Exempts opioid treatment program services received, including methadone maintenance treatment and the use of buprenorphine, from all recipient restriction program coverage and payment restrictions.
STATE OF NEW YORK
________________________________________________________________________
9002
2025-2026 Regular Sessions
IN ASSEMBLY
August 13, 2025
___________
Introduced by M. of A. SIMON -- read once and referred to the Committee
on Health
AN ACT to amend the social services law, in relation to exemptions from
the recipient restriction program
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The social services law is amended by adding a new section
2 368-g to read as follows:
3 § 368-g. Exemptions from the recipient restriction program. 1.
4 Notwithstanding any law, rule or regulation to the contrary, any indi-
5 vidual who is receiving medical assistance under this title from a Medi-
6 caid fee-for-service or Medicaid managed care provider and who is iden-
7 tified as part of the recipient restriction program set forth in 18
8 NYCRR 360-6.4 shall be fully exempt from all recipient restriction
9 program coverage and payment restrictions with respect to any opioid
10 treatment program services received, including methadone maintenance
11 treatment and the use of buprenorphine. All Medicaid managed care plans
12 shall cover medically necessary opioid use disorder services delivered
13 in an opioid treatment program for recipient restriction program members
14 without any additional restrictions, edits, authorizations, or referral
15 requirements, and claims for opioid treatment program services shall not
16 be denied due to recipient restriction program restrictions.
17 2. The department shall promulgate rules and regulations to implement
18 the provisions of this section.
19 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13097-01-5
