Prohibits Medicaid from requiring prior authorization for certain HIV medications

• Democratic1

◆ The sponsor's argument

Why the sponsor says this is needed

New York State's "Ending the Epidemic" plan identified three key points to ending the HIV epidemic, including identifying undiagnosed people living with HIV, helping people who are HIV positive get treatment, and facilitating access to medications that protect high -risk persons from contracting HIV. The plan highlighted the importance of providing better, more immediate access to antiretroviral drugs to combat the epidemic, but prior authorization requirements have tong contributed to treatment delays and disruptions. In 2024, New York State passed into law a measure (Chapter 152 of 2024) to prohibit private insurers from restricting or delaying access to antiretroviral medications through prior authorization requirements, though the law did not cover Medicaid plans. Antiretroviral drugs are critical to preventing transmission and controlling growth of the virus, but it is important that patients can access them quickly when prescribed. Given the complexities of HIV/AIDS, doctors may need to try various treatments and drug combinations, and delays can have harmful consequences. This legislation would build upon the 2024 law by also prohibiting the use of prior authorization for antiretroviral drugs used in connection to HIV/AIDS for patients on Medicaid, ensuring they can access lifesav- ing treatments without delay.

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.