2016 -- S 2460 SUBSTITUTE A

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LC004770/SUB A

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2016

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Senators Miller, Coyne, Satchell, Jabour, and Nesselbush

     Date Introduced: February 11, 2016

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness

Insurance Policies" is hereby amended by adding thereto the following section:

     27-18-82. Opioid antagonists. -- (a) Every individual or group health insurance contract,

plan, or policy that provides prescription coverage that is delivered, issued for delivery, amended

or renewed in this state on or after January 1, 2017, shall provide coverage for at least one generic

opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid

antagonists and devices.

     (b) As used in this section:

     "Opioid antagonist" means naloxone hydrochloride and any other drug approved by the

United States Food and Drug Administration for the treatment of opioid overdose.

     (c) The coverage mandated by this section shall include generic opioid antagonists

prescribed or dispensed via standing order or collaborative practice agreement intended for use on

patients other than the insured, as permitted by Rhode Island Admin. Code 31-2-9. Prior

authorization may be required for non-generic forms of opioid antagonists and devices.

     (d) Notwithstanding §27-18-19 or any other provision to the contrary, this section shall

apply to blanket or group polices of insurance.

     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-73. Opioid antagonists. -- (a) Every individual or group health insurance contract,

plan, or policy that provides prescription coverage that is delivered, issued for delivery, amended

or renewed in this state on or after January 1, 2017, shall provide coverage for at least one generic

opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid

antagonists and devices.

     (b) As used in this section:

     "Opioid antagonist" means naloxone hydrochloride and any other drug approved by the

United States Food and Drug Administration for the treatment of opioid overdose.

     (c) The coverage mandated by this section shall include generic opioid antagonists

prescribed or dispensed via standing order or collaborative practice agreement intended for use on

patients other than the insured, as permitted by Rhode Island Admin. Code 31-2-9. Prior

authorization may be required for non-generic forms of opioid antagonists and devices.

     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-69. Opioid antagonists. -- (a) Every individual or group health insurance contract,

plan, or policy that provides prescription coverage that is delivered, issued for delivery, amended

or renewed in this state on or after January 1, 2017, shall provide coverage for at least one generic

opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid

antagonists and devices.

     (b) As used in this section:

     "Opioid antagonist" means naloxone hydrochloride and any other drug approved by the

United States Food and Drug Administration for the treatment of opioid overdose.

     (c) The coverage mandated by this section shall include generic opioid antagonists

prescribed or dispensed via standing order or collaborative practice agreement intended for use on

patients other than the insured, as permitted by Rhode Island Admin. Code 31-2-9. Prior

authorization may be required for non-generic forms of opioid antagonists and devices.

     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

Organizations" is hereby amended by adding thereto the following section:

     27-41-86. Opioid antagonists. -- (a) Every individual or group health insurance contract,

plan, or policy that provides prescription coverage that is delivered, issued for delivery, amended

or renewed in this state on or after January 1, 2017, shall provide coverage for at least one generic

opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid

antagonists and devices.

     (b) As used in this section:

     "Opioid antagonist" means naloxone hydrochloride and any other drug approved by the

LC004770/SUB A - Page 2 of 3

United States Food and Drug Administration for the treatment of opioid overdose.

     (c) The coverage mandated by this section shall include generic opioid antagonists

prescribed or dispensed via standing order or collaborative practice agreement intended for use on

patients other than the insured, as permitted by Rhode Island Admin. Code 31-2-9. Prior

authorization may be required for non-generic forms of opioid antagonists and devices.

     SECTION 5. This act shall take effect on January 1, 2017.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

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     This act would require all health insurance providers that provide prescription coverage

to include coverage for generic opioid antagonists (overdose preventive medicine), and devices. It

would permit prior authorization for non-generic forms of opioid antagonists and devices. This

act would apply to nonprofit hospital service corporations, nonprofit medical service corporations

and health maintenance organizations.

     This act would take effect on January 1, 2017.

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