Assembly Bill A4077

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4077
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 31, 2025
                                ___________
 
 Introduced  by  M.  of  A.  CUNNINGHAM  -- 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
   evidence-based mobile medical applications

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Legislative finding and declaration. New Yorkers in recov-
 ery for substance and opioid use disorders and in treatment  for  mental
 health  conditions  are  losing  access to in-person treatment under the
 state's "stay at home" and social distancing orders as part of coronavi-
 rus pandemic mitigation efforts. In recent news  reports,  experts  warn
 that  the  coronavirus  pandemic may be "a national relapse trigger" for
 individuals in treatment for alcohol, cocaine, methamphetamine, marijua-
 na, and heroin addiction.   Evidence-based mobile  medical  applications
 are  new,  software-based  disease treatments designed to directly treat
 disease, tested for safety and efficacy in randomized  clinical  trials,
 evaluated  by  the  FDA,  and  prescribed by healthcare providers. These
 therapies are designed and tested  much  like  traditional  prescription
 drugs  with  one distinction: rather than swallowing a pill or taking an
 injection, patients are treated with  software.  Certain  evidence-based
 mobile   medical  applications  provide  clinicians  and  patients  with
 evidence-based remote treatment modalities to treat substance and opioid
 use disorders, mental health, and other diseases and conditions.  Howev-
 er,  there  is  no  clear  statutory  benefit category to allow Medicaid
 coverage for evidence-based mobile medical applications.   In  light  of
 the promise of evidence-based mobile medical applications for the treat-
 ment  of patients with substance use and opioid use disorders during the
 coronavirus pandemic, this legislation would require that the  New  York
 state  department  of health seek guidance from the Centers for Medicare
 and Medicaid Services relative to a coverage and  reimbursement  pathway
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02326-01-5
              

 A. 4077                             2
 
 for  evidence-based  mobile medical applications, in order to accelerate
 access to such therapies for enrollees.
   §  2.  No  later than 30 days from the effective date of this section,
 the New York state department of health shall 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  evidence-based mobile medical applications approved by the
 food and drug administration to  treat  substance  use  and  opioid  use
 disorders.
   § 3. This act shall take effect immediately.