Memorandum in Opposition

For Immediate Release: February 4, 2022

Re:      S.3231-A (Sanders)/ A.832-A (Gottfried) – AN ACT to amend the public health law and insurance law, in relation to certain contracts or agreements by health maintenance organizations

This legislation, S.3231-A/ A.832-A, is anti-consumer and encourages off label prescriptions. Moreover, it is duplicative of existing law. Accordingly, the New York Health Plan Association (HPA) opposes this bill.

Subdivision 12 of this proposal promotes out-of-network referrals that will cause patients to incur additional and unnecessary out-of-pocket expenses for health care, but makes no requirement for providers to inform patients that they will be liable for those costs. This provision of the bill is decidedly anti-consumer.

Subdivision 13 of the bill unnecessarily requires the approval of prescribing providers for all pharmaceutical substitutions except for generic drugs. This duplicates New York’s prescribing Dispense As Written laws that already require alterations in drug therapy may only be executed under the authority of the patient’s provider. Pharmacists can be sanctioned if they are found to be “substituting without authorization” drugs specified in a prescription.

We believe S.3231-A/A.832-A is unnecessary, burdensome, and, more importantly, anti-consumer. For all these reasons, the New York Health Plan Association urges your opposition to this proposal.