Bill Text: NY A03642 | 2021-2022 | General Assembly | Introduced

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Bill Title: Directs the department of health to request guidance from the Centers for Medicare and Medicaid Services to determine whether the state can claim federal financial participation for coverage of and payment for certain prescription digital therapeutics.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2022-05-31 - substituted by s559 [A03642 Detail]

Download: New_York-2021-A03642-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          3642

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                    January 28, 2021
                                       ___________

        Introduced  by  M.  of  A. L. ROSENTHAL -- read once and referred to the
          Committee on Health

        AN ACT in relation to determining whether the state  can  claim  federal
          financial  participation  for  coverage  of  and  payment  for certain
          prescription digital therapeutics

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1. Legislative finding and declaration. New Yorkers in recov-
     2  ery for substance and opioid use disorders and in treatment  for  mental
     3  health  conditions  are  losing  access to in-person treatment under the
     4  state's "stay at home" and social distancing orders as part of coronavi-
     5  rus pandemic mitigation efforts. In recent news  reports,  experts  warn
     6  that  the  coronavirus  pandemic may be "a national relapse trigger" for
     7  individuals in treatment for alcohol, cocaine, methamphetamine, marijua-
     8  na, and heroin addiction.  Prescription Digital Therapeutics (PDTs)  are
     9  new,  software-based  disease  treatments  designed  to  directly  treat
    10  disease, tested for safety and efficacy in randomized  clinical  trials,
    11  evaluated  by  the  FDA,  and  prescribed by healthcare providers. These
    12  therapies are designed and tested  much  like  traditional  prescription
    13  drugs  with  one distinction: rather than swallowing a pill or taking an
    14  injection, patients are treated  with  software.  Certain  PDTs  provide
    15  clinicians  and patients with evidence-based remote treatment modalities
    16  to treat substance and opioid use disorders, mental  health,  and  other
    17  diseases  and  conditions.  However, there is no clear statutory benefit
    18  category to allow Medicaid coverage for PDTs. In light of the promise of
    19  PDTs for the treatment of patients with substance  use  and  opioid  use
    20  disorders  during  the  coronavirus  pandemic,  this  legislation  would
    21  require that the New York state department of health seek guidance  from
    22  the  Centers  for  Medicare and Medicaid Services relative to a coverage
    23  and reimbursement pathway for PDTs, in order  to  accelerate  access  to
    24  such therapies for enrollees.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01006-01-1
        A. 3642                             2

     1    §  2.  No  later than 30 days from the effective date of this section,
     2  the New York state department of health shall request guidance from  the
     3  Centers  for  Medicare  and  Medicaid  Services to determine whether the
     4  state can claim federal financial  participation  for  coverage  of  and
     5  payment  for  certain  prescription digital therapeutics approved by the
     6  food and drug administration to  treat  substance  use  and  opioid  use
     7  disorders.
     8    § 3. This act shall take effect immediately.