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Bill

S 5013

Requires health insurers to provide coverage for opioid antagonists and devices

2025 Regular Session Introduced by Pete Harckham

Requires health insurers to cover opioid antagonists and overdose-reversal devices, boosting access for insured individuals and providers.

REFERRED TO INSURANCE
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WeVote Research Nonpartisan
Bill Summary · S 5013

Summary of Bill S 5013 (New York)

Overview

  • Bill Number: S 5013
  • Title: Requires health insurers to provide coverage for opioid antagonists and devices
  • Sponsor: Pete Harckham (primary)
  • Status: REFERRED TO INSURANCE
  • Introduced: February 18, 2025
  • Legislative Class: Bill
  • Related Bills (prior-session): A 10622, A 2773, S 6733, S 5380

Purpose and Legislative Intent

S 5013 seeks to ensure that health insurance plans provide coverage for opioid antagonists (medications that reverse opioid overdoses) and the devices used to administer them. While the specific text is not provided here, the title indicates a mandate or requirement that such products be covered by insurers, potentially improving access to overdose-reversal therapies for insured individuals.

Key Provisions (High-Level)

  • Mandate coverage by health insurers for opioid antagonists (e.g., naloxone) and related administration devices.
  • Scope and specifics (e.g., dosage forms, administration devices, copays/coinsurance, quantity limits, prior authorization) would be defined in the bill’s text; these details are not included in the information provided.
  • The measure would operate within the existing state insurance framework and any applicable state program requirements.

Note: The exact terms, exemptions, implementation timelines, and cost-sharing rules would be clarified in the enacted language. This summary reflects the bill’s stated objective based on the title.

Who Would Be Affected

  • Insured individuals seeking opioid antagonists and related devices through their health plans.
  • Health insurers and plan sponsors that would be required to cover these products.
  • Pharmacies and distributors dispensing naloxone and administration devices.
  • Healthcare providers and organizations prescribing or administering overdose-reversal therapies.

Procedural and Timeline Aspects

  • Introduced on February 18, 2025.
  • Referred to the Senate Committee on Insurance (status shown as REFERRED TO INSURANCE); no further actions are listed here.
  • Related bills from prior sessions suggest ongoing legislative interest in expanding overdose-reversal medication access.

Potential Impacts and Considerations

  • Public health: Increased access to overdose reversal medications could reduce overdose fatalities and expand availability in community settings.
  • Economic impact: Insurers may adjust premiums or cost-sharing; manufacturers and retailers could see changes in demand.
  • Policy alignment: May interact with existing parity requirements and broader medication coverage policies.

Next Steps for Stakeholders

  • Monitor committee hearings and subsequent floor votes for S 5013.
  • Review the full text when available to understand specific coverage details, exemptions, and implementation dates.
  • Consider alignment with related bills (A 10622, A 2773, S 6733, S 5380) and ongoing overdose-prevention initiatives.

Compiled from official sources — confirm details with the bill’s official record.

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