S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         1832
                              2015-2016 Regular Sessions
                                 I N  A S S E M B L Y
                                   January 13, 2015
                                      ___________
       Introduced by M. of A. GUNTHER, PEOPLES-STOKES, ROBINSON, PERRY, LAVINE,
         TITONE, MOYA, JAFFEE, COLTON, DenDEKKER -- Multi-Sponsored by -- M. of
         A.  COOK,  DUPREY, FARRELL, GLICK, HOOPER, RIVERA, ROSENTHAL, SCARBOR-
         OUGH, SCHIMEL, TITUS -- read once and referred  to  the  Committee  on
         Health
       AN  ACT  to amend the social services law, in relation to establishing a
         prohibition on prior approval or preferred drug list requirements  for
         certain drugs used to treat AIDS, HIV infection or hepatitis C
         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 subdivision 2 of section 365-a  of
    2  the social services law, as amended by section 6 of part D of chapter 56
    3  of  the  laws  of  2013, is amended and a new subdivision 10 is added to
    4  read as follows:
    5    "Standard coverage" shall mean payment of part or all of the  cost  of
    6  medically  necessary  medical,  dental  and  remedial care, services and
    7  supplies, as authorized in this title or the regulations of the  depart-
    8  ment,  which  are necessary to prevent, diagnose, correct or cure condi-
    9  tions in the person that cause acute suffering, endanger life, result in
   10  illness or infirmity, interfere with such person's capacity  for  normal
   11  activity,  or threaten some significant handicap and which are furnished
   12  an eligible person in accordance with this title and the regulations  of
   13  the  department.  Such  care,  services  and  supplies shall include the
   14  following medical  care,  services  and  supplies,  together  with  such
   15  medical  care, services and supplies provided for in subdivisions three,
   16  four and five of this section,  and  such  medical  care,  services  and
   17  supplies  as  are  authorized  in  the  regulations  of  the department;
   18  NOTWITHSTANDING ANY  INCONSISTENT  PROVISION  OF  LAW,  SUBJECT  TO  THE
   19  PROVISIONS OF SUBDIVISION TEN OF THIS SECTION:
   20    10.  (A)  UNLESS REQUIRED BY FEDERAL LAW AND REGULATION AS A CONDITION
   21  OF QUALIFYING  FOR  FEDERAL  FINANCIAL  PARTICIPATION  IN  THE  MEDICAID
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02948-01-5
       A. 1832                             2
    1  PROGRAM,  THE  DEPARTMENT  OTHERWISE  NOTWITHSTANDING  ANY  INCONSISTENT
    2  PROVISION OF LAW, SHALL NOT RESTRICT BY PRIOR AUTHORIZATION OR PREFERRED
    3  DRUG LIST PROGRAM REQUIREMENT ANY PRESCRIPTION DRUG, INCLUDED IN CERTAIN
    4  THERAPEUTIC  DRUG CLASSES, AS PRESCRIBED AND DETERMINED BY A PRESCRIBING
    5  PRACTITIONER LICENSED BY THE STATE, TO BE MEDICALLY  NECESSARY  FOR  THE
    6  TREATMENT AND PREVENTION OF AIDS, HIV INFECTION, AND HEPATITIS C.
    7    (B)  THERAPEUTIC  CLASSES CONTAINING PRESCRIPTION DRUGS WHICH SHALL BE
    8  EXCLUDED FROM ANY PRIOR AUTHORIZATION OR  PREFERRED  DRUG  LIST  PROGRAM
    9  REQUIREMENT PROVISIONS SHALL INCLUDE THE FOLLOWING:
   10    (1) ANTI-RETROVIRAL MEDICATIONS, INCLUDING BUT NOT LIMITED TO PROTEASE
   11  INHIBITORS,  NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS, NUCLEOSIDE
   12  REVERSE TRANSCRIPTASE INHIBITORS,  ANTI-VIRALS,  AND  FUSION  INHIBITORS
   13  PRESCRIBED FOR THE TREATMENT OF AIDS OR HIV INFECTION.
   14    (2)   IMMUNOMODULATORS   AND   HEPATITIS  C-SPECIFIC  ANTIVIRAL  DRUGS
   15  PRESCRIBED FOR THE TREATMENT OF HEPATITIS C.
   16    S 2. Severability. If any clause, sentence, paragraph, section or part
   17  of this act shall be adjudged by any court of competent jurisdiction  to
   18  be  invalid  and  after  exhaustion  of all further judicial review, the
   19  judgment shall not affect, impair or invalidate the  remainder  thereof,
   20  but  shall  be  confined in its operation to the clause, sentence, para-
   21  graph, section or part of this act directly involved in the  controversy
   22  in which the judgment shall have been rendered.
   23    S  3. This act shall take effect on the first of January next succeed-
   24  ing the date on which it shall have become  a  law;  provided  that  the
   25  state  commissioner  of  health  is authorized to promulgate any and all
   26  rules and regulations and take any other measures necessary to implement
   27  this act on its effective date on or before such date.