Deal reached in Albany on heroin, opioids

The deal, between Cuomo, Senate Majority Leader John Flanagan, Assembly Speaker Carl Heastie and Senate Independent Democratic Conference Leader Jeffrey Klein “builds on the state’s aggressive efforts to better monitor prescription drugs, increase access to treatment, and break the cycle of heroin and opioid addiction in New York,” according to Cuomo’s office.

Highlights of the bill include provisions to limit the over-prescription of opioids, limits prescriptions of those opiods from 30 to seven days, and remove barriers to access for inpatient treatment and medication.

“New York and the nation as a whole is grappling with how to combat heroin and opioid addiction and, with this comprehensive plan, we are continuing to take decisive action to end this epidemic and protect our families and communities,” Gov. Cuomo said. “This multi-faceted legislative package will increase access to treatment, expand prevention strategies, and save lives by helping ensure New Yorkers struggling with addiction have access to the services and resources they need to get well.”

Specific details of the bill according to Cuomo’s office:

• Ends Prior Insurance Authorization to Allow for Immediate Access to Inpatient Treatment as Long as Such Treatment is Needed: People suffering from addiction who seek treatment need immediate access to services, but prior authorization requirements by insurance companies are often a roadblock to admission to inpatient programs. This legislation requires insurers to cover necessary inpatient services for the treatment of substance use disorders for as long as an individual needs them. In addition, the legislation establishes that utilization review by insurers can begin only after the first 14 days of treatment, ensuring that every patient receives at least two weeks of uninterrupted, covered care before the insurance company becomes involved.
• Ends Prior Insurance Authorization to Allow for Greater Access to Drug Treatment Medications: People seeking medication to manage withdrawal symptoms or maintain recovery must often request prior approval from their insurance company, which slows or stops the individual from getting needed medication. This legislation prohibits insurers from requiring prior approval for emergency supplies of these medications. Similar provisions will also apply to managed care providers treating individuals on Medicaid who seek access to buprenorphine and injectable naltrexone.
• Requires All Insurance Companies Use Objective State-Approved Criteria to Determine the Level of Care for Individuals Suffering from Substance Abuse: Insurance companies often use inconsistent criteria to determine the covered level of care for persons suffering from substance use disorder, which often creates barriers preventing these individuals from receiving care. This legislation will require all insurers operating in New York State to use objective, state-approved criteria when making coverage determinations for all substance use disorder treatment in order to make sure individuals get the treatment they need.
• Mandate Insurance Coverage for Opioid Overdose-Reversal Medication: Naloxone is a medication that revives an individual from a heroin or opioid overdose and has saved thousands of New Yorkers’ lives. To expand access to this life-saving medication, the new legislation requires insurance companies to cover the costs of naloxone when prescribed to a person who is addicted to opioids and to his/her family member/s on the same insurance plan.
• Increase Evaluation for Individuals Incapacitated by Drugs from 48 to 72-Hours: Sometimes, individuals suffering from addiction are at risk for overdose and thus pose a threat to themselves. The legislation allows families to seek 72-hours of emergency treatment, an increase from the current 48-hours, for their loved one to stabilize and connect them to longer-term treatment options while also balancing individual rights of the incapacitated individuals.
• Require Hospitals to Provide Follow-Up Treatment Service Options to Individuals Upon Hospital Discharge: Hospitals play an important role in caring for individuals suffering from addiction who are often admitted to hospital emergency rooms after an overdose. This legislation requires hospital medical staff to provide discharge-planning services to connect patients who have or are at-risk for substance use disorder with nearby treatment options to provide continuous medical care.
• Allow More Trained Professionals to Administer Life-Saving Overdose-Reversal Medication: Overdose-reversal medication such as naloxone saves lives. However, the law does not currently allow certain licensed professionals to administer this medication to individuals overdosing from heroin and opioids. To ensure that more people are able to help reverse overdoses, the new legislation authorizes trained professionals to administer naloxone in emergency situations without risk to their professional license.
• Expand Wraparound Services to Support Long-Term Recovery: Individuals leaving treatment are at great risk for relapse. To provide services during this critical period, the legislation extends the wraparound program launched in 2014 to provide services to individuals completing treatment including education and employment resources; legal services; social services; transportation assistance, childcare services; and peer support groups.
• Reduce Prescription Limits for Opioids from 30-days to Seven Days: There is a well-established link between the rise in opioid prescriptions and the current heroin crisis. To reduce unnecessary access to opioids, the legislation lowers the limit for opioid prescriptions for acute pain from 30-days to no more than a 7-day supply, with exceptions for chronic pain and other conditions.
• Require Ongoing Education on Addiction & Pain Management for All Physicians and Prescribers: Physicians and other opioid prescribers are important partners in preventing addiction linked to abuse of prescription opioids. To ensure that prescribers understand the risks presented by prescription opioids, the legislation mandates that these health care professionals complete three hours of education every three years on addiction, pain management, and palliative care.
• Mandate Pharmacists Provide Easy to Understand Information on Risks Associated with Drug Addiction and Abuse: Consumers may not understand the addiction and abuse risks posed by prescription opioids. To improve consumer awareness about these risks the legislation requires pharmacists to provide educational materials to consumers about the risk of addiction, including information about local treatment services.
• Require Data Collection on Overdoses and Prescriptions to Assist the State in Providing Additional Protections to Combat this Epidemic: Current and accurate data is critical to combat the heroin and opioid crisis yet gaps currently exist in statewide data on overdoses and usage of opioid reversal medication. To fill that gap the legislation requires the State Commissioner of Health to report county-level data on opioid overdoses and usage of overdose-reversal medication on a quarterly basis.

NYS Office of Alcoholism and Substance Abuse Services Commissioner Arlene González-Sánchez said, “We traveled the state and heard from New Yorkers about what they need to battle opioids and addiction. I am pleased and proud to say that this comprehensive package of legislation addresses the needs of New Yorkers battling addiction and positions New York’s substance use disorder care system as one of the strongest in the nation. I thank Governor Cuomo, Lieutenant Governor Hochul, Task Force members, the Senate and Assembly, and my dedicated team at OASAS, for their commitment to strengthening our addiction system of care and their hard work to enact a package of bills that will help New Yorkers overcome addiction now and into the future.”

Today’s agreement also allocates funding to add 270 treatment beds and 2,335 opioid treatment program slots across the state to help New Yorkers suffering from substance use disorder and to expand vital treatment and recovery resources.

The agreement funds additional family support navigators across New York to assist substance users and their families locate and access treatment options and cope with addiction. The agreement will also expand the on-call peer program which partners individuals in recovery with people in hospitals suffering from substance use disorder to help connect these individuals to treatment and other resources upon discharge. The state is also increasing the number of Recovery Community and Outreach Centers and Adolescent Club Houses statewide to provide safe spaces for teens in recovery that deliver health and wellness services for teens and young adults.

NYS Health Commissioner Dr. Howard Zucker said the agreement “will help us battle the growing opioid and heroin epidemic and save countless lives. These measures will increase access to treatment for people trying to recover from addiction, and require physicians and patients alike to fully understand the potential dangers of opioid abuse.”

Anne Constantino, a Task Force member and CEO of Horizon Health Services, said, “The changes represented in this package will go a long way in helping us to prevent serious addiction and to provide timely access to treatment and recovery support. These solutions are workable and will make an immediate impact. I am grateful for the courage of those who shared their personal stories, and for the commitment and compassion shown by all those that have advocated for lives to be saved.”

New Yorkers struggling with an addiction, or whose loved ones are struggling, can find help and hope by calling the state’s HOPEline at 1-877-8-HOPENY (1-877-846-7369) or by texting HOPENY (Short Code 467369).