Bill > S05012

This bill prohibits health care plans, insurers, and health maintenance organizations (HMOs) from requiring prior authorization for anti-retroviral medications used to treat and prevent HIV infection. Prior authorization is a process where healthcare providers must obtain approval from an insurance company before a medication can be prescribed or covered. The bill specifically amends sections of New York's public health law and insurance law to ensure that prescription drug coverage providers cannot mandate this additional administrative step for HIV-related medications. While these providers are prevented from requiring prior authorization, the bill does allow them to deny claims for such medications if they are later determined to be medically unnecessary. The legislation is designed to reduce barriers to accessing critical HIV treatment and prevention medications, potentially improving health outcomes by making these drugs more quickly and easily available to patients. The act will take effect 180 days after becoming law, giving health care plans and insurers time to adjust their policies and procedures.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/S5012