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A02824 Summary:

BILL NOA02824
 
SAME ASNo Same As
 
SPONSORGottfried (MS)
 
COSPNSRDavila, Dinowitz, D'Urso, Epstein, Hunter, Lifton, Lupardo, Miller ML, Mosley, Paulin, Peoples-Stokes, Rosenthal L, Seawright, Simon, Sayegh
 
MLTSPNSRHevesi, Lentol
 
Amd 3368, Pub Health L; amd 365-a, Soc Serv L
 
Relates to providing insurance coverage for medical marihuana.
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A02824 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A2824
 
SPONSOR: Gottfried (MS)
  TITLE OF BILL: An act to amend the public health law and the social services law, in relation to health coverage for medical marihuana   PURPOSE: To add coverage of medical marijuana to public insurance programs and clarify that it may be covered by private insurance.   SUMMARY OF SPECIFIC PROVISIONS: Section 1: Amends Public Health Law § 3368 to deem medical marijuana a "prescription drug," "covered drug," or "health care service" as neces- sary to authorize coverage under the Medicaid, Child Health Plus, Elder- ly Pharmaceutical Insurance Coverage (EPIC), Essential Plan programs, workers compensation, and clarify that it may be covered as a prescription drug under commercial insurance coverage. Health plans are not required to cover medical marijuana, unless they are providing it under one of the public health coverage plans. This would be regardless of whether there is federal financial participation in coverage for the product. Section 2: Authorizes the commissioner to certify medical marijuana dispensing sites as Medicaid providers solely for the purpose of dispensing medical marijuana Section 3: Effective date: April 1 after it becomes a law.   JUSTIFICATION: For thousands of patients, medical marijuana is a safer and more effec- tive medication than other drugs, especially opioids. While it can be prohibitively expensive for many patients, especially in the absence of insurance coverage, it may often be less expensive than what their insurance coverage pays for other medications. Cost is the primary barrier to patient access in New York's medical marijuana program. Medi- caid, other public health plans, and commercial health insurance plans do not cover medical marijuana, forcing patients to pay out of pocket. Some patients begin treatment only to stop due to inability to pay, while others turn to the black market. Efforts by registered organiza- tions to offer discounts have helped, but are inadequate for many low- income patients. Access to medical marijuana should not be limited to those who can pay out of pocket. This bill adds medical marijuana to four publicly-funded health programs - Medicaid, Child Health Plus, workers compensation, and EPIC - and the heavily publicly funded Essential Plan. For Medicaid and Child Health Plus, there would presumably not be federal matching funds until the federal government changes its policies, but New York's Medi- caid and Child Health Plus programs have always covered people and services for which we do not receive federal match. For commercial insurance plans, coverage of medical marijuana would be optional. However, if the plan is providing coverage under the public health plans, such as Medicaid managed care plans, managed long-term care plans, Child Health Plus plans, or the Essential Plan, medical marijuana would be required to be covered. The Commissioner of Health is authorized to certify medical marijuana dispensaries as Medicaid providers solely for the purpose of dispensing medical marijuana (i.e. they can't sell other drugs or provide other Medicaid services.) For the EPIC program, medical marijuana would be added to the drugs the State currently covers (medical marijuana is excluded from Medicare Part D).   PRIOR LEGISLATIVE HISTORY: 2018: A11390 referred to Health   FISCAL IMPLICATIONS: To be determined To the extent medical marijuana displaces other prescription drugs, there could be substantial savings.   EFFECTIVE DATE: April 1 succeeding the date on which it shall have become law
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A02824 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2824
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 25, 2019
                                       ___________
 
        Introduced  by  M.  of  A. GOTTFRIED, DAVILA, DINOWITZ, D'URSO, EPSTEIN,
          HUNTER, LIFTON, LUPARDO, M. L. MILLER, MOSLEY, PAULIN, PEOPLES-STOKES,
          L. ROSENTHAL, SEAWRIGHT, SIMON -- Multi-Sponsored by -- M. of A. HEVE-
          SI, LENTOL -- read once and referred to the Committee on Health
 
        AN ACT to amend the public health law and the social  services  law,  in
          relation to health coverage for medical marihuana
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 3368 of the public health law, as added by  chapter
     2  90 of the laws of 2014, is amended to read as follows:
     3    §  3368. Relation to other laws. 1. (a) The provisions of this article
     4  shall apply to this title, except that where a provision of  this  title
     5  conflicts  with  another  provision  of  this  article, this title shall
     6  apply.
     7    (b) Medical marihuana shall not be deemed to be a "drug" for  purposes
     8  of  article  one  hundred  thirty-seven of the education law.   However,
     9  regardless of federal financial participation, medical  marihuana,  when
    10  dispensed  under  this  title, shall be deemed to be (i) a "prescription
    11  drug" for purposes of coverage  under  medical  assistance  under  title
    12  eleven  of  article  five  of the social services law (provided that the
    13  dispensing site is certified under  subdivision  ten  of  section  three
    14  hundred sixty-five-a of the social services law), title one-A of article
    15  twenty-five of this chapter, the insurance law, and the workers' compen-
    16  sation  law;  (ii) a "covered drug" for purposes of coverage under title
    17  three of article two of the elder law; and (iii) a "health care service"
    18  under section three hundred sixty-nine-gg of  the  social  services  law
    19  (unless  the  commissioner  finds  that  this will result in the loss of
    20  federal financial participation in the program under that section).
    21    2. Nothing in this title shall be construed to require or prohibit  an
    22  insurer  or  health  plan  under  this  chapter  or the insurance law to
    23  provide coverage for medical marihuana, except that it shall be covered,
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD03876-01-9

        A. 2824                             2
 
     1  as provided in subdivision one of this section, by any insurer or health
     2  plan under title eleven of article five  of  the  social  services  law,
     3  title one-A of article twenty-five of this chapter, the workers' compen-
     4  sation  law,  title  three  of article two of the elder law, and section
     5  three hundred sixty-nine-gg of the social services law. [Nothing in this
     6  title shall be construed to require coverage for medical marihuana under
     7  article twenty-five of this  chapter  or  article  five  of  the  social
     8  services law.]
     9    §  2.  Section 365-a of the social services law is amended by adding a
    10  new subdivision 10 to read as follows:
    11    10. The commissioner may certify a dispensing  site  authorized  under
    12  title  five-A of article thirty-three the public health law as a medical
    13  assistance provider, solely for the purpose of dispensing medical  mari-
    14  huana.
    15    §  3. This act shall take effect on the first of April next succeeding
    16  the date on which it shall have become a law; provided  that,  effective
    17  immediately,  the commissioner of health and superintendent of financial
    18  services shall make regulations and take other actions reasonably neces-
    19  sary to implement this act on that date; and provided further  that  the
    20  amendments  to section 3368 of the public health law made by section one
    21  of this act shall not affect the repeal of such section and shall expire
    22  and be deemed repealed therewith.
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