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Mental Health Update

June 11, 2019
Mental Health Update

MH Update – 6/11/19 – Bill to Eliminate Prior Authorization for Medication Proven to be Effective for those with an Opioid Addiction Passed by the Legislature

In all the last minute activity taking place at the end of New York’s legislative session, there are some important bills that have been debated and passed by the Legislature. One of the most important bill is S-4808 (Harkham) and A-02904 (Quartz).

Eliminating Prior Authorizations for Sab Oxone and Vivitrol is an effective strategy for individuals with Substance Use Disorders

This law would eliminate prior authorization for initial and renewal prescriptions for buprenorphine (Sab Oxone) and naltrexone (Vivitrol) for commercial insurance plans.  It is estimated that over half of individuals with a serious mental health issue also have a co-occurring drug or alcohol dependency issue.

Medication Assistance Therapy (MAT) is a combination of medication and counseling and has proven to be one of the most effective tool in treatment of Substance Use Disorders. These two medications are integral to a MAT strategy

What this Means in Real Life

Under this proposed law,  individuals covered by commercial insurance plan would automatically have access to Sab Oxone and Vivitrol without having to go through a health plan formulary.  This is significant.  Think about an individual struggling with an opioid addiction who finally has the courage to reach out to a medical professional. This medical professional recognizes that access to either Sab Oxone or Vivitrol could help end diminish the pain of addiction.  Yet if these medications are not part of a plan’s formulary, the individual would have to pay out of a pocket for medication that could help save their lives. With passage of this bill, individuals in commercial plans would have automatic access to these medications without having to go through a prior authorization process. It will save lives.

On a personal note, I know of several people who would not be alive today if they did not have access to these medications.

Where is the bill now?

The Legislature has passed this bill and it is awaiting Governor Cuomo’s signature. We have no sense yet of when it will come to his desk. We are very hopeful he will sign this legislation. Governor Cuomo has been a strong advocate for behavioral health parity. He has championed a series of initiatives that have helped provide greater access to commercial insurance and Medicaid for people with behavioral health issues.

We urge him to support this legislation when it comes to his desk.

Future Advocacy

We will keep people apprised when this bill comes to his desk.  We will have to rely on your advocacy and support to get this law passed.