STATE OF NEW YORK ________________________________________________________________________ 5389 2025-2026 Regular Sessions IN ASSEMBLY February 13, 2025 ___________ Introduced by M. of A. WEPRIN -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring insurance coverage for child and family treatment and support services and chil- dren's home and community based services The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Item (i) of subparagraph (A) of paragraph 35 of subsection 2 (i) of section 3216 of the insurance law, as amended by section 1 of 3 subpart A of part II of chapter 57 of the laws of 2023, is amended to 4 read as follows: 5 (i) where the policy provides coverage for inpatient hospital care, 6 such policy shall include benefits for: inpatient care in a hospital as 7 defined by subdivision ten of section 1.03 of the mental hygiene law; 8 sub-acute care in a residential facility licensed or operated by the 9 office of mental health; outpatient care provided by a facility issued 10 an operating certificate by the commissioner of mental health pursuant 11 to the provisions of article thirty-one of the mental hygiene law or by 12 a facility operated by the office of mental health; outpatient care 13 provided by a crisis stabilization center licensed pursuant to section 14 36.01 of the mental hygiene law; outpatient care provided by a mobile 15 crisis intervention services provider licensed, certified, or designated 16 by the office of mental health or the office of addiction services and 17 supports; outpatient and inpatient care for critical time intervention 18 services and outpatient care for assertive community treatment services 19 provided by facilities issued an operating certificate by the commis- 20 sioner of mental health pursuant to the provisions of article thirty-one 21 of the mental hygiene law, beginning no later than thirty days following 22 discharge from a hospital as defined by subdivision ten of section 1.03 23 of the mental hygiene law or the emergency department of a hospital 24 licensed pursuant to article twenty-eight of the public health law; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD07845-01-5A. 5389 2 1 child and family treatment and support services; children's home and 2 community based services; or, for care provided in other states, to 3 similarly licensed or certified hospitals, facilities, or licensed, 4 certified or designated providers; and 5 § 2. Item (i) of subparagraph (A) of paragraph 5 of subsection (l) of 6 section 3221 of the insurance law, as amended by section 5 of subpart A 7 of part II of chapter 57 of the laws of 2023, is amended to read as 8 follows: 9 (i) where the policy provides coverage for inpatient hospital care, 10 benefits for: inpatient care in a hospital as defined by subdivision ten 11 of section 1.03 of the mental hygiene law; sub-acute care in a residen- 12 tial facility licensed or operated by the office of mental health; 13 outpatient care provided by a facility issued an operating certificate 14 by the commissioner of mental health pursuant to the provisions of arti- 15 cle thirty-one of the mental hygiene law, or by a facility operated by 16 the office of mental health; outpatient care provided by a crisis 17 stabilization center licensed pursuant to section 36.01 of the mental 18 hygiene law; outpatient care provided by a mobile crisis intervention 19 services provider licensed, certified, or designated by the office of 20 mental health or the office of addiction services and supports; outpa- 21 tient and inpatient care for critical time intervention services and 22 outpatient care for assertive community treatment services provided by 23 facilities issued an operating certificate by the commissioner of mental 24 health pursuant to the provisions of article thirty-one of the mental 25 hygiene law, beginning no later than thirty days following discharge 26 from a hospital as defined by subdivision ten of section 1.03 of the 27 mental hygiene law or the emergency department of a hospital licensed 28 pursuant to article twenty-eight of the public health law; child and 29 family treatment and support services; children's home and community 30 based services; or, for care provided in other states, to similarly 31 licensed or certified hospitals, facilities, or licensed, certified or 32 designated providers; and 33 § 3. Paragraph 1 of subsection (g) of section 4303 of the insurance 34 law, as amended by section 9 of subpart A of part II of chapter 57 of 35 the laws of 2023, is amended to read as follows: 36 (1) where the contract provides coverage for inpatient hospital care, 37 benefits for: in-patient care in a hospital as defined by subdivision 38 ten of section 1.03 of the mental hygiene law; sub-acute care in a resi- 39 dential facility licensed or operated by the office of mental health; 40 outpatient care provided by a facility issued an operating certificate 41 by the commissioner of mental health pursuant to the provisions of arti- 42 cle thirty-one of the mental hygiene law or by a facility operated by 43 the office of mental health; outpatient care provided by a crisis 44 stabilization center licensed pursuant to section 36.01 of the mental 45 hygiene law; outpatient care provided by a mobile crisis intervention 46 services provider licensed, certified, or designated by the office of 47 mental health or the office of addiction services and supports; outpa- 48 tient and inpatient care for critical time intervention services and 49 outpatient care for assertive community treatment services provided by 50 facilities issued an operating certificate by the commissioner of mental 51 health pursuant to the provisions of article thirty-one of the mental 52 hygiene law, beginning no later than thirty days following discharge 53 from a hospital as defined by subdivision ten of section 1.03 of the 54 mental hygiene law or the emergency department of a hospital licensed 55 pursuant to article twenty-eight of the public health law; child and 56 family treatment and support services; children's home and communityA. 5389 3 1 based services; or for care provided in other states, to similarly 2 licensed or certified hospitals, facilities, or licensed, certified or 3 designated providers; and 4 § 4. This act shall take effect January 1, 2026 and shall apply to 5 policies and contracts issued, renewed, amended, modified or altered on 6 or after such date; provided, however, that: 7 (a) if section 1 of subpart A of part II of chapter 57 of the laws of 8 2023 shall not have taken effect on or before such date, then section 9 one of this act shall take effect on the same date and in the same 10 manner as such section of such subpart of such part of such chapter of 11 the laws of 2023, takes effect; 12 (b) if section 5 of subpart A of part II of chapter 57 of the laws of 13 2023 shall not have taken effect on or before such date, then section 14 two of this act shall take effect on the same date and in the same 15 manner as such section of such subpart of such part of such chapter of 16 the laws of 2023, takes effect; and 17 (c) if section 9 of subpart A of part II of chapter 57 of the laws of 18 2023 shall not have taken effect on or before such date, then section 19 three of this act shall take effect on the same date and in the same 20 manner as such section of such subpart of such part of such chapter of 21 the laws of 2023, takes effect.