State Budget Enacted – MSSNY Advocacy Results in the Removal of Many Problematic Provisions

The New York State Legislature completed passage of a $153 Billion State Budget last night, 9 days after the State due date of April 1, and after several weeks of “round the clock” negotiations on an extraordinary number of difficult issues including raising the age of criminal responsibility, ride-sharing, education funding, emergency Budgetary powers, a Medicaid prescription drug price cap and Workers Compensation reform.  While the Legislature passed a two-month Budget extender last week, this final Budget deal overrides that legislation. Thanks to strong advocacy by MSSNY physician leaders, MSSNY member physicians, county medical societies, and the many specialty societies with whom MSSNY works closely, the final Budget enacted DID NOT contain several objectionable provisions that had been opposed by MSSNY.  The final Budget:
  • Deleted a proposal opposed by MSSNY that would have required a physician to receive a “tax clearance” as a pre-condition of receiving Excess Medical Liability Insurance coverage, while assuring that the more than 20,000 physicians who currently receive Excess coverage continue to receive such coverage;
  • Deleted a proposal opposed by MSSNY that would have expanded burdensome prior authorization requirements by repealing statutory provisions that assure that the prescriber has the final say for all prescriptions for fee for service Medicaid patients as well for several drug classes for patients covered through Medicaid managed care;
  • Deleted a proposal opposed by MSSNY that would have permitted pharmacists to enter into “comprehensive medication management protocols” with nurse practitioners to manage, adjust and change the medications of patients with a chronic disease or who have not met clinical goals of therapy;
  • Deleted a proposal opposed by MSSNY to create a Regulatory Modernization Team that could have empowered state agencies to override existing scope of practice laws without legislative approval;
  • Substantially revised provisions to permit Medicaid to sanction or remove a health care practitioner who violates a statutory limit on opioid prescribing, by assuring that a prescriber has appropriate due process protections before a sanction is imposed.
  • Continues necessary funding for MSSNY’s Committee for Physician’s Health and MSSNY’s Veterans Mental Health Care educational program;
  • Deleted several problematic elements that had been under serious consideration to be included in Workers’ Compensation Reform package enacted as part of the Budget, including provisions that would have:
    • Limited injured worker choice of treating physician by expanding the required use of Workers Compensation PPOs;
    • Removed the authority of county medical societies to recommend physicians to be approved to be WC-authorized providers or IMEs;
    • Expanded the penalties that the Board could impose on WC-authorized physicians;
    • Expanded the list of authorized health care providers in Workers Compensation, without any requirement for several of these providers to collaborate with a physician.
It should be noted that the final package includes a number of notable reforms that will have a significant long-term impact on New York’s Workers Compensation system including provisions that will:
  • Implement new impairment guidelines by year end 2017 after “consultation with  representatives of labor, business, medical providers, insurance carriers, and  self-insured employers”;
  • Create a prescription drug formulary by year end 2017 which “shall  include  a tiered list of high-quality, cost-effective medications that are pre-approved to be  prescribed  and  dispensed,  as well as additional non-preferred drugs that can be prescribed with prior approval”.
  • Create a workgroup in 2018 to review the criteria for those who provide Independent Medical Exams (IMEs);
  • Expedite the timeframe for Workers Compensation coverage disputes to be resolved; and
  • Grant additional powers to the Workers Compensation Board to impose “performance standards” on Workers Compensation carriers.