NY A10725

Requires utilization review agents to use evidence-based clinical review tools designated by the Office of Alcoholism and Substance Abuse Services for substance use disorder treatment, with inter rater reliability testing completed by December 31, 2016; effective January 1, 2017.

Mandates insurance coverage for immediate access to a five-day emergency supply of prescription medications for substance use disorder treatment without prior authorization, including opioid overdose reversal medication; effective January 1, 2017.

Prohibits prior authorization requirements for initial or renewal prescriptions of buprenorphine or injectable naltrexone for opioid addiction treatment unless the prescription is for a non-preferred or non-formulary form; effective immediately.

Extends the heroin and opioid addiction wraparound services demonstration program to provide case management, peer support, employment support, and transportation services up to nine months after treatment completion; requires evaluation report by June 30, 2018; program expires March 31, 2019.

Redefines emergency services procedures for persons intoxicated or incapacitated by alcohol and/or substances, establishing treatment facilities as designated facilities with on-site medical staff, extending maximum retention from 48 to 72 hours, and requiring comprehensive discharge planning; effective 90 days after enactment.