A 3833: Requires insurance companies, medical expense indemnity corporations, hospital service corporations, health service corporations and medical assistance programs to provide coverage for prescribed antiviral therapeutics approved by the food and drug administration for the treatment of COVID-19 at no cost to the patient.

  
  STATE OF NEW YORK ________________________________________________________________________ 3833 2025-2026 Regular Sessions  IN ASSEMBLY January 30, 2025 ___________ Introduced by M. of A. WEPRIN -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law and the social services law, in relation to capping cost sharing for antiviral COVID-19 therapeutics The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 40 to read as follows: 3 (40) (A) Every policy that provides coverage for prescription drugs 4 shall provide coverage for antiviral therapeutics approved or granted 5 emergency use authorization by the food and drug administration for the 6 treatment of COVID-19 when prescribed by a licensed health care provider 7 legally authorized to prescribe under title eight of the education law. 8 (B) Coverage under this paragraph shall not be subject to annual 9 deductibles or coinsurance, provided, however, that an insured who is 10 eligible for and able to obtain prescribed antiviral therapeutics at no 11 cost or reduced cost under a manufacturer or government program may be 12 required to use such program before using coverage required pursuant to 13 this paragraph. 14 § 2. Subsection (k) of section 3221 of the insurance law is amended by 15 adding a new paragraph 24 to read as follows: 16 (24) (A) Every group or blanket policy delivered or issued for deliv- 17 ery in this state that provides coverage for prescription drugs shall 18 provide coverage for antiviral therapeutics approved or granted emergen- 19 cy use authorization by the food and drug administration for the treat- 20 ment of COVID-19 when prescribed by a licensed health care provider 21 legally authorized to prescribe under title eight of the education law. 22 (B) Coverage under this paragraph shall not be subject to annual 23 deductibles or coinsurance, provided, however, that an insured who is 24 eligible for and able to obtain prescribed antiviral therapeutics at no 25 cost or reduced cost under a manufacturer or government program may be EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD07443-01-5 
 A. 3833 2 1 required to use such program before using coverage required pursuant to 2 this paragraph. 3 § 3. Section 4303 of the insurance law is amended by adding a new 4 subsection (ww) to read as follows: 5 (ww) (1) Every contract issued by a medical expense indemnity corpo- 6 ration, a hospital service corporation, or a health service corporation 7 that provides coverage for prescription drugs shall provide coverage for 8 antiviral therapeutics approved or granted emergency use authorization 9 by the food and drug administration for the treatment of COVID-19 when 10 prescribed by a licensed health care provider legally authorized to 11 prescribe under title eight of the education law. 12 (2) Coverage under this subsection shall not be subject to annual 13 deductibles or coinsurance, provided, however, that an insured who is 14 eligible for and able to obtain prescribed antiviral therapeutics at no 15 cost or reduced cost under a manufacturer or government program may be 16 required to use such program before using coverage required pursuant to 17 this subsection. 18 § 4. Subdivision 2 of section 365-a of the social services law is 19 amended by adding a new paragraph (nn) to read as follows: 20 (nn) (i) antiviral therapeutics approved or granted emergency use 21 authorization by the food and drug administration for the treatment of 22 COVID-19 when prescribed by a licensed health care provider legally 23 authorized to prescribe under title eight of the education law. 24 (ii) coverage under this paragraph shall be provided at no cost to the 25 insured, provided, however, that an insured who is eligible for and able 26 to obtain prescribed antiviral therapeutics at no cost or reduced cost 27 under a manufacturer or government program may be required to use such 28 program before using coverage required pursuant to this paragraph. 29 § 5. This act shall take effect on the first day of January next 30 succeeding the date on which it shall have become a law and shall apply 31 to all policies and contracts issued, renewed, modified, altered, or 32 amended on or after such date.