Prescriber Prevails bills S.4893 and A.7208

Update: August 11, 2015

Prescriber Prevails legislation S.4893 (Hannon)/A.7208 (Gottfried) passed both the New York State Senate and the New York State Assembly. The legislation was officially delivered to Governor Cuomo. This bill affects those who have Medicaid that need certain types and classes of medication to be prescribed.

Governor Cuomo will sign or veto this legislation in the next few days.

You can help by calling 518-362-8946 and asking that Governor Cuomo sign S.4893/A.7208 into law. It would be of great help to call today and/or tomorrow.

There is more information on our chapter’s website here.

Prescriber Prevails bills S.4893 and A.7208 will allow physicians and their patients (as opposed to Medicaid managed care) to have the final say with regard to nine class of medications including immunosuppression medications.

Prescriber Prevails bills S.4893 and A.7208 will allow physicians and their patients (as opposed to Medicaid managed care) to have the final say with regard to nine class of medications including immunosuppression medications.

This bill will allow physicians and their patients to have the final say with regard to Medicaid managed care and the nine drug classes detailed below.

Governor Cuomo could take action on this bill within the next ten days.
Call the Governor’s office at 518.362.8946.

Write to Governor Cuomo’s Executive Assistant Katherine Santandrea at katherine.santandrea@exec.ny.gov.

-Prevailed in the New York State Capitol.

Update: Now that this bill passed in both New York State chambers, the bill was delivered to Governor Cuomo.

This bill passed at the end of the session. The idea is that physicians know their patients and his or her expertise allows the physician to make a determination with regard to which medications and combination medication therapies will be most effective for their patients. Now, even when a Medicaid managed care carrier denies a prescription that is considered “non-preffered drug in fee-for-service” Medicaid will be able to override those denials.

The classes of medications include immunosuppression medications prescribed to transplant recipients. Other drug classes include anti-depressant, hematologic, atypical antipsychotic,
anti-retroviral, seizure, epilepsy, and endocrine medications.

In the past, with Medicare managed care plans were able to prevent a physician’s prescription to his or her patient from being prescribed due to the bureaucracy and the continuous demand for proof that only that one particular medication would help the patient.

With this bill, a physicians choice based on his or her judgment will determine which prescription will be filled and given to the patient and the Medicaid managed plan will have no choice but to cover the medications in the above cited classes.

This bill was delivered to Governor Cuomo today.
Please call the Governor’s office at 518.362.8946.

A07208 Actions:
BILL NO A07208

04/28/2015 referred to health
05/12/2015 reported referred to ways and means
06/03/2015 reported referred to rules
06/09/2015 reported
06/09/2015 rules report cal.142
06/09/2015 ordered to third reading rules cal.142
06/09/2015 passed assembly
06/09/2015 delivered to senate
06/09/2015 REFERRED TO FINANCE
06/18/2015 SUBSTITUTED FOR S4893
06/18/2015 PASSED SENATE
06/18/2015 RETURNED TO ASSEMBLY
08/03/2015 delivered to governor

Senate bill sponsored by Senator Kemp Hannon and multiple cosponsors.

Assembly sponsored by Gottfried

cosponsors Rosenthal, Linares, Clark, Steck, Kearns, Ortiz, Zebrowski,
Magnarelli, Lavine, Stirpe, Lupardo, Davila, Kaminsky, Brindisi,
Solages, Titone, Gunther, Russell, Dinowitz, Crespo, Abbate, Hevesi,
Blake, Abinanti, Galef, Moya, DenDekker, Ryan, Jaffee, Cook,
Goldfeder, Silver, Saladino, Montesano, Brennan, Rivera, Dilan, Fahy,
Buchwald, Englebright, Perry, Skoufis, Arroyo, Hooper, Otis,
Rodriguez

Please note that the New York Health Plan opposed this bill. Their opposition documentation is here.