New York S 6937: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

Bill Text

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S06937 Summary:

BILL NOS06937 

&nbsp

SAME ASSAME AS A07920

&nbsp

SPONSORLANZA

&nbsp

COSPNSR

&nbsp

MLTSPNSR

&nbsp

Add §3216-a, Ins L

&nbsp

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

Go to top S06937 Actions:

BILL NOS06937 

&nbsp

03/27/2025REFERRED TO INSURANCE

01/07/2026REFERRED TO INSURANCE

Go to topS06937 Committee&nbspVotes:

Go to topS06937 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS06937 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6937

 2025-2026 Regular Sessions

 IN SENATE

 March 27, 2025
 ___________

 Introduced by Sen. LANZA -- 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 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

 S. 6937 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.

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