Joint Statement by New York’s Leading Patient Advocacy Groups Regarding Legislative Restoration of Medicaid “Prescriber Prevails” Protections

We are pleased that the State Senate included a restoration of Medicaid “prescriber prevails” protections in its one-house budget bill.

The Senate restored protections for all classes of patients, which is the right thing to do.

All patients expect and deserve to have doctors – not health plan managers — make the final determination on which drugs they receive.  No one should have their treatment regimen disrupted and their health endangered.

The State Assembly — while agreeing that the policy needs to be changed – made only a partial restoration of the protections –applying only to those few individuals left in fee for service Medicaid and those being treated for mental illness in managed care.

We hope the Assembly will work with the Senate to further strengthen the protections.

In this regard, the logic that leads one to conclude that a doctor should have a final say over which drugs a mental health patient receives must also apply to cancer patients or AIDS patients or anyone suffering from a chronic disease.

Today’s Siena poll strongly underscores this point. An overwhelming percentage of New Yorkers believes that doctors, not health plan managers, should determine what drugs Medicaid patients receive. And when asked directly who they wanted to make final prescribing decisions for themselves and their families, 98 percent of respondents said they wanted their doctor to make the decision.

Moreover, as a recent CornellUniversity study has found, the cost of restoring the full protections is only fraction of what was claimed by the administration.

Restoring prescriber prevails protections is right from a health care perspective, is supported overwhelmingly by New Yorkers and is affordable.

American Cancer Society Cancer Action Network

NAACP NYS Conference

Hispanic Federation

Gay Men’s Health Crisis

Latino Commission on AIDS

1 in 9: The Breast Cancer Action Coalition

Medical Society of the State of New York

New York Chapter, AmericanCollege of Physicians

New YorkStateAcademy of Family Physicians

New YorkState Osteopathic Medical Society

Association of Hispanic Mental Health Professionals

National Association of Black Cardiologists

NY Chapter of the National Association of Hispanic Nurses

NY State Rheumatology Society

Mental Heath Association in New YorkState

US Pain Foundation

Northeast Kidney Foundation

The Coalition of Behavioral Health Agencies, Inc.


Lupus Foundation of Mid and Northern NY

Lupus Foundation of Genesee Valley NY, Inc.

S.L.E. Lupus Foundation

Lupus Alliance of America, NY Southern Tier Affiliate

Lupus Alliance of America, Long Island/Queens Affiliate

Lupus Alliance of America, Upstate NY Affiliate

Sjögren’s Syndrome Foundation

NAMI Queens/Nassau


International Institute for Human Empowerment

Jewish Board of Family and Children’s Services

Epilepsy Foundation of Northeastern New York

National Multiple Sclerosis Society

New York MS Coalition Action Network

American Autoimmune Related Diseases Association

SKIP of New York, Inc.

Global Healthy Living Foundation