Directs the department of health to convene a health technology assessment committee to advise the commissioner of health on coverage of health technology under the medical assistance program; repealer

BILL NUMBER:S1112A

Title of bill

An act to amend the social services law, in relation to establishing a health technology assessment committee within the medical assistance program; and to repeal section 365-d of such law relating to early and periodic screening diagnosis and treatment outreach demonstration projects

Purpose

This bill establishes a committee to provide advice and recommendations to the Department of Health regarding Medicaid coverage of medical devices and surgical procedures thus enhancing transparency and public participation in the process.

Summary of provisions

Section 1 of the bill repeals the existing section 365-d of the social services law which was a demonstration program that expired in June 1983. A new section 365-d is added to the social services law to establish a health technology assessment committee which would provide advice and recommendations to the commissioner for purposes of health technology (i.e. medical device and surgical procedure) coverage determinations. Section 1 also authorizes the commissioner to appoint members to the committee and defines committee members' qualifications including representatives of consumer groups, health professions, insurers and others. The committee would be a public committee for purposes of the open meetings law, the public would receive notice of the committee's deliberations and have an opportunity to provide comment.

Section 2 of the bill is the effective date.

Justification

Medical technology, including medical devices and surgical procedures have greatly improved health care, reduced health expenditures, and reduced medical errors. Medical technology is subject to extensive review at the federal level including review by the Agency for Healthcare Quality and Research, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services. New York, through its efforts to reform the Medicaid system, has begun to examine some medical technology to determine if particular applications should continue to be covered by the Medicaid program. This bill insures that such decision are made with ample opportunity for input and transparency.

The Department of Health has implemented a health care technology assessment process through one of its MRT workgroups which has led to the exclusion of certain devices and procedures from coverage by the medical assistance program. While it is important to closely evaluate expenditures and benefits within the publicly funded Medicaid program, decisions must be made based upon sound evidence, with as much information as possible available and in a transparent manner. This legislation is modeled on the Drug Utilization Board which is established to review and make recommendations to the Department on changes to pharmaceutical benefits under the Medicaid Program. It

would open the Department's health technology assessment process to similar public participation and review, creating the needed transparency and accountability. Public participation would also provide the Department the benefit of stakeholder input which will improve the Department's deliberations.

Legislative history

S.4509 of 2014

Fiscal implications

To be determined.

Effective date

Immediately.