Bill Text: NY A00579 | 2017-2018 | General Assembly | Introduced
Bill Title: Relates to allowing individuals to obtain a twelve month supply of contraceptive at one time, with a three month supply of a contraceptive for the initial dispensing of the contraceptive and a twelve month supply of the same contraceptive for all subsequent dispensings.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2018-01-03 - referred to insurance [A00579 Detail]
Download: New_York-2017-A00579-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 579 2017-2018 Regular Sessions IN ASSEMBLY January 9, 2017 ___________ Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law and the social services law, in relation to allowing individuals to obtain a twelve month supply of contraception at one time The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The opening paragraph of paragraph 16 of subsection (l) of 2 section 3221 of the insurance law, as added by chapter 554 of the laws 3 of 2002, is amended to read as follows: 4 Every group or blanket policy which provides coverage for prescription 5 drugs shall include coverage for the cost of contraceptive drugs or 6 devices approved by the federal food and drug administration or generic 7 equivalents approved as substitutes by such food and drug administration 8 under the prescription of a health care provider legally authorized to 9 prescribe under title eight of the education law. This coverage shall 10 allow for a three month supply of a contraceptive for the initial 11 dispensing of the contraceptive and a twelve month supply of the same 12 contraceptive for all subsequent dispensings to the certificate holder 13 regardless of whether such certificate holder was enrolled in the policy 14 at the time of the initial dispensing. The coverage required by this 15 section shall be included in policies and certificates only through the 16 addition of a rider. 17 § 2. Subsection (cc) of section 4303 of the insurance law, as added by 18 chapter 554 of the laws of 2002, is amended to read as follows: 19 (cc) Every contract which provides coverage for prescription drugs 20 shall include coverage for the cost of contraceptive drugs or devices 21 approved by the federal food and drug administration or generic equiv- 22 alents approved as substitutes by such food and drug administration 23 under the prescription of a health care provider legally authorized to 24 prescribe under title eight of the education law. This coverage shall EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01936-01-7A. 579 2 1 allow for a three month supply of a contraceptive for the initial 2 dispensing of the contraceptive and a twelve month supply of the same 3 contraceptive for all subsequent dispensings to the insured regardless 4 of whether the insured was enrolled under the contract at the time of 5 the initial dispensing. The coverage required by this section shall be 6 included in contracts and certificates only through the addition of a 7 rider. 8 § 3. Paragraph 25 of subsection (b) of section 4322 of the insurance 9 law, as added by chapter 504 of the laws of 1995 and the opening para- 10 graph as amended by chapter 388 of the laws of 2013, is amended to read 11 as follows: 12 (25) Prescription drugs, including contraceptive drugs or devices 13 approved by the federal food and drug administration or generic equiv- 14 alents approved as substitutes by such food and drug administration and 15 nutritional supplements (formulas), whether administered orally or via a 16 feeding tube for the therapeutic treatment of phenylketonuria, branched- 17 chain ketonuria, galactosemia and homocystinuria, obtained at a partic- 18 ipating pharmacy under a prescription written by an in-plan or out-of- 19 plan provider. Health maintenance organizations, in addition to 20 providing coverage for prescription drugs at a participating pharmacy, 21 may utilize a mail order prescription drug program. Health maintenance 22 organizations may provide prescription drugs pursuant to a drug formu- 23 lary; however, health maintenance organizations must implement an 24 appeals process so that the use of non-formulary prescription drugs may 25 be requested by a physician or other provider. 26 With respect to contraceptive drugs, any plan shall allow for a three 27 month supply of a contraceptive for the initial dispensing of the 28 contraceptive and a twelve month supply of the same contraceptive for 29 all subsequent dispensings to the enrollee. 30 Health maintenance organizations shall impose a one hundred dollar 31 individual deductible and a three hundred dollar family deductible per 32 calendar year for prescription drugs obtained at a participating pharma- 33 cy. Health maintenance organizations may not impose a deductible on 34 prescriptions obtained through the mail order drug program. 35 In addition to the deductible, a ten dollar copayment shall be imposed 36 on up to a thirty-four day supply of brand name prescription drugs 37 obtained at a participating pharmacy. A five dollar copayment shall be 38 imposed on up to a thirty-four day supply of generic prescription drugs 39 or brand name drugs for which there is no generic equivalent obtained at 40 a participating pharmacy. 41 If a mail order drug program is utilized, a twenty dollar copayment 42 shall be imposed on a ninety day supply of brand name prescription 43 drugs. A ten dollar copayment shall be imposed on a ninety day supply of 44 generic prescription drugs or brand name drugs for which there is no 45 generic equivalent obtained through the mail order drug program. 46 In no event shall the copayment exceed the cost of the prescribed 47 drug. 48 § 4. Subparagraph (E) of paragraph 17 of subsection (i) of section 49 3216 of the insurance law is amended by adding a new clause (v) to read 50 as follows: 51 (v) contraceptives, allowing for a three month supply for the initial 52 dispensing of the contraceptive and a twelve month supply of the same 53 contraceptive for all subsequent dispensings to the insured regardless 54 of whether the insured was enrolled under the policy at the time of the 55 initial dispensing.A. 579 3 1 § 5. Paragraph (d) of subdivision 3 of section 365-a of the social 2 services law, as amended by chapter 909 of the laws of 1974 and as 3 relettered by chapter 82 of the laws of 1995, is amended to read as 4 follows: 5 (d) family planning services and supplies, including contraception, 6 for eligible persons of childbearing age, including children under twen- 7 ty-one years of age who can be considered sexually active, who desire 8 such services and supplies, in accordance with the requirements of 9 federal law and regulations and the regulations of the department. No 10 person shall be compelled or coerced to accept such services or 11 supplies. With respect to contraception, coverage shall allow for a 12 three month supply of a contraceptive for the initial dispensing of the 13 contraceptive and a twelve month supply of the same contraceptive for 14 all subsequent dispensings. 15 § 6. This act shall take effect immediately, and shall apply to poli- 16 cies and contracts issued, renewed, modified, altered or amended on or 17 after such effective date.
