Prescriber Prevails 2016 Advocacy Group Sign On Letter
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March 03, 2016

  Senator John Flanagan
Senate Majority Leader John Flanagan
Capitol Building, Room 330
Albany, NY 12248
Senator Jeff Klein  
Senate Coalition Leader Jeffrey Klein
Legislative Office Building, Room 913
Albany, NY 12247
Assemblymember Carl Heastie  
Assembly Speaker Carl Heastie
Capitol Building, Room 932
Albany, NY 12248
Dear Majority Leader Flanagan, Speaker Heastie, and Coalition Leader Klein,

The Senate and Assembly have played a crucial role in defending the rights and health of millions of patients across the state, including supporting patient access to medications in the state's Medicaid program. Unfortunately, the Executive Budget is seeking to repeal important patient protections. On behalf of the undersigned and the patients we serve, we ask that you oppose provisions that repeal prescriber prevails in Medicaid fee for service and managed care, and that you consider expanding this important patient protection to all drug classes across both programs.

Patients and their health care providers face challenges when it comes to finding proper treatment, because no illness comes in a one-size-fits-all form. Responses to medications vary based on an individual's age, ethnicity, and comorbidities, making it crucial that health care providers have the ability to select medications best suited to treat their patients' unique needs. Prescriber prevails is a cost-effective means to help ensure that patients get the most appropriate treatments - and get treatments that they can adhere to. Appropriateness and adherence are proven to help avoid costly inpatient and emergency room care, as well as to improve quality of life. 
In 2015, the Assembly and Senate passed legislation to require that a prescriber's determination is final in managed care. Unfortunately, the Governor vetoed this measure. We request your consideration in inserting the bill's provisions into the final budget. This measure would simply require that the prescriber prevails statute works as originally intended.
The Executive Budget also proposes to bypass the longstanding processes of the Medicaid Drug Utilization Review Board (DURB) by allowing prior authorization of drugs before they have been reviewed. The DURB is an independent body comprised of doctors, pharmacists, disease experts, and consumers who provide expert counsel to the Department of Health (DOH) regarding the Preferred Drug Program. According to the DOH website, the DURB is charged with helping to ensure if drugs are appropriate, medically necessary, and safe. It makes no sense to grant the DOH authority to bypass this important consumer protection body. We urge you to reject this proposal.

Regardless of disease state, all patients deserve equal and meaningful protections. We thank you for your time and attention to this issue.
Latino Commission on AIDS
Hispanic Health Network
Hispanic Federation
New York Association of Psychiatric Rehabilitative Services
US Pain Foundation
International Institute for Human Empowerment
Mental Health Association in New York State
Jewish Board
Northeast Kidney Foundation
Callen-Lorde Community Health Center
1 in 9: The Long Island Breast Cancer Coalition
BOOM! Health
VOCAL New York
Women in Progress
New York State Academy of Family Physicians
Iris House
Housing Works
Bronx HIV Care Network
Bronx Parent Housing Network
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