What's happening
This bill requires certain New York health insurance and assistance programs to cover medical marijuana as a prescription drug.
Why it matters
Expands access for vulnerable populations. By requiring Medicaid, Child Health Plus, Elderly Pharmaceutical Insurance Coverage (EPIC), and workers’ compensation to cover medical marijuana, the bill ensures that low-income individuals, children, seniors, and injured workers can access this treatment option if medically necessary.
Shields state coverage from federal policy changes. The bill mandates coverage for medical marijuana “regardless of federal financial participation,” meaning New York will provide coverage even if the federal government withholds matching funds due to marijuana’s federal status, potentially setting up a state-federal policy clash.
Normalizes medical marijuana as a standard treatment. By classifying medical marijuana as a “prescription drug,” “covered drug,” or “health care service” in various state programs and insurance contexts, the bill aims to integrate medical marijuana into mainstream medical care, which could influence prescribing habits and patient care standards.
Establishes a regulatory framework for dispensing. The law enables the state health commissioner to certify medical marijuana dispensaries as official Medicaid providers, creating a regulated pathway for patients to obtain medical marijuana using their health benefits, while also giving the state oversight of these transactions.
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Who cares
Headline styles
Cover Medical Marijuana Costs
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Referred to health
- Referred to health
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2054
2019-2020 Regular Sessions
IN SENATE
January 22, 2019
Introduced by Sen. SAVINO -- read twice and ordered printed, and when printed to be committed 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 Assembly, do enact as follows:
Section 1. Section 3368 of the public health law, as added by chapter 90 of the laws of 2014, is amended to read as follows:
§ 3368. Relation to other laws. 1. (a) The provisions of this article shall apply to this title, except that where a provision of this title conflicts with another provision of this article, this title shall apply.
(b) Medical marihuana shall not be deemed to be a "drug" for purposes of article one hundred thirty-seven of the education law. However, regardless of federal financial participation, medical marihuana, when dispensed under this title, shall be deemed to be (i) a "prescription drug" for purposes of coverage under medical assistance under title eleven of article five of the social services law (provided that the dispensing site is certified under subdivision ten of section three hundred sixty-five-a of the social services law), title one-A of article twenty-five of this chapter, the insurance law, and the workers' compensation law; (ii) a "covered drug" for purposes of coverage under title three of article two of the elder law; and (iii) a "health care service" under section three hundred sixty-nine-gg of the social services law (unless the commissioner finds that this will result in the loss of federal financial participation in the program under that section).
2. Nothing in this title shall be construed to require or prohibit an insurer or health plan under this chapter or the insurance law to provide coverage for medical marihuana, except that it shall be covered, as provided in subdivision one of this section, by any insurer or health 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.
LBD03876-02-9
S. 2054 2
title one-A of article twenty-five of this chapter, the workers' compensation law, title three of article two of the elder law, and section three hundred sixty-nine-gg of the social services law. [Nothing in this title shall be construed to require coverage for medical marihuana under article twenty-five of this chapter or article five of the social services law.]
§ 2. Section 365-a of the social services law is amended by adding a new subdivision 10 to read as follows:
10. The commissioner may certify a dispensing site authorized under title five-A of the public health law as a medical assistance provider, solely for the purpose of dispensing medical marihuana.
§ 3. 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, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized to be made and completed on or before such date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
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
To add coverage of medical marijuana to public insurance programs and clarify that it may be covered by private insurance.
Summary of specific 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, Elder- ly 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
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- income 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 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).
Prior legislative history
2018 Session New bill - S.9189 - no significant action
Fiscal implications
To be determined to the extent medical marijuana displaces other prescription drugs, there could be substantial savings.
Effective date
April 1 succeeding the date on which it shall have become law
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.