A 4077: Directs the department of health to 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 certain evidence-based mobile medical applications.

  
  STATE OF NEW YORK ________________________________________________________________________ 4077 2025-2026 Regular Sessions  IN ASSEMBLY 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: 1 Section 1. Legislative finding and declaration. New Yorkers in recov- 2 ery for substance and opioid use disorders and in treatment for mental 3 health conditions are losing access to in-person treatment under the 4 state's "stay at home" and social distancing orders as part of coronavi- 5 rus pandemic mitigation efforts. In recent news reports, experts warn 6 that the coronavirus pandemic may be "a national relapse trigger" for 7 individuals in treatment for alcohol, cocaine, methamphetamine, marijua- 8 na, and heroin addiction. Evidence-based mobile medical applications 9 are new, software-based disease treatments designed to directly treat 10 disease, tested for safety and efficacy in randomized clinical trials, 11 evaluated by the FDA, and prescribed by healthcare providers. These 12 therapies are designed and tested much like traditional prescription 13 drugs with one distinction: rather than swallowing a pill or taking an 14 injection, patients are treated with software. Certain evidence-based 15 mobile medical applications provide clinicians and patients with 16 evidence-based remote treatment modalities to treat substance and opioid 17 use disorders, mental health, and other diseases and conditions. Howev- 18 er, there is no clear statutory benefit category to allow Medicaid 19 coverage for evidence-based mobile medical applications. In light of 20 the promise of evidence-based mobile medical applications for the treat- 21 ment of patients with substance use and opioid use disorders during the 22 coronavirus pandemic, this legislation would require that the New York 23 state department of health seek guidance from the Centers for Medicare 24 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 1 for evidence-based mobile medical applications, in order to accelerate 2 access to such therapies for enrollees. 3 § 2. No later than 30 days from the effective date of this section, 4 the New York state department of health shall request guidance from the 5 Centers for Medicare and Medicaid Services to determine whether the 6 state can claim federal financial participation for coverage of and 7 payment for evidence-based mobile medical applications approved by the 8 food and drug administration to treat substance use and opioid use 9 disorders. 10 § 3. This act shall take effect immediately.