Hochul Signs Long-Awaited Bill Removing MOUD Barriers for New Yorkers on Medicaid

    New York Governor Kathy Hochul signed legislation that removed prior authorization for people on Medicaid to access medication for opioid use disorder (MOUD), a move that activists said signaled a seismic shift in the way the new administration is approaching harm reduction.

    The bill, which takes effect in March 2022, will enable New Yorkers on Medicaid to receive methadone, buprenorphine and naltrexone waiting for approval from their insurer. The move is expected to save hundreds of lives a year, as well as more than $50 million in annual Medicaid savings.

    Activists had pushed for the removal of prior authorization for MOUD for years. In 2020, then-governor Andrew Cuomo issued a last-minute veto on a bill that would have removed them for Medicaid recipients—despite signing a partner measure that removed them for people who had private insurance, effectively creating a two-tiered system for New Yorkers with opioid use disorder.

    Hochul’s signing of this bill “really sets the tone for her administration, of how this administration is going to be 360-degrees different from Governor Cuomo,” VOCAL-NY Director of Drug Policy Jasmine Budnella told Filter.

    The legislation was initially part of a trio of harm reduction bills VOCAL and other advocates had been urging Hochul to sign upon her inauguration in August. The other two, which decriminalized syringes for drug use and guaranteed MOUD access to people in jails and prisons, were signed in October. The Medicaid bill was left out without public explanation.

    A week before Hochul signed the two other harm reduction measures, New York implemented a formulary that standardized which drugs Medicaid covered without prior authorization. But Budnella said that the change has created confusion for some MOUD recipients, which may have contributed to Hochul’s decision to sign the bill now.

    “I am much more hopeful than I ever have been,” said Assemblymember Linda Rosenthal.

    A spokesperson for the governor did not state whether implementation of the formulary influenced her decision to sign the bill, nor whether the prior authorization legislation received more scrutiny than the harm reduction measures signed in October.

    “Upon taking office less than five months ago Governor Hochul began the process of reviewing nearly 500 pieces of legislation that were awaiting the executive’s signature,” the spokesperson stated to Filter. “[S]he is proud to have signed multiple new bills into law that expand harm reduction policies.”

    Assemblymember Linda Rosenthal, one of the Medicaid bill’s sponsors, told Filter the signing was “a great holiday present for a lot of people.”

    Pointing to Hochul’s selection of Chinazo Cunningham as the commissioner of the Office of Addiction Services and Supports and Mary Bassett as the Health Commissioner, Rosenthal said that Hochul’s early decisions around harm reduction have been encouraging.

    “I’m hopeful that she brings a much different understanding to the issue and that she understands that these are not just numbers and stats,” Rosenthal told Filter. “These are real people that we have an obligation to help. I am much more hopeful than I ever have been about the state and the governor being serious about affecting change for people with substance use disorder.”

    Opioid-involved overdose has skyrocketed during the pandemic. More than 2,000 people in New York City alone died of overdose in 2020, representing the highest death toll since the city began tracking such data.



    Photograph via New York State Office of Addiction Services and Supports

    • Daniel is a freelance reporter whose work has been published in outlets including Fortune, The Appeal and Gothamist. He will FOIA documents related to criminal justice if you ask nicely. He lives in Brooklyn.

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