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A11390 Summary:

BILL NOA11390
 
SAME ASSAME AS S09189
 
SPONSORGottfried
 
COSPNSRDavila, Dinowitz, D'Urso, Epstein, Hunter, Lifton, Lupardo, Miller ML, Mosley, Paulin, Pellegrino, Peoples-Stokes, Rosenthal L, Seawright, Simon, Hevesi, Lentol
 
MLTSPNSR
 
Amd 3368, Pub Health L; amd 365-a, Soc Serv L
 
Relates to providing insurance coverage for medical marihuana.
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A11390 Actions:

BILL NOA11390
 
10/22/2018referred to health
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A11390 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A11390
 
SPONSOR: Rules (Gottfried)
  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: New bill   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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A11390 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          11390
 
                   IN ASSEMBLY
 
                                    October 22, 2018
                                       ___________
 
        Introduced  by  COMMITTEE ON RULES -- (at request of M. of A. Gottfried,
          Davila,  Dinowitz,   D'Urso,   Epstein,   Hunter,   Lifton,   Lupardo,
          M. L. Miller,  Mosley,  Paulin,  Pellegrino, Peoples-Stokes, L. Rosen-
          thal, Seawright, Simon, Hevesi, 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 is shall be covered,
    24  as provided in subdivision one of this section, by any insurer or health
    25  plan  under  title  eleven  of  article five of the social services law,
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD16589-01-8

        A. 11390                            2
 
     1  title one-A of article twenty-five of this chapter, the workers' compen-
     2  sation law, title three of article two of the  elder  law,  and  section
     3  three hundred sixty-nine-gg of the social services law. [Nothing in this
     4  title shall be construed to require coverage for medical marihuana under
     5  article  twenty-five  of  this  chapter  or  article  five of the social
     6  services law.]
     7    § 2. Section 365-a of the social services law is amended by  adding  a
     8  new subdivision 10 to read as follows:
     9    10.  The  commissioner  may certify a dispensing site authorized under
    10  title five-A of the public health law as a medical assistance  provider,
    11  solely for the purpose of dispensing medical marihuana.
    12    §  3. This act shall take effect on the first of April next succeeding
    13  the date on which it shall have become a law; provided  that,  effective
    14  immediately,  the commissioner of health and superintendent of financial
    15  services shall make regulations and take other actions reasonably neces-
    16  sary to implement this act on that date; and provided further  that  the
    17  amendments  to section 3368 of the public health law made by section one
    18  of this act shall not affect the repeal of such section and shall expire
    19  and be deemed repealed therewith.
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