BILL NUMBER: S6736

SPONSOR: FAHY
 
TITLE OF BILL:

An act to amend the social services law, in relation to requiring Medi-
caid to cover a wearable medical device to treat certain forms of cancer

 
PURPOSE:

This legislation would require Medicaid coverage for the National
Comprehensive Cancer Network (NCCN) recommended treatment for an aggres-
sive form of brain cancer, glioblastoma, and other cancers that meet
rigorous standards set forth in the bill.

 
SUMMARY OF PROVISIONS:

Section 1: Amends the social services law to require Medicaid Fee-For-
Service (FFS) coverage of a wearable, medical device to treat glioblas-
toma, and other cancers that meet rigorous standards.

Section 2: Establishes the effective date.
              

 
JUSTIFICATION:

TTfields is an FDA-approved and National Comprehensive Cancer Network-
preferred, wearable treatment option for one of the most aggressive
forms of brain cancer - glioblastoma (GBM). It also is showing as an
effective treatment for other forms of cancer. Although GBM is a rare
form of cancer, it requires swift and thorough treatment and patients
deserve access to all approved treatments that may extend their lives.
TTFields was the first therapy in over a decade that demonstrated an
increase in overall survival in newly-diagnosed GBM. The innovative
technology utilizes alternating electric fields to disrupt the rapid
cell division exhibited by cancer cells while bypassing healthy cells.
Despite ample clinical evidence in support of the technology's overall
effectiveness and safety, New York State Medicaid continues to deny
coverage under Fee-for-Service (FFS) for New Yorkers enrolled in Medi-
caid who need access to this life extending treatment. On average, there
are 5-10 patients in New York with FFS Medicaid each year who are seek-
ing such coverage. Income status should not dictate who can access and
benefit from a life-extending treatment. Those with commercial insur-
ance, Medicare, or VA benefits can all receive coverage to access the
device. Also, Medicaid-managed care plans in New York have been covering
this treatment at patients' request. However, individuals with Medicaid
FFS, many of whom already face many challenges to receiving effective
and equitable healthcare, are currently being excluded. This legislation
is supported by leading cancer care providers, cancer centers, and
physicians and patient advocates supporting individuals with brain
tumors. It must be enacted to address the serious inequity in Medicaid
FFS coverage of TTFields for the treatment of GBM in New York State.

 
LEGISLATIVE HISTORY:

New Bill

 
FISCAL IMPLICATIONS:

This legislation will have a minimal fiscal impact to Medicaid.
 
EFFECTIVE DATE:
This act shall take effect April 1, 2025 accordance with Senate Rule VI.
Sec 1