The Issues

Preserving Patient Protections

New York Health Works is working to improve the access to medications for all patents in New York. Patients should have access to the treatment options and medication regimens they need to better their health. Prescriber prevails, transparency in medication coverage and non-discrimination standards are essentials in preserving patient protections in New York.  

Prescriber Prevails

Prescriber Prevails is critical to providing patients with access to quality health care. It means that patients and health care providers have the final say in medications that are medically necessary for patients. Prescriber Prevails eliminates barriers between patients and the care they deserve.

Transparency in Medication Coverage

While New York has extensive regulation requiring patient access to prescription formulary information, the New York State of Health website’s formulary information is difficult to access and confusing to patients. In order to improve access to quality health care for patients, New York must improve transparency in medication coverage.

Non-Discrimination Standards

The Affordable Care Act (ACA) and New York State of Health Qualified Health Plans have adopted non-discrimination standards. This has not prevented health plans from placing all medicines in a therapeutic drug class in the highest cost tier. High cost tiers require patients to pay at least 30 percent of the cost of the medicine, which can leave patients with no affordable option for medication coverage.