NY A04823

Prohibits step therapy requirements for atypical anti-psychotics, anti-depressants, anti-retrovirals for HIV/AIDS treatment, anti-rejection drugs for organ/tissue transplants, and other mental illness or HIV/AIDS therapeutic classes approved by the DUR Board and Commissioner.

Prohibits limiting quantity, frequency, and duration of drug therapy for the same drug classes listed above, with exceptions for emergency circumstances involving severe pain or life-threatening conditions.

Prohibits designating drugs in the exempt classes as non-preferred drugs under manufacturer agreements, except drugs selected as preferred due to being significantly more clinically effective and safer than others in their therapeutic class.

Requires prior authorization procedures to comply with Section 273 of the Public Health Law for all DUR program restrictions.

Takes effect immediately, with amendments to Public Health Law Section 272 expiring upon repeal of that section.