STATE OF NEW YORK
________________________________________________________________________
8135--B
2015-2016 Regular Sessions
IN ASSEMBLY
June 9, 2015
___________
Introduced by M. of A. CAHILL, SEAWRIGHT, ROSENTHAL, GALEF, GLICK,
JAFFEE, KAMINSKY, RUSSELL, SIMOTAS, SOLAGES, GOTTFRIED, LAVINE,
BARRON, BLAKE, BARRETT, MAGNARELLI -- Multi-Sponsored by -- M. of A.
ARROYO, BRAUNSTEIN, BRONSON, CLARK, COOK, DUPREY, FAHY, FARRELL, HOOP-
ER, LIFTON, LUPARDO, MAYER, McLAUGHLIN, MOSLEY, PEOPLES-STOKES, ROZIC,
SCHIMEL, SIMON, THIELE, TITUS -- (at request of the Department of Law)
-- read once and referred to the Committee on Insurance -- recommitted
to the Committee on Insurance in accordance with Assembly Rule 3, sec.
2 -- committee discharged, bill amended, ordered reprinted as amended
and recommitted to said committee -- again reported from said commit-
tee with amendments, ordered reprinted as amended and recommitted to
said committee
AN ACT to amend the insurance law, the social services law, the educa-
tion law and the public health law, in relation to requiring health
insurance policies to include coverage of all FDA-approved contracep-
tive drugs, devices, and products, as well as voluntary sterilization
procedures, contraceptive education and counseling, and related follow
up services and prohibiting a health insurance policy from imposing
any cost-sharing requirements or other restrictions or delays with
respect to this coverage
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. This act shall be known and may be cited as the "comprehen-
2 sive contraception coverage act".
3 § 2. Paragraph 16 of subsection (l) of section 3221 of the insurance
4 law, as added by chapter 554 of the laws of 2002, is amended to read as
5 follows:
6 (16) (A) Every group or blanket policy [which provides coverage for
7 prescription drugs shall include coverage for the cost of contraceptive
8 drugs or devices approved by the federal food and drug administration or
9 generic equivalents approved as substitutes by such food and drug admin-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10923-11-6
A. 8135--B 2
1 istration under the prescription of a health care provider legally
2 authorized to prescribe under title eight of the education law. The
3 coverage required by this section shall be included in policies and
4 certificates only through the addition of a rider.
5 (A)] that is issued, amended, renewed, effective or delivered on or
6 after January first, two thousand seventeen, shall provide coverage for
7 all of the following services and contraceptive methods:
8 (1) All FDA-approved contraceptive drugs, devices, and other products.
9 This includes all FDA-approved over-the-counter contraceptive drugs,
10 devices, and products as prescribed or as otherwise authorized under
11 state or federal law. The following applies to this coverage:
12 (a) where the FDA has approved one or more therapeutic and pharmaceu-
13 tical equivalent, as defined by the FDA, versions of a contraceptive
14 drug, device, or product, a group or blanket policy is not required to
15 include all such therapeutic and pharmaceutical equivalent versions in
16 its formulary, so long as at least one is included and covered without
17 cost-sharing and in accordance with this paragraph;
18 (b) if the covered therapeutic and pharmaceutical equivalent versions
19 of a drug, device, or product are not available or are deemed medically
20 inadvisable a group or blanket policy shall provide coverage for an
21 alternate therapeutic and pharmaceutical equivalent version of the
22 contraceptive drug, device, or product without cost-sharing;
23 (c) this coverage shall include emergency contraception without cost-
24 sharing when provided pursuant to an ordinary prescription, non-patient
25 specific regimen order, or order under section sixty-eight hundred thir-
26 ty-one of the education law and when lawfully provided other than
27 through a prescription or order; and
28 (d) this coverage must allow for the dispensing of twelve months worth
29 of a contraceptive at one time;
30 (2) Voluntary sterilization procedures;
31 (3) Patient education and counseling on contraception; and
32 (4) Follow-up services related to the drugs, devices, products, and
33 procedures covered under this paragraph, including, but not limited to,
34 management of side effects, counseling for continued adherence, and
35 device insertion and removal.
36 (B) A group or blanket policy subject to this paragraph shall not
37 impose a deductible, coinsurance, copayment, or any other cost-sharing
38 requirement on the coverage provided pursuant to this paragraph.
39 (C) Except as otherwise authorized under this paragraph, a group or
40 blanket policy shall not impose any restrictions or delays on the cover-
41 age required under this paragraph.
42 (D) Benefits for an enrollee under this paragraph shall be the same
43 for an enrollee's covered spouse or domestic partner and covered
44 nonspouse dependents.
45 (E) Notwithstanding any other provision of this subsection, a reli-
46 gious employer may request a contract without coverage for federal food
47 and drug administration approved contraceptive methods that are contrary
48 to the religious employer's religious tenets. If so requested, such
49 contract shall be provided without coverage for contraceptive methods.
50 This paragraph shall not be construed to deny an enrollee coverage of,
51 and timely access to, contraceptive methods.
52 (1) For purposes of this subsection, a "religious employer" is an
53 entity for which each of the following is true:
54 (a) The inculcation of religious values is the purpose of the entity.
55 (b) The entity primarily employs persons who share the religious
56 tenets of the entity.
A. 8135--B 3
1 (c) The entity serves primarily persons who share the religious tenets
2 of the entity.
3 (d) The entity is a nonprofit organization as described in Section
4 6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended.
5 (2) Every religious employer that invokes the exemption provided under
6 this paragraph shall provide written notice to prospective enrollees
7 prior to enrollment with the plan, listing the contraceptive health care
8 services the employer refuses to cover for religious reasons.
9 [(B) (i)] (F) (1) Where a group policyholder makes an election not to
10 purchase coverage for contraceptive drugs or devices in accordance with
11 subparagraph [(A)] (E) of this paragraph each certificateholder covered
12 under the policy issued to that group policyholder shall have the right
13 to directly purchase the rider required by this paragraph from the
14 insurer which issued the group policy at the prevailing small group
15 community rate for such rider whether or not the employee is part of a
16 small group.
17 [(ii)] (2) Where a group policyholder makes an election not to
18 purchase coverage for contraceptive drugs or devices in accordance with
19 subparagraph [(A)] (E) of this paragraph, the insurer that provides such
20 coverage shall provide written notice to certificateholders upon enroll-
21 ment with the insurer of their right to directly purchase a rider for
22 coverage for the cost of contraceptive drugs or devices. The notice
23 shall also advise the certificateholders of the additional premium for
24 such coverage.
25 [(C)] (G) Nothing in this paragraph shall be construed as authorizing
26 a group or blanket policy which provides coverage for prescription drugs
27 to exclude coverage for prescription drugs prescribed for reasons other
28 than contraceptive purposes.
29 [(D) Such coverage may be subject to reasonable annual deductibles and
30 coinsurance as may be deemed appropriate by the superintendent and as
31 are consistent with those established for other drugs or devices covered
32 under the policy.]
33 § 3. Subsection (cc) of section 4303 of the insurance law, as added by
34 chapter 554 of the laws of 2002, is amended to read as follows:
35 (cc) (1) Every contract [which provides coverage for prescription
36 drugs shall include coverage for the cost of contraceptive drugs or
37 devices approved by the federal food and drug administration or generic
38 equivalents approved as substitutes by such food and drug administration
39 under the prescription of a health care provider legally authorized to
40 prescribe under title eight of the education law. The coverage required
41 by this section shall be included in contracts and certificates only
42 through the addition of a rider.
43 (1)] that is issued, amended, renewed, effective or delivered on or
44 after January first, two thousand seventeen, shall provide coverage for
45 all of the following services and contraceptive methods:
46 (A) All FDA-approved contraceptive drugs, devices, and other products.
47 This includes all FDA-approved over-the-counter contraceptive drugs,
48 devices, and products as prescribed or as otherwise authorized under
49 state or federal law. The following applies to this coverage:
50 (i) where the FDA has approved one or more therapeutic and pharmaceu-
51 tical equivalent, as defined by the FDA, versions of a contraceptive
52 drug, device, or product, a contract is not required to include all such
53 therapeutic and pharmaceutical equivalent versions in its formulary, so
54 long as at least one is included and covered without cost-sharing and in
55 accordance with this subsection;
A. 8135--B 4
1 (ii) if the covered therapeutic and pharmaceutical equivalent versions
2 of a drug, device, or product are not available or are deemed medically
3 inadvisable a contract shall provide coverage for an alternate therapeu-
4 tic and pharmaceutical equivalent version of the contraceptive drug,
5 device, or product without cost-sharing;
6 (iii) this coverage shall include emergency contraception without
7 cost-sharing when provided pursuant to an ordinary prescription, non-pa-
8 tient specific regimen order, or order under section sixty-eight hundred
9 thirty-one of the education law and when lawfully provided other than
10 through a prescription or order; and
11 (iv) this coverage must allow for the dispensing of twelve months
12 worth of a contraceptive at one time;
13 (B) Voluntary sterilization procedures;
14 (C) Patient education and counseling on contraception; and
15 (D) Follow-up services related to the drugs, devices, products, and
16 procedures covered under this subsection, including, but not limited to,
17 management of side effects, counseling for continued adherence, and
18 device insertion and removal.
19 (2) A contract subject to this subsection shall not impose a deduct-
20 ible, coinsurance, copayment, or any other cost-sharing requirement on
21 the coverage provided pursuant to this subsection.
22 (3) Except as otherwise authorized under this subsection, a contract
23 shall not impose any restrictions or delays on the coverage required
24 under this subsection.
25 (4) Benefits for an enrollee under this subsection shall be the same
26 for an enrollee's covered spouse or domestic partner and covered
27 nonspouse dependents.
28 (5) Notwithstanding any other provision of this subsection, a reli-
29 gious employer may request a contract without coverage for federal food
30 and drug administration approved contraceptive methods that are contrary
31 to the religious employer's religious tenets. If so requested, such
32 contract shall be provided without coverage for contraceptive methods.
33 This paragraph shall not be construed to deny an enrollee coverage of,
34 and timely access to, contraceptive methods.
35 (A) For purposes of this subsection, a "religious employer" is an
36 entity for which each of the following is true:
37 (i) The inculcation of religious values is the purpose of the entity.
38 (ii) The entity primarily employs persons who share the religious
39 tenets of the entity.
40 (iii) The entity serves primarily persons who share the religious
41 tenets of the entity.
42 (iv) The entity is a nonprofit organization as described in Section
43 6033(a)(2)(A)i or iii, of the Internal Revenue Code of 1986, as amended.
44 (B) Every religious employer that invokes the exemption provided under
45 this paragraph shall provide written notice to prospective enrollees
46 prior to enrollment with the plan, listing the contraceptive health care
47 services the employer refuses to cover for religious reasons.
48 [(2)](6) (A) Where a group contractholder makes an election not to
49 purchase coverage for contraceptive drugs or devices in accordance with
50 paragraph [one] five of this subsection, each enrollee covered under the
51 contract issued to that group contractholder shall have the right to
52 directly purchase the rider required by this subsection from the insurer
53 or health maintenance organization which issued the group contract at
54 the prevailing small group community rate for such rider whether or not
55 the employee is part of a small group.
A. 8135--B 5
1 (B) Where a group contractholder makes an election not to purchase
2 coverage for contraceptive drugs or devices in accordance with paragraph
3 [one] five of this subsection, the insurer or health maintenance organ-
4 ization that provides such coverage shall provide written notice to
5 enrollees upon enrollment with the insurer or health maintenance organ-
6 ization of their right to directly purchase a rider for coverage for the
7 cost of contraceptive drugs or devices. The notice shall also advise the
8 enrollees of the additional premium for such coverage.
9 [(3)](7) Nothing in this subsection shall be construed as authorizing
10 a contract which provides coverage for prescription drugs to exclude
11 coverage for prescription drugs prescribed for reasons other than
12 contraceptive purposes.
13 [(4) Such coverage may be subject to reasonable annual deductibles and
14 coinsurance as may be deemed appropriate by the superintendent and as
15 are consistent with those established for other drugs or devices covered
16 under the policy.]
17 § 4. Subparagraph (E) of paragraph 17 of subsection (i) of section
18 3216 of the insurance law is amended by adding a new clause (v) to read
19 as follows:
20 (v) all FDA-approved contraceptive drugs, devices, and other products,
21 including all over-the-counter contraceptive drugs, devices, and
22 products as prescribed or as otherwise authorized under state or federal
23 law; voluntary sterilization procedures; patient education and coun-
24 seling on contraception; and follow-up services related to the drugs,
25 devices, products, and procedures covered under this clause, including,
26 but not limited to, management of side effects, counseling for continued
27 adherence, and device insertion and removal. Except as otherwise author-
28 ized under this clause, a contract shall not impose any restrictions or
29 delays on the coverage required under this clause. However, where the
30 FDA has approved one or more therapeutic and pharmaceutical equivalent,
31 as defined by the FDA, versions of a contraceptive drug, device, or
32 product, a contract is not required to include all such therapeutic and
33 pharmaceutical equivalent versions in its formulary, so long as at least
34 one is included and covered without cost-sharing and in accordance with
35 this clause. If the covered therapeutic and pharmaceutical equivalent
36 versions of a drug, device, or product are not available or are deemed
37 medically inadvisable a contract shall provide coverage for an alternate
38 therapeutic and pharmaceutical equivalent version of the contraceptive
39 drug, device, or product without cost-sharing. This coverage shall
40 include emergency contraception without cost-sharing when provided
41 pursuant to an ordinary prescription, non-patient specific regimen
42 order, or order under section sixty-eight hundred thirty-one of the
43 education law and when lawfully provided other than through a
44 prescription or order; and this coverage must allow for the dispensing
45 of twelve months worth of a contraceptive at one time.
46 § 5. Paragraph (d) of subdivision 3 of section 365-a of the social
47 services law, as amended by chapter 909 of the laws of 1974 and as
48 relettered by chapter 82 of the laws of 1995, is amended to read as
49 follows:
50 (d) family planning services and twelve months of supplies for eligi-
51 ble persons of childbearing age, including children under twenty-one
52 years of age who can be considered sexually active, who desire such
53 services and supplies, in accordance with the requirements of federal
54 law and regulations and the regulations of the department. No person
55 shall be compelled or coerced to accept such services or supplies.
A. 8135--B 6
1 § 6. Subdivision 6 of section 6527 of the education law, as added by
2 chapter 573 of the laws of 1999, paragraph (c) as added by chapter 221
3 of the laws of 2002, paragraph (d) as added by chapter 429 of the laws
4 of 2005, paragraph (e) as added by chapter 352 of the laws of 2014 and
5 paragraph (f) as added by section 6 of part V of chapter 57 of the laws
6 of 2015, is amended to read as follows:
7 6. A licensed physician may prescribe and order a non-patient specific
8 regimen [to a registered professional nurse], pursuant to regulations
9 promulgated by the commissioner, and consistent with the public health
10 law, [for] to:
11 (a) a registered professional nurse for:
12 (i) administering immunizations[.];
13 [(b)] (ii) the emergency treatment of anaphylaxis[.];
14 [(c)] (iii) administering purified protein derivative (PPD) tests[.];
15 [(d)] (iv) administering tests to determine the presence of the human
16 immunodeficiency virus[.];
17 [(e)] (v) administering tests to determine the presence of the hepati-
18 tis C virus[.];
19 [(f)] (vi) emergency contraception, to be administered to or dispensed
20 to be self-administered by the patient, under section sixty-eight
21 hundred thirty-two of this title; or
22 (vii) the urgent or emergency treatment of opioid related overdose or
23 suspected opioid related overdose.
24 (b) a licensed pharmacist, for dispensing emergency contraception, to
25 be self-administered by the patient, under section sixty-eight hundred
26 thirty-two of this title.
27 § 6-a. Paragraph (c) of subdivision 6 of section 6527 of the education
28 law, as amended by chapter 464 of the laws of 2015, is amended to read
29 as follows:
30 [(c)](iii) administering purified protein derivative (PPD) tests or
31 other tests to detect or screen for tuberculosis infections[.];
32 § 7. Subdivision 3 of section 6807 of the education law, as added by
33 chapter 573 of the laws of 1999, is amended and a new subdivision 4 is
34 added to read as follows:
35 3. A pharmacist may dispense drugs and devices to a registered profes-
36 sional nurse, and a registered professional nurse may possess and admin-
37 ister, drugs and devices, pursuant to a non-patient specific regimen
38 prescribed or ordered by a licensed physician, licensed midwife or
39 certified nurse practitioner, pursuant to regulations promulgated by the
40 commissioner and the public health law.
41 4. A pharmacist may dispense a non-patient specific regimen of emer-
42 gency contraception, to be self-administered by the patient, prescribed
43 or ordered by a licensed physician, certified nurse practitioner, or
44 licensed midwife, under section sixty-eight hundred thirty-two of this
45 article.
46 § 8. The education law is amended by adding a new section 6832 to read
47 as follows:
48 § 6832. Emergency contraception; non-patient specific prescription or
49 order. 1. As used in this section, the following terms shall have the
50 following meanings, unless the context requires otherwise:
51 (a) "Emergency contraception" means one or more prescription or
52 nonprescription drugs, used separately or in combination, in a dosage
53 and manner for preventing pregnancy when used after intercourse, found
54 safe and effective for that use by the United States food and drug
55 administration, and dispensed or administered for that purpose.
A. 8135--B 7
1 (b) "Prescriber" means a licensed physician, certified nurse practi-
2 tioner or licensed midwife.
3 2. This section applies to the administering or dispensing of emergen-
4 cy contraception by a registered professional nurse or the dispensing of
5 emergency contraception by a licensed pharmacist pursuant to a
6 prescription or order for a non-patient specific regimen made by a pres-
7 criber under section sixty-five hundred twenty-seven, sixty-nine hundred
8 nine or sixty-nine hundred fifty-one of this title. This section does
9 not apply to administering or dispensing emergency contraception when
10 lawfully done without such a prescription or order.
11 3. The administering or dispensing of emergency contraception by a
12 registered professional nurse or the dispensing of emergency contracep-
13 tion by a licensed pharmacist shall be done in accordance with profes-
14 sional standards of practice and in accordance with written procedures
15 and protocols agreed to by the registered professional nurse or licensed
16 pharmacist and the prescriber or a hospital (licensed under article
17 twenty-eight of the public health law) that provides gynecological or
18 family planning services.
19 4. (a) When emergency contraception is administered or dispensed, the
20 registered professional nurse or licensed pharmacist shall provide to
21 the patient written material that includes: (i) the clinical consider-
22 ations and recommendations for use of the drug; (ii) the appropriate
23 method for using the drug; (iii) information on the importance of
24 follow-up health care; (iv) information on the health risks and other
25 dangers of unprotected intercourse; and (v) referral information relat-
26 ing to health care and services relating to sexual abuse and domestic
27 violence.
28 (b) Such written material shall be developed or approved by the
29 commissioner in consultation with the department of health and the Amer-
30 ican college of obstetricians and gynecologists.
31 § 9. Subdivision 4 of section 6909 of the education law, as added by
32 chapter 573 of the laws of 1999, paragraph (a) as amended and paragraph
33 (c) as added by chapter 221 of the laws of 2002, paragraph (d) as added
34 by chapter 429 of the laws of 2005, paragraph (e) as added by chapter
35 352 of the laws of 2014 and paragraph (f) as added by section 5 of part
36 V of chapter 57 of the laws of 2015, is amended to read as follows:
37 4. A certified nurse practitioner may prescribe and order a non-pa-
38 tient specific regimen [to a registered professional nurse], pursuant to
39 regulations promulgated by the commissioner, consistent with subdivision
40 three of section [six thousand nine] sixty-nine hundred two of this
41 article, and consistent with the public health law, for:
42 (a) a registered professional nurse for:
43 (i) administering immunizations[.];
44 [(b)] (ii) the emergency treatment of anaphylaxis[.];
45 [(c)] (iii) administering purified protein derivative (PPD) tests[.];
46 [(d)] (iv) administering tests to determine the presence of the human
47 immunodeficiency virus[.];
48 [(e)] (v) administering tests to determine the presence of the hepati-
49 tis C virus[.];
50 [(f)] (vi) emergency contraception, to be administered to or dispensed
51 to be self-administered by the patient, under section sixty-eight
52 hundred thirty-two of this title; or
53 (vii) the urgent or emergency treatment of opioid related overdose or
54 suspected opioid related overdose.
A. 8135--B 8
1 (b) a licensed pharmacist, for dispensing emergency contraception, to
2 be self-administered by the patient, under section sixty-eight hundred
3 thirty-two of this title.
4 § 9-a. Paragraph (c) of subdivision 4 of section 6909 of the education
5 law, as amended by chapter 464 of the laws of 2015, is amended to read
6 as follows:
7 [(c)](iii) administering purified protein derivative (PPD) tests or
8 other tests to detect or screen for tuberculosis infections[.];
9 § 10. Subdivision 5 of section 6909 of the education law, as added by
10 chapter 573 of the laws of 1999, is amended to read as follows:
11 5. A registered professional nurse may execute a non-patient specific
12 regimen prescribed or ordered by a licensed physician, licensed midwife
13 or certified nurse practitioner, pursuant to regulations promulgated by
14 the commissioner.
15 § 11. Section 6951 of the education law is amended by adding a new
16 subdivision 4 to read as follows:
17 4. A licensed midwife may prescribe and order a non-patient specific
18 regimen pursuant to regulations promulgated by the commissioner,
19 consistent with this section and the public health law, to:
20 (a) a registered professional nurse for emergency contraception, to be
21 administered to or dispensed to be self-administered by the patient,
22 under section sixty-eight hundred thirty-two of this title; or
23 (b) a licensed pharmacist, for dispensing emergency contraception, to
24 be self-administered by the patient, under section sixty-eight hundred
25 thirty-two of this title.
26 § 12. Subdivision 1 of section 207 of the public health law is amended
27 by adding a new paragraph (m) to read as follows:
28 (m) Emergency contraception, including information about its safety,
29 efficacy, appropriate use and availability.
30 § 13. This act shall take effect January 1, 2017; provided that
31 section six of this act shall take effect January 1, 2018; provided,
32 however, that if chapter 464 of the laws of 2015 shall not have taken
33 effect on or before such date then the amendments to paragraph (c) of
34 subdivision 6 of section 6527 of the education law made by section six-a
35 of this act shall take effect on the same date and in the same manner as
36 chapter 464 of the laws of 2015, takes effect; provided, further, that
37 if chapter 464 of the laws of 2015 shall not have taken effect on or
38 before such date then the amendments to paragraph (c) of subdivision 4
39 of section 6909 of the education law made by section nine-a of this act
40 shall take effect on the same date and in the same manner as chapter 464
41 of the laws of 2015, takes effect; and provided, further, that effective
42 immediately, the addition, amendment and/or repeal of any rule or regu-
43 lation necessary for the implementation of this act on its effective
44 date is authorized and directed to be made and completed by the commis-
45 sioner of education and the board of regents on or before such effective
46 date.
