A 7920: Provides for patient access to FDA approved abuse-deterrent technology to help combat opioid abuse.

  
  STATE OF NEW YORK ________________________________________________________________________ 7920 2025-2026 Regular Sessions  IN ASSEMBLY April 11, 2025 ___________ Introduced by M. of A. SLATER -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to the use of abuse-det- errent technology for opioids as a mechanism for reducing abuse and diversion of opioid drugs The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The insurance law is amended by adding a new section 3216-a 2 to read as follows: 3 § 3216-a. Access to abuse-deterrent opioid medications. (a) An insur- 4 ance carrier or health plan shall provide coverage on its formulary, 5 drug list or other lists of similar construct for at least one abuse- 6 deterrent opioid analgesic drug product per opioid analgesic active 7 ingredient. 8 (1) Cost-sharing for brand name abuse-deterrent opioid analgesic drug 9 products covered pursuant to this section shall not exceed the lowest 10 cost-sharing level applied to brand name non-abuse deterrent opioid 11 drugs covered under the applicable health plan or policy. 12 (2) Cost-sharing for generic abuse-deterrent opioid analgesic drug 13 products covered pursuant to this section shall not exceed the lowest 14 cost-sharing level applied to generic non-abuse deterrent opioid drugs 15 covered under the applicable health plan or policy. 16 (3) An increase in patient cost-sharing or disincentives for prescri- 17 bers or dispensers shall not be allowed to achieve compliance with this 18 section. 19 (b) Any prior-authorization requirements or other utilization review 20 measures for opioid analgesics, and any service denials made pursuant 21 thereto, shall not require use of opioid analgesic drug products without 22 abuse-deterrent properties in order to access abuse-deterrent opioid 23 analgesic drug products. 24 (c) Definitions. As used in this section: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD07431-01-5 
 A. 7920 2 1 (1) "Opioid analgesic drug product" means a drug in the opioid anal- 2 gesic drug class prescribed to treat moderate to severe pain or other 3 conditions, whether in immediate release or extended long acting release 4 form and whether or not combined with other drug substances to form a 5 single drug product or other dosage form. 6 (2) "Abuse deterrent opioid analgesic drug product" means a brand or 7 generic opioid analgesic drug product approved by the federal food and 8 drug administration with abuse-deterrence labeling claims indicating its 9 abuse-deterrent properties are expected to deter or reduce its abuse. 10 (3) "Cost-sharing" means any coverage limit, copayment, coinsurance, 11 deductible or other out-of-pocket patient expense requirements. 12 § 2. This act shall take effect on the one hundred twentieth day after 13 it shall have become a law, and shall apply to all policies and 14 contracts issued, renewed, modified, altered or amended on or after such 15 date.