STATE OF NEW YORK
________________________________________________________________________
6779--A
Cal. No. 422
2019-2020 Regular Sessions
IN SENATE
October 16, 2019
___________
Introduced by Sens. HOYLMAN, JACKSON, RIVERA -- read twice and ordered
printed, and when printed to be committed to the Committee on Rules --
recommitted to the Committee on Health in accordance with Senate Rule
6, sec. 8 -- reported favorably from said committee, ordered to first
and second report, ordered to a third reading, amended and ordered
reprinted, retaining its place in the order of third reading
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 11 to read as follows:
3 11. 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 (m) to read as follows:
10 (m) 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 (n) to read as follows:
17 (n) 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.
LBD08766-05-0
S. 6779--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.
