Insurance coverage

New York Senate Approves Bill to Mandate Medicare Coverage for Medical Marijuana

The New York Senate on Wednesday approved a bill that would require public health insurance programs to cover medical marijuana expenses and specify that private insurers are allowed to do the same.

The bill, sponsored by Diane Savino (D), went through two committees before passing the Senate by a vote of 53 to 10, and it has now made its way to the Assembly, where it awaits action in the in the Ways and Means Committee.

SB S8837 would amend state public health and human services laws to remove one of the most significant barriers to patient access to medical cannabis: the direct cost of the drug.

It would achieve this by defining medical marijuana as a “prescription drug”, “covered drug” or “health care service” under the relevant codes, so that public health insurance providers , including Medicaid and workers’ compensation, would be mandated to provide coverage. For private and commercial insurers, however, cannabis coverage would be optional.

“For thousands of patients, medical marijuana is a safer and more effective medicine than other drugs, especially opioids,” says a rationale note attached to the bill. “While this can be prohibitively expensive for many patients, especially in the absence of insurance coverage, it can often be less expensive than what their insurance coverage pays for other medications.”

Responding to concerns from fellow lawmakers in attendance ahead of the vote about the potential costs of the legislation, Savino said “it’s time for New York State to lead the way on this issue.”

“Some states are going to have to force this issue,” she said. “I believe our state is the one that should lead the way on this.”

If the invoice is enacted, public health insurance programs that would be subject to the proposed policy change include Medicaid, Child Health Plus, Pharmaceutical Insurance Coverage for the Elderly (EPIC), Essential Plan programs, and Workers’ Compensation. work.

“Cost is the number one barrier to patient access to New York’s medical marijuana program. Medicaid, other public health plans, and commercial health insurance plans do not cover medical marijuana, requiring patients to pay out of pocket,” the rationale note continues. “Some patients start treatment only to stop because they cannot pay, while others turn to the black market. Efforts by registered organizations to offer discounts have helped, but are insufficient for many low-income patients. »

Although there “likely are no federal matching funds until the federal government changes its policies” for programs such as Medicaid and Child Health Plus, the memo states that “the Medicaid and Child New York’s Health Plus has always covered people and services for which we do not receive a federal match.

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Additionally, the legislation would allow the state health commissioner to certify medical marijuana dispensaries as Medicaid providers, as long as they only sell medical cannabis and no other drugs. .

A tax impact statement notes that there would be “substantial” cost savings if the bill were enacted “to the extent that medical marijuana replaces other prescription drugs.” And several studies have shown that many people have used cannabis as a substitute for a variety of prescription medications such as opioid painkillers.

If passed in the Assembly and signed by the Governor, the bill will come into effect from the following April. But for 2022, the normal legislative session is due to end on Thursday, meaning it will likely have to be reintroduced unless it is brought up in a special session.

Similar legislation was tabled in the Assembly in 2018, but it did not make it to committee.

Outside of New York, New Mexico’s largest marijuana company lobbied earlier this year for insurers to cover medical cannabis expenses, which it said was required by law, but until present, this effort has not affected a change in policy.

With regard to workers’ compensation, there have been various court cases in which employees have asked their employer to obtain compensation to cover the costs of medical cannabis for injuries they have suffered on the spot. . Two Minnesota cases on the issue have reached the U.S. Supreme Court, but the Justice Department asked judges to dismiss the case last month. Part of the department’s reasoning, however, was that it believed the matter would be best handled by the executive or legislative branches.

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