S 5013: Requires health insurers to provide coverage for opioid antagonists and devices.

  
  STATE OF NEW YORK ________________________________________________________________________ 5013 2025-2026 Regular Sessions  IN SENATE February 18, 2025 ___________ Introduced by Sen. HARCKHAM -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring health insurers to provide coverage for opioid antagonists and devices 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 41 to read as follows: 3 (41) (A) (i) Every policy which provides coverage for prescription 4 drugs shall include coverage for at least one opioid antagonist and 5 device. Prior authorization may be required for non-generic forms of 6 opioid antagonists and devices. 7 (ii) As used in this paragraph "opioid antagonist and device" means a 8 drug approved by the food and drug administration that, when adminis- 9 tered, negates or neutralizes in whole or in part the pharmacological 10 effects of an opioid in the body. "Opioid antagonist" shall be limited 11 to naloxone and other medications approved by the department of health 12 for such purpose. 13 (B) The coverage mandated by this paragraph shall include opioid 14 antagonists prescribed or dispensed via standing order or collaborative 15 practice agreement intended for use on patients other than the insured. 16 (C) Coverage provided under this paragraph may be subject to annual 17 deductibles and co-insurance as deemed appropriate by the superintendent 18 and that are consistent with those imposed on other benefits within a 19 given policy. 20 § 2. Subsection (l) of section 3221 of the insurance law is amended by 21 adding a new paragraph 7-c to read as follows: 22 (7-c) (A) (i) Every policy which provides coverage for prescription 23 drugs shall include coverage for at least one opioid antagonist and 24 device. Prior authorization may be required for non-generic forms of 25 opioid antagonists and devices. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09743-02-5 
 S. 5013 2 1 (ii) As used in this paragraph "opioid antagonist and device" means a 2 drug approved by the food and drug administration that, when adminis- 3 tered, negates or neutralizes in whole or in part the pharmacological 4 effects of an opioid in the body. "Opioid antagonist" shall be limited 5 to naloxone and other medications approved by the department of health 6 for such purpose. 7 (B) The coverage mandated by this paragraph shall include opioid 8 antagonists prescribed or dispensed via standing order or collaborative 9 practice agreement intended for use on patients other than the insured. 10 (C) Coverage provided under this paragraph may be subject to annual 11 deductibles and co-insurance as deemed appropriate by the superintendent 12 and that are consistent with those imposed on other benefits within a 13 given policy. 14 § 3. Section 4303 of the insurance law is amended by adding a new 15 subsection (ww) to read as follows: 16 (ww) (1) (A) Every policy which provides coverage for prescription 17 drugs shall include coverage for at least one opioid antagonist and 18 device. Prior authorization may be required for non-generic forms of 19 opioid antagonists and devices. 20 (B) As used in this subsection "opioid antagonist and device" means a 21 drug approved by the food and drug administration that, when adminis- 22 tered, negates or neutralizes in whole or in part the pharmacological 23 effects of an opioid in the body. "Opioid antagonist" shall be limited 24 to naloxone and other medications approved by the department of health 25 for such purpose. 26 (2) Coverage provided under this subsection may be subject to annual 27 deductibles and co-insurance as deemed appropriate by the superintendent 28 and that are consistent with those imposed on other benefits within a 29 given policy. 30 § 4. This act shall take effect on the thirtieth day after it shall 31 have become a law.