Bill > A09360

This bill requires New York's Medicaid program to cover FDA-approved GLP-1 receptor agonist medications (a class of drugs primarily used for diabetes and weight management) for three specific medical purposes: obesity treatment for individuals with a body mass index (BMI) of 30 or greater (or 27 with related health complications), metabolic disorders like prediabetes and type 2 diabetes, and autism-related compulsive eating behaviors with clinical certification. The bill authorizes the Department of Health to implement step therapy protocols, require prior authorization, prioritize coverage for low-income recipients, and establish documentation requirements. The department must develop clear coverage rules within 180 days, streamline authorization processes, evaluate health outcomes and potential cost savings, and submit annual reports to the legislature. The coverage will apply to existing and future GLP-1 receptor agonist medications approved by the FDA, ensuring that Medicaid recipients have access to these potentially beneficial treatments across a range of medical conditions. The bill aims to improve healthcare access and potentially reduce long-term health complications for Medicaid recipients by expanding medication coverage.

Health and Social Services

https://www.nysenate.gov/legislation/bills/2025/A9360