Bill > A01287

This bill amends New York insurance law to require that insurance policies providing prescription drug coverage include provisions ensuring continuous coverage for "single source drugs" (brand-name drugs without a generic equivalent) during an appeal process. Specifically, if an insurance formulary (the list of covered medications) changes and removes or reduces coverage for a single source drug that a patient is currently taking, the patient can continue receiving coverage for that drug under the same terms while they file a grievance or appeal with the insurer or a state/federal agency. This protection remains in effect until a final decision is rendered on the appeal, which helps ensure patients are not suddenly cut off from medications they are already using as part of their prescribed therapy. The bill applies to individual, group, and blanket insurance policies, and will take effect on the first calendar month following 60 days after becoming law, but only for policies issued, renewed, or amended on or after that date.

Business and Industry

https://www.nysenate.gov/legislation/bills/2025/A1287