January 6, 2017  — Categorized in:

Governor Cuomo Signs New York Step Therapy Bill

Governor Andrew Cuomo signed a bill Saturday changing the rules surrounding step therapy, a process by which insurers can require that certain drugs be tried first before approving a physician’s prescription.

The bill, which passed unanimously in the State Senate and Assembly, does not ban the use of step therapy but does provide rules governing how physicians may appeal an insurer’s decision and how long an insurer has to answer that appeal.

The new law requires insurers to provide an answer to the appeal within 72 hours, or 24 hours in case of emergency.

Physician groups and patient advocates were quick to praise Cuomo.

“We thank Governor Cuomo for seeking to address the concerns regarding step therapy protocols that had been raised by patients and physicians,” Malcom Reid, president of the Medical Society of the State of New York, said in a statement.

“By signing this bill to limit step therapy policies, the Governor is helping patients get access to the lifesaving medicine they need” Julie Hart, director of government relations for the American Cancer Society Action Network, said in a statement.

The bill was opposed by the New York Health Plan Association, a trade group representing insurers, which worried about vague language in the law that could let physicians declare their preference is in the “best interest of the patient” — a subjective term — and override an insurer’s decision.

Cuomo on Saturday also vetoed legislation that would have created a new definition for safety net hospitals and required the administration to provide a higher Medicaid rate to those newly designated hospitals.

The bill passed unanimously in both chambers last June. Cuomo’s veto was expected because the legislation would have required increased Medicaid funding without specifying how the state would pay for this new obligation or how much it would cost.

View Cuomo’s veto messages here: http://politi.co/2iROVm

* Originally posted on Politico


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