Prohibits certain insurance policies from requiring prior authorization for buprenorphine products, methadone and long acting injectable naltrexone for detoxification or maintenance treatment of substance use disorders.
STATE OF NEW YORK
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4808
2019-2020 Regular Sessions
IN SENATE
March 26, 2019
___________
Introduced by Sen. HARCKHAM -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to prohibiting certain
insurance policies from requiring prior authorization for certain
medications used in the treatment of substance use disorders; and to
repeal certain provisions of such law relating thereto
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph 31-a of subsection (i) of section 3216 of the
2 insurance law is REPEALED and a new paragraph 31-a is added to read as
3 follows:
4 (31-a) (A) No policy that provides medical, major medical or similar
5 comprehensive-type coverage and provides coverage for prescription drugs
6 for medication for the treatment of a substance use disorder shall
7 require prior authorization for an initial or renewal prescription for
8 all buprenorphine products, methadone or long acting injectable naltrex-
9 one for detoxification or maintenance treatment of a substance use
10 disorder except where otherwise prohibited by law.
11 (B) Coverage provided under this paragraph may be subject to copay-
12 ments, coinsurance, and annual deductibles that are consistent with
13 those imposed on other benefits within the policy.
14 § 2. Paragraphs 7-a and 7-b of subsection (l) of section 3221 of the
15 insurance law are REPEALED and a new paragraph 7-a is added to read as
16 follows:
17 (7-a) (A) Every policy that provides medical, major medical or similar
18 comprehensive-type large group coverage shall provide immediate coverage
19 for all buprenorphine products, methadone or long acting injectable
20 naltrexone without prior authorization for the detoxification or mainte-
21 nance treatment of a substance use disorder.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01428-01-9
S. 4808 2
1 (B) Coverage provided under this paragraph may be subject to copay-
2 ments, coinsurance, and annual deductibles that are consistent with
3 those imposed on other benefits within the policy.
4 § 3. Subsections (l-1) and (l-2) of section 4303 of the insurance law
5 are REPEALED and a new subsection (l-1) is added to read as follows:
6 (l-1) (A) Every contract that provides medical, major medical, or
7 similar comprehensive-type large group coverage shall provide immediate
8 coverage for all buprenorphine products, methadone or long acting
9 injectable naltrexone without prior authorization for the detoxification
10 or maintenance treatment of a substance use disorder.
11 (B) Coverage provided under this paragraph may be subject to copay-
12 ments, coinsurance, and annual deductibles that are consistent with
13 those imposed on other benefits within the policy.
14 § 4. This act shall take effect on the sixtieth day after it shall
15 have become a law.
