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S04721 Summary:

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S04721 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         4721--A
            Cal. No. 1059
 
                               2015-2016 Regular Sessions
 
                    IN SENATE
 
                                     April 10, 2015
                                       ___________
 
        Introduced  by  Sens.  HANNON, LARKIN -- read twice and ordered printed,
          and when printed to  be  committed  to  the  Committee  on  Health  --
          reported  favorably  from  said  committee,  ordered  to first report,
          amended on first report,  ordered  to  a  second  report  and  ordered
          reprinted, retaining its place in the order of second report
 
        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.
    23    § 3. This act shall take effect immediately.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04038-03-5