Important Victory re: MAT Medications

June 6, 2021

NYS Council members,

As you may recall, last year the Governor vetoed a bill that would have prohibited prior authorization of MAT medications in the Medicaid Program, however he signed the bill that applied to commercial insurance.

After a ton of advocacy and pressure on the part of many stakeholders and advocates including the NYS Council, last month the Assembly passed its’ bill (again) pertaining to the Medicaid Program, and last week the Senate passed its’ ‘same as’ version. The bill now moves to the Governor’s desk for final action. We will need to advocate hard to ensure the Governor addresses the current disparity that exists for New Yorkers who need MAT, by signing the bill quickly.

Summary: This legislation would allow individuals with Medicaid insurance the ability to access whichever MAT medication is most beneficial to them and their needs, without utilization control, mandated prior authorization, or lifetime limits.

The bills are:

A02030 (L. Rosenthal) /S00649A (Harckham)

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LEGISLATIVE JUSTIFICATION: Medication assisted treatment, or MAT, is an evidence-based treatment method that uses FDA approved medications to help an individual overcome a substance use disorder. Medications such as methadone, buprenorphine and naltrexone have all been used successfully and more treatment providers are turning to this approach given its ability to reduce and block cravings, ease withdrawal symptoms and otherwise enable an individual to reach recovery more easily. However, medications used in MAT programs are not interchangeable and each patient may respond differently, therefore it is imperative that this choice be left to the patient and their doctor to determine the appropriate medication. Under current law, individuals under Medicaid are not given the opportunity to access all forms of medication assisted treatment and may be limited to one specific type. This legislation would allow individuals under Medicaid the ability to access whichever MAT medication is most beneficial to them and their needs, without utilization control, mandated prior authorization, or lifetime limits.

LEGISLATIVE HISTORY: 2019: A.7246-B/S.5935-A – Vetoed

EFFECTIVE DATE: This act shall take effect in 90 days.


S00649 Summary:

BILL NO S00649A
 
SAME AS SAME AS A02030
 
SPONSOR HARCKHAM
 
COSPNSR AKSHAR, BROUK, JACKSON
 
MLTSPNSR  
 
Amd §§365-a & 364-j, Soc Serv L; amd §273, Pub Health L
 
Relates to medication assisted treatment for substance abuse disorders; prohibits prior authorization.

S00649 Actions:

BILL NO S00649A
 
01/06/2021 REFERRED TO HEALTH
02/08/2021 AMEND AND RECOMMIT TO HEALTH
02/08/2021 PRINT NUMBER 649A
05/11/2021 REPORTED AND COMMITTED TO FINANCE
05/26/2021 COMMITTEE DISCHARGED AND COMMITTED TO RULES
05/26/2021 ORDERED TO THIRD READING CAL.1294
06/03/2021 SUBSTITUTED BY A2030
  A02030 AMEND= Rosenthal L
  01/14/2021 referred to health
  02/02/2021 reported referred to ways and means
  05/11/2021 reported
  05/13/2021 advanced to third reading cal.347
  05/24/2021 PASSED ASSEMBLY 
  05/24/2021 delivered to senate
  05/24/2021 REFERRED TO FINANCE
  06/03/2021 SUBSTITUTED FOR S649A
  06/03/2021 3RD READING CAL.1294
  06/03/2021 PASSED SENATE
  06/03/2021 RETURNED TO ASSEMBLY