New York Committee Approves Bill to Add Medical Marijuana Coverage to Public Insurance Programs

Legislation that would “add coverage of medical marijuana to public insurance programs and clarify that it may be covered by private insurance” has been passed by its initial committee in the New York Assembly.

Sponsored by Majority Leader Crystal Peoples-Stokes, A04713 was given approval today in an 18 to 7 vote by the Assembly Health Committee, moving it forward to the Ways and Means Committee .

“For thousands of patients, medical marijuana is a safer and more effective medication than other drugs, especially opioids”, states the “Justification” segment of the bill’s text. “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.”

The bill notes that “Cost is the primary barrier to patient access in New York’s medical marijuana program. Medicaid, other public health plans, and commercial health insurance plans do not cover medical marijuana, forcing patients to pay out of pocket.”

The bill’s authors say “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 bill clarifies that “The Commissioner of Health is authorized to certify medical marijuana dispensaries as Medicaid providers 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).”

Here’s the official legislative summary of the bill:

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.

More information on this proposal, including its full text, can be found by clicking here.

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