Senate Bill S8541

                                 
BILL NUMBER: S8541

SPONSOR: WEBB
 
TITLE OF BILL:

An act to amend the social services law, in relation to requiring
medical assistance to include medical care, services or supplies to
monitor blood pressure that have been validated for accuracy and are
furnished without prior authorization to eligible pregnant women

 
PURPOSE OR GENERAL IDEA OF BILL:

To have medical assistance cover validated medical care, services and
supplies used to monitor blood pressure for pregnant women without prior
authorization.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1: Subdivision 6 of section 365-a of the Social Services Law, as
amended by chapter 484 of the laws of 2009, is amended to include new
subsections a and b which detail the inclusion of validated medical
care, services and supplies used to monitor blood pressure for pregnant
              

women in Medicaid coverage.

Section 2: Sets effective date

 
JUSTIFICATION:

High blood pressure during pregnancy carries potential risks and needs
close monitoring. High blood pressure may begin prior to pregnancy, but
in some cases, the condition can develop during pregnancy. High blood
pressure in pregnant individuals can cause chronic hypertension, chronic
hypertension with superimposed preeclampsia, gestational hypertension,
and preeclampsia. Untreated preeclampsia can lead to serious and some-
times fatal complications for both the birthing individual and the baby.
Therefore, facilitating easier access to at-home blood pressure monitors
is essential to prenatal and postpartum care. Regular blood pressure
checks can help identify high blood pressure conditions early on, allow-
ing for prompt treatment and reduced risk of complications during deliv-
ery.  Currently, in New York State, Medicaid provides up to $50 in
coverage for blood pressure cuffs and devices, but only if ordered by a
qualified practitioner as part of a comprehensive treatment plan that
requires monitoring and recording of blood pressure readings in-home.
It is concerning that a prescription creates unnecessary barriers to
access, that none of the devices covered by Medicaid are validated by
the American Medical Association, that damaged devices and cuffs are not
being punctually replaced, and that coverage is not being extended for
larger sized cuffs. It is particularly concerning that validated devices
most beneficial to pregnant and postpartum individuals are seemingly not
currently covered by Medicaid.

To address this issue, this bill would require Medicaid to automatically
authorize coverage for blood pressure monitors without a prescription
for individuals who are pregnant.

 
PRIOR LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
Effective immediately.