BILL NUMBER: S2568
SPONSOR: COONEY
 
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 dispensing medical
marijuana
Section 3: Effective date.
 
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 provid-
ers solely for dispensing medical marijuana (i.e. they cannot 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:
2017-18 Session - S9189
2021-22 - S.8837 (Savino)
 
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

Statutes affected:
S2568: 3368 public health law, 365-a social services law