New Law Ends Two-Tiered Treatment System for MAT Low-Income
New Yorkers Struggling w/ Addiction

December 23, 2021

Major victory for Medicaid beneficiaries!  THANK YOU to everyone who raised your voices as we awaited final action by the Governor.  Incredible thanks to Assemblywoman Rosenthal and Senator Pete Harckham for their incredible leadership and to Governor Hochul for her decision to prioritize the needs of New Yorkers requiring MAT.

Hooray!

For Immediate Release

Contact: Lauren Schuster – 347.729.4729, schusterl@nyassembly.gov

Assemblymember Linda B. Rosenthal’s New Law Will Help End Overdose Crisis by Making Medication Assisted Treatment More Accessible 

New Law eliminates Prior Authorization for Medicaid Recipients Needing Access to MAT 

New York, NY- Assemblymember Linda B. Rosenthal (D/WF-Manhattan) today heralded the signing of her legislation into law requiring Medicaid to cover medication assisted treatment (MAT) drugs, including all formulations of methadone, buprenorphine and vivitrol. Prior authorization does not serve any medical purpose and instead is a bureaucratic tool used by insurance companies to control costs. When an insurance company requires prior authorization, insurance companies take several days to approve a prescription after it is written by a licensed medical professional. For people struggling with substance use disorder, this delay has the potential to be deadly, because it delays or disrupts  an individual’s treatment regimen. This new law signals an important shift in the way New York State approaches the addiction crisis, with a clear focus on ensuring universal access to MAT. The bill was carried by Pete Harckham in the State Senate.

“New York lost more people in 2020 to preventable overdose than in any other year that records were kept. Eliminating prior authorization for MAT drugs for people covered by Medicaid represents a historic step forward in our work to end the overdose crisis,” said Assemblymember Linda B. Rosenthal. “Every single overdose is a policy failure, and eliminating prior authorization will make it easier for people to access lifesaving MAT drugs. Addiction is a disease, and universal access to MAT should not be denied to anyone on the basis of income.” 

“Governor Hochul’s signing of this bill is a major step forward to saving lives and a huge step forward towards addressing inequities in our healthcare system that Substance Use Disorder patients on Medicaid face. For too long those with private, commercial insurance have received better access to care, treatment and medicine than those with Medicaid. Finally, we have eliminated the time-wasting—and dangerous—process of having to wrestle with insurers when individuals have an immediate need for medication, and I thank Governor Hochul for supporting this legislation,” said State Senator Pete Harckham, Chair of the Committee on Alcoholism and Drug Abuse.

Assemblymember Rosenthal passed her legislation to eliminate prior authorization in 2019, but it was vetoed by then-Governor Cuomo. Instead, the Cuomo Administration implemented a statewide formulary on MAT drugs, which resulted in medication disruption and chaos for people who need MAT. Under the new law, (A.2030/S.649), Medicaid will be required to cover the MAT drug that best suits the client’s need, without any unitization control or prior authorization. Medications used in MAT programs are not interchangeable, and patients respond differently to different drugs. The choice about which medication to use must be left to the patient and treatment provider, without limitation or restriction by insurance companies. 

This legislation was supported by a broad group of relentless advocates, including VOCAL-NY, Legal Action Center, COMPA-Coalition of Medication-Assisted Treatment Providers and Advocates, Drug Policy Alliance and more. The bill was sponsored by Pete Harckham in the New York State Senate. 

“Governor Hochul’s signing of this bill is a major step forward to saving lives and a huge step forward towards addressing inequities in our healthcare system that Substance Use Disorder patients on Medicaid face. For too long those with private, commercial insurance have received better access to care, treatment and medicine than those with Medicaid. Finally, we have eliminated the time-wasting—and dangerous—process of having to wrestle with insurers when individuals have an immediate need for medication, and I thank Governor Hochul for supporting this legislation,” said State Senator Pete Harckham (D-Hudson Valley).

“We thank and applaud Governor Hochul for bringing an end to Cuomo’s two-tiered treatment system, and expanding access to Medication for Opioid Use Disorder for New Yorkers enrolled in Medicaid,” said Jasmine Budnella, Director of Drug Policy at VOCAL-NY. “The governor’s action on this bill signals her commitment to guide New York out of the dark era of political games waged on the most marginalized – and into an era that prioritizes evidence-based solutions rooted in racial and economic justice, and saving lives.

“We’re extremely grateful for Assemblymember Linda Rosenthal and Senator Pete Harckham’s unwavering leadership in ensuring this piece of legislation has finally become law. Thousands of low-income New Yorkers will now have immediate access to the life-saving medications, and treatment providers will no longer be faced with the burdensome, bureaucratic prior authorization process. After a devastating year, with the highest rates of overdose deaths in New York State’s history, this is a significant step in our efforts to turn the tide on the overdose crisis.”

Allegra Schorr, President of the Coalition of Medication-Assisted Treatment Providers and Advocates of New York State (COMPA), said “COMPA commends Governor Kathy Hochul and the NYS legislature for enacting A.2030 (Rosenthal) /S.649 (Harckham).  Medication-assisted treatment is the standard of care for the treatment of opioid use disorder. This bill ensures that New York’s Medicaid patients have access to these life-saving medications without prior authorization, utilization control, or lifetime limits. COMPA congratulates the bill’s sponsors Senator Pete Harckham and Assemblymember Linda Rosenthal for their expert leadership on this critical legislation to create parity among all patients struggling with addiction in New York.”

“Today’s action by Gov. Hochul to sign into law legislation that will expand access to medication-assisted treatment (MAT) and medications for opioid use disorder for people on Medicaid is a vitally important step forward for New York. Champions Assemblymember Rosenthal and Senator Harckham worked with allies to shepherd this important bill to passage multiple times in the legislature, and now, in this year of record-breaking overdoses across New York state, we applaud Gov. Hochul for signing it into law and underscoring her commitment to forging a new path for drug policy in New York.

“Let’s be clear – ending prior authorization for access to lifesaving medication-assisted treatment means New York is finally treating Medicaid patients with the same regard as patients with private insurance and addressing the horrendous two-tier health access that has had devastating consequences for marginalized New Yorkers and exacerbated overdose deaths.  We applaud Governor Hochul for taking this long-awaited step to address preventable overdose deaths and look forward to continuing our work with the Legislature and Gov. Hochul to prioritize public health and evidence-based policy over failed draconian drug war logic that has utterly failed to keep New Yorkers safe and has upended countless lives,” said Melissa Moore, Civil Systems Reform Director, Drug Policy Alliance

“We applaud Governor Hochul for signing legislation, S649A/A2030, which eliminates prior authorization requirements in Medicaid for medications for addiction treatment (MAT). We are also deeply grateful for the tireless work and long-standing commitment of Assemblymember Rosenthal and Senator Pete Harckham for being stalwart champions in New York State’s fight against the overdose epidemic.

“This legislation which has been a Legal Action Center priority, will end the two-tier system under which lower-income New Yorkers, a disproportionate number of whom are Black or Latino, faced greater obstacles to these life-saving medications than those covered by private insurance,” said Tracie Gardner, Senior Vice President of Policy Advocacy of Legal Action Center.

“Making all FDA-approved MAT medications available under New York’s Medicaid program will make a dramatic improvement in patient-centered care and the way we address the ongoing addiction and overdose crisis,” said John Coppola, Executive Director of the New York Association of Alcoholism and Substance Abuse Providers (ASAP). “By implementing this smart and simple reform, healthcare professionals will be better positioned to make clinical judgements that best suit the individual needs of their patients, and will remove barriers to access for these life-saving medications,” said John Coppola, Executive Director of Alcoholism and Substance Abuse Providers of New York State.

“Overdose deaths are skyrocketing. New York must use every tool available to stem the tide and save lives. It’s unacceptable that the State has created a two-tiered system where individuals with private insurance have better access to medication-assisted treatment than individuals with Medicaid. We thank Governor Hochul for signing this crucial legislation that will eliminate disparities and ensure healthcare professionals can make the best decisions for their clients,” said Amy Dorin, President and CEO of the Coalition for Behavioral Health.

Assemblymember Linda B. Rosenthal is the Chair of the Committee on Social Services, and was previously the Chair of the Committee on Alcoholism and Drug Abuse. She represents the 67th Assembly district, which includes the Upper West Side and parts of Hell’s Kitchen in Manhattan.

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