Advocates urge Governor Hochul to sign the bills without delay
ALBANY, NY / ACCESSWIRE / June 28, 2023 / Patient advocacy and health policy organizations are applauding the New York Legislature for passing multiple bills that expand protections for patients with health insurance in New York.
"Governor Kathy Hochul should swiftly sign these bills and ensure patients gain these important protections," Ashira Vantrees, counsel to the not-for-profit Aimed Alliance, said.
The New York Senate and Assembly passed a bill sponsored by Senator Neil Breslin and Assemblymember John McDonald that requires health insurance plans to include certain information in a step-therapy denial letter (S.2677/A.463). Step-therapy policies require patients to try and fail on alternative treatments before the plan will cover the originally prescribed treatment. Many consumers are unaware that they have a right to appeal this requirement.
This bill will require health insurance plans to include in a step-therapy denial letter (1) the reason for the determination; (2) instructions on how to appeal; and (3) names of alternative medication covered, relevant clinical review criteria, and other necessary information.
"Providing these details in the denial letter will help ensure New York patients and caregivers have the necessary tools to have an active voice in their health care decisions," Ms. Vantrees said.
The New York Legislature also passed a bill sponsored by Senator Roxanne Persaud and Assemblymember Pamela Hunter that requires health insurance plans and the state Medicaid program to cover the cost of biomarker testing (S.1196/A.1673). Biomarker testing allows health care providers to have critical information about an individual's specific cancer and genetics, which can help inform treatment decisions.
Lastly, the New York Senate passed a bill sponsored by Senator Neil Breslin 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 (S.1267).
"Given this legislature also has the 2024 session to pass this legislation, the Assembly must act swiftly during the 2024 session to pass the bill and ensure New York patients are protected by these reasonable guardrails," Ms. Vantrees said.
To learn more about step therapy reform in New York, read Aimed Alliance's report: Utilization Mismanagement: Assessing Compliance with Step Therapy and Prior Authorization Laws in Select States (Jan. 2020).
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. Aimed Alliance is a leading member of the New York Step Therapy Alliance.
Media Contact:
Ashira Vantrees, Counsel
policy@aimedalliance.org
SOURCE: Aimed Alliance
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