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.
Summary
S10136 would require most New York health insurance coverage that includes prescription drugs to cover FDA-approved or FDA-authorized antiviral therapeutics for the treatment of COVID-19 when prescribed by a licensed health care provider. The mandate applies to individual policies, group and blanket policies, and certain health service and hospital service corporation contracts. For those private coverage types, the bill bars annual deductibles and coinsurance for the covered antiviral drugs.
The bill also amends the social services law to require medical assistance programs to cover these COVID-19 antiviral therapeutics at no cost to the patient. In both the private insurance and public assistance contexts, the bill allows a patient who can obtain the medication at no or reduced cost through a manufacturer or government assistance program to be required to use that program first. The measure would take effect on the first day of January after enactment and would apply to policies and contracts issued, renewed, modified, altered, or amended on or after that date.
Impact
The bill would expand mandated drug coverage under the insurance law and Medicaid-related coverage under the social services law by adding COVID-19 antiviral therapeutics to the list of required benefits. It would prohibit cost-sharing for these drugs in most private insurance plans that cover prescription drugs, while requiring no-cost coverage in medical assistance programs, subject to coordination with other available manufacturer or government assistance programs. Insurers, health plans, and public benefit programs would need to update coverage terms and claims processing for affected policies and contracts.
Sentiment
No committee transcript or vote record was provided, so there is no direct evidence of debate, support, or opposition in the available materials. Based on the bill text and caption, the measure appears to be framed as a consumer-protection and public-health bill aimed at reducing out-of-pocket costs for COVID-19 treatment. The absence of recorded votes or discussion prevents a reliable assessment of broader legislative sentiment.
Contention
The main policy issue likely to generate contention is the cost mandate on insurers and public programs, since the bill requires coverage without deductibles or coinsurance for private plans and no-cost coverage in medical assistance programs. Another possible point of debate is the bill’s coordination rule allowing insurers or programs to require use of manufacturer or government assistance first, which may affect how quickly patients can access coverage. No specific objections or supporters are identified in the provided record.
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.
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.
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