120.939 Physician-Directed Medication Access
The Medical Society of the State of New York will continue to advocate for:
Legislation which will ensure that the physician’s judgment regarding the necessity of a particular medication for their patient prevails over an insurer’s judgment, including for all patients insured through Medicare and Medicaid;
Legislation or regulation that would prohibit an insurer from denying care for needed treatment or medications unless it is reviewed by a physician of the same specialty as the treating physician; and
Legislation, regulation, or other appropriate means to assure that health plans consult with appropriate specialty physicians in the creation of formularies and policy regarding drug-tiers. (HOD 2015-53; Reaffirmed HOD 2016-67)
