in this section:
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        S. 6962--A                          2
     1    (1) "Opioid analgesic drug product" means a drug in the  opioid  anal-
     2  gesic  drug  class  prescribed to treat moderate to severe pain or other
     3  conditions, whether in immediate release or extended long acting release
     4  form and whether or not combined with other drug substances  to  form  a
     5  single drug product or other dosage form.
     6    (2)  "Abuse  deterrent opioid analgesic drug product" means a brand or
     7  generic opioid analgesic drug product approved by the federal  food  and
     8  drug administration with abuse-deterrence labeling claims indicating its
     9  abuse-deterrent properties are expected to deter or reduce its abuse.
    10    (3)  "Cost-sharing"  means any coverage limit, copayment, coinsurance,
    11  deductible or other out-of-pocket patient expense requirements.
    12    § 2. This act shall take effect on the one hundred twentieth day after
    13  it shall have become  a  law,  and  shall  apply  to  all  policies  and
    14  contracts issued, renewed, modified, altered or amended on or after such
    15  date.
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