Memorandum in Support of A.7246A/S.5935
An Act to amend the Public Health Law, in relation to medication assisted treatment for substance use disorders

Health Care For All New York (HCFANY) is a statewide coalition of over 170 organizations dedicated to achieving quality, affordable health coverage for all New Yorkers. We strive to bring consumer voices to the policy conversation, ensuring that the concerns of real New Yorkers are heard and reflected. HCFANY strongly supports A.7246A/S.5935, which would make available to Medicaid recipients, without prior authorization, all US Food and Drug Administration (FDA) approved forms of medication-assisted treatment (MAT) used to treat substance use disorders.

New York faces a substance use and mental health crisis. In 2017, 3,264 New Yorkers died of opioid overdose, far surpassing motor vehicle deaths during the same period, and over 1,600 New Yorkers died of suicide.

Medicated-Assisted Treatment (MAT), also known in New York as “Medication-Supported Recovery” (MSR), is the use of FDA approved medications along with counseling and behavioral therapies to provide a “whole-patient” approach to treating substance use disorders.[1] For most people, the use of medications combined with psychosocial treatment is better than drug or psychosocial treatment on its own.[2] MAT can be used to treat opioid dependence and addiction as well as alcohol use disorder. MAT helps people sustain recovery by increasing treatment retention, decreasing criminal activity, and supporting a patient’s ability to gain and maintain employment.[3]

Despite MAT’s demonstrated effectiveness, however, many are unable to access its benefits. Limited insurance coverage is one key reason why people do not use MAT. New York state law includes Medicaid coverage of inpatient and outpatient services for someone with a substance use disorder, and screening for individuals at risk, but does not specifically mention coverage of MAT. A.7246A/S.5935 would remove this insurance barrier by making available to the state’s Medicaid population all FDA approved forms of MAT.

In addition, under federal and state law, Medicaid must cover all medically necessary services. When someone has a substance use disorder, the provider in consultation with the patient should be able to determine what is medically necessary to support the individual’s recovery, and if appropriate, then prescribe the MAT that best supports the individual’s recovery. Removing the barrier of prior authorization makes it easier for the patient to get and take MAT. Supporting A.7246A/S.5935 means standing behind substance use disorder providers who work tirelessly for their patients and giving New Yorkers in recovery every chance for success.

For those reasons HCFANY strongly urges the enactment of this bill.

[1] Substance Abuse and Mental Health Services Administration, https://www.samhsa.gov/medication-assisted-treatment.

[2] Medication-Assisted Treatment Improves Outcomes for Patients With Opioid Use Disorder, Fact Sheet, The Pew Charitable Trusts, November 2016, available at https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2016/11/medication-assisted-treatment-improves-outcomes-for-patients-with-opioid-use-disorder.

[3] Substance Abuse and Mental Health Services Administration, https://www.samhsa.gov/medication-assisted-treatment/treatment#medications-used-in-mat.

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