NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A4713
SPONSOR: Peoples-Stokes 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 OR GENERAL IDEA OF BILL:
The purpose of this bill is to add coverage of medical marijuana to
public insurance programs and clarify that it may be covered by private
insurance.
SUMMARY OF 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,
Elderly 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-in-
come 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 provid-
ers 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
2019/2020: A2824
2021/2022: A242
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
To be determined.
EFFECTIVE DATE:
This act shall take effect on the first of April next succeeding the
date on which it shall have become a law; provided that the amendments
to section 3368 of the public health law made by section one of this act
shall not affect the repeal of such section and shall expire and be
deemed repealed therewith. Effective immediately, the addition, amend-
ment and/or repeal of any rule or regulation necessary for the implemen-
tation of this act on its effective date are authorized to be made and
completed on or before such effective date.
STATE OF NEW YORK
________________________________________________________________________
4713
2023-2024 Regular Sessions
IN ASSEMBLY
February 22, 2023
___________
Introduced by M. of A. PEOPLES-STOKES -- 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 eleven 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,
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.
LBD06526-01-3
A. 4713 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 11 to read as follows:
9 11. The commissioner may certify a dispensing site authorized under
10 title five-A of article thirty-three the public health law as a medical
11 assistance provider, solely for the purpose of dispensing medical mari-
12 huana.
13 § 3. This act shall take effect on the first of April next succeeding
14 the date on which it shall have become a law; provided that the amend-
15 ments to section 3368 of the public health law made by section one of
16 this act shall not affect the repeal of such section and shall expire
17 and be deemed repealed therewith. Effective immediately, the addition,
18 amendment and/or repeal of any rule or regulation necessary for the
19 implementation of this act on its effective date are authorized to be
20 made and completed on or before such effective date.
