Press Release – July 6, 2022
(Albany, New York) – Over thirty patient advocacy and health policy organizations applaud the New York Legislature for passing multiple bills that expand protections for patients with health insurance in New York. Governor Hochul should swiftly sign these bills and ensure patients gain these important protections.
During the 2022 session, the New York Assembly and Senate passed a copay accumulator ban bill that will ensure all cost-sharing by or on behalf of patients counts towards meeting their deductible and annual out-of-pocket limits (S5229A/A1741-A); and a bill that redefines the term “clinical peer reviewer” to ensure that health plans only use a physician, or other health care professional in the same or similar specialty as the provider who ordered the treatment, when denying benefits on the basis of medical necessity (S8113/A879).
“Patients need timely and affordable access to medication, especially those with complex conditions,” said Jessica Graham, President for Bleeding Disorders Advocacy Network. “These bills will help deliver that access, ensuring a healthier and more promising future for New Yorkers.”
The New York Legislature also passed a bill that prohibits applying step-therapy protocols to treatments for mental health conditions so that plans cannot require patients to first try and fail on medications before they are able to access their originally prescribed treatment (S5909/A3276). Moreover, the New York Senate also passed a bill that would create new guardrails on step-therapy protocols, such as prohibiting patients from trying and failing on more than one medication and requiring health plans to uphold a step-therapy override for 12 months (S8191).
“People in need of mental health treatment already wait an average of 10 years to get help. Subjecting patients to sequential trials of medications in a step therapy fashion unnecessarily postpones their recovery even further,” said John Richter, Director of Public Policy for the Mental Health Association in New York State.
“The Medical Society of the State of New York (MSSNY) applauds the New York State Assembly and Senate for passing multiple pieces of legislation this session that seek to ensure patients have timely access to the treatment and medications they need to treat their conditions.” said Dr. Parag Mehta, President of MSSNY. “Our patients who rely upon these needed medications and treatments should not have to face the unnecessary administrative roadblocks often imposed by health insurers these bills seek to remedy. We urge Governor Hochul to sign all three bills and put these important safeguards in place as soon as possible.”
LEARN MORE ABOUT STEP THERAPY REFORM IN NEW YORK
ABOUT AIMED ALLIANCE
Aimed Alliance is a 501 (c)(3) not-for-profit health policy organization that protects and enhances the rights of health care consumers and professionals.