STATE OF NEW YORK
________________________________________________________________________
3227--A
2023-2024 Regular Sessions
IN SENATE
January 30, 2023
___________
Introduced by Sens. HOYLMAN-SIGAL, JACKSON, MYRIE, RIVERA, SALAZAR --
read twice and ordered printed, and when printed to be committed to
the Committee on Health -- recommitted to the Committee on Health in
accordance with Senate Rule 6, sec. 8 -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee
AN ACT to amend the public health law and the insurance law, in relation
to prohibiting health insurers from requiring prior authorization for
pre-exposure prophylaxis used to prevent HIV infection
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 4406-c of the public health law is amended by
2 adding a new subdivision 14 to read as follows:
3 14. A health care plan which provides prescription drug coverage shall
4 not require a prior authorization determination for pre-exposure prophy-
5 laxis used to prevent HIV infection. Nothing in this subdivision shall
6 prohibit a health care plan from denying a claim for such services if
7 the services are subsequently determined not medically necessary.
8 § 2. Section 3217-b of the insurance law is amended by adding a new
9 subsection (p) to read as follows:
10 (p) An insurer which provides prescription drug coverage shall not
11 require a prior authorization determination for pre-exposure prophylaxis
12 used to prevent HIV infection. Nothing in this subsection shall prohibit
13 an insurer from denying a claim for such services if the services are
14 subsequently determined not medically necessary.
15 § 3. Section 4325 of the insurance law is amended by adding a new
16 subsection (p) to read as follows:
17 (p) A corporation organized under this article which provides
18 prescription drug coverage shall not require a prior authorization
19 determination for pre-exposure prophylaxis used to prevent HIV
20 infection. Nothing in this subsection shall prohibit a corporation
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07908-02-4
S. 3227--A 2
1 organized under this article from denying a claim for such services if
2 the services are subsequently determined not medically necessary.
3 § 4. This act shall take effect on the one hundred eightieth day after
4 it shall have become a law.
