Bill Text: NY A09111 | 2019-2020 | General Assembly | Introduced

---

Bill Title: Provides reimbursement for transportation to and from inpatient and outpatient diagnosis and treatment of substance use disorder.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2020-01-21 - referred to insurance [A09111 Detail]

Download: New_York-2019-A09111-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________

                                          9111

                   IN ASSEMBLY

                                    January 21, 2020
                                       ___________

        Introduced  by  M.  of  A. L. ROSENTHAL -- read once and referred to the
          Committee on Insurance

        AN ACT to amend the insurance law, in relation to  providing  reimburse-
          ment for transportation to and from inpatient and outpatient diagnosis
          and treatment of substance disorder

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Subparagraph (A) of  paragraph  30  of  subsection  (i)  of
     2  section  3216 of the insurance law, as amended by section 5 of subpart A
     3  of part BB of chapter 57 of the laws of 2019,  is  amended  to  read  as
     4  follows:
     5    (A)  Every  policy  that  provides  hospital, major medical or similar
     6  comprehensive coverage shall provide inpatient coverage for the  diagno-
     7  sis  and  treatment  of substance use disorder, including detoxification
     8  and rehabilitation services, and shall provide reimbursement for  trans-
     9  portation  to  and  from  such  inpatient  diagnosis  and  treatment  of
    10  substance use disorder. Such inpatient coverage shall include  unlimited
    11  medically  necessary  treatment  for  substance  use  disorder treatment
    12  services provided  in  residential  settings.  Further,  such  inpatient
    13  coverage  shall  not  apply  financial requirements or treatment limita-
    14  tions, including utilization review requirements, to inpatient substance
    15  use disorder benefits that are more  restrictive  than  the  predominant
    16  financial requirements and treatment limitations applied to substantial-
    17  ly all medical and surgical benefits covered by the policy.
    18    §  2.  Subparagraph  (A)  of paragraph 31 of subsection (i) of section
    19  3216 of the insurance law, as amended by section 6 of subpart A of  part
    20  BB of chapter 57 of the laws of 2019, is amended to read as follows:
    21    (A)  Every  policy  that  provides  medical,  major medical or similar
    22  comprehensive-type coverage shall provide outpatient  coverage  for  the
    23  diagnosis and treatment of substance use disorder, including detoxifica-
    24  tion  and  rehabilitation  services, and shall provide reimbursement for
    25  transportation to and from such outpatient diagnosis  and  treatment  of
    26  substance use disorder. Such coverage shall not apply financial require-
    27  ments  or  treatment  limitations  to  outpatient substance use disorder

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14557-01-9
        A. 9111                             2

     1  benefits that  are  more  restrictive  than  the  predominant  financial
     2  requirements  and  treatment  limitations  applied  to substantially all
     3  medical and surgical benefits covered by the policy.
     4    § 3. Subparagraph (A) of paragraph 6 of subsection (l) of section 3221
     5  of  the  insurance law, as amended by section 15 of subpart A of part BB
     6  of chapter 57 of the laws of 2019, is amended to read as follows:
     7    (A) Every policy that provides  hospital,  major  medical  or  similar
     8  comprehensive  coverage shall provide inpatient coverage for the diagno-
     9  sis and treatment of substance use  disorder,  including  detoxification
    10  and  rehabilitation services, and shall provide reimbursement for trans-
    11  portation  to  and  from  such  inpatient  diagnosis  and  treatment  of
    12  substance  use disorder. Such inpatient coverage shall include unlimited
    13  medically necessary  treatment  for  substance  use  disorder  treatment
    14  services  provided  in  residential  settings.  Further,  such inpatient
    15  coverage shall not apply financial  requirements  or  treatment  limita-
    16  tions, including utilization review requirements, to inpatient substance
    17  use  disorder  benefits  that  are more restrictive than the predominant
    18  financial requirements and treatment limitations applied to substantial-
    19  ly all medical and surgical benefits covered by the policy.
    20    § 4. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221
    21  of the insurance law, as amended by section 16 of subpart A of  part  BB
    22  of chapter 57 of the laws of 2019, is amended to read as follows:
    23    (A)  Every  policy  that  provides  medical,  major medical or similar
    24  comprehensive-type coverage shall provide outpatient  coverage  for  the
    25  diagnosis and treatment of substance use disorder, including detoxifica-
    26  tion  and  rehabilitation  services, and shall provide reimbursement for
    27  transportation to and from such outpatient diagnosis  and  treatment  of
    28  substance  use  disorder.    Such  coverage  shall  not  apply financial
    29  requirements or treatment limitations to outpatient substance use disor-
    30  der benefits that are more restrictive than  the  predominant  financial
    31  requirements  and  treatment  limitations  applied  to substantially all
    32  medical and surgical benefits covered by the policy.
    33    § 5. Paragraph 1 of subsection (k) of section 4303  of  the  insurance
    34  law,  as  amended by section 26 of subpart A of part BB of chapter 57 of
    35  the laws of 2019, is amended to read as follows:
    36    (1) Every contract that provides hospital, major  medical  or  similar
    37  comprehensive  coverage shall provide inpatient coverage for the diagno-
    38  sis and treatment of substance use  disorder,  including  detoxification
    39  and  rehabilitation services, and shall provide reimbursement for trans-
    40  portation  to  and  from  such  inpatient  diagnosis  and  treatment  of
    41  substance use disorder.  Such inpatient coverage shall include unlimited
    42  medically  necessary  treatment  for  substance  use  disorder treatment
    43  services provided  in  residential  settings.  Further,  such  inpatient
    44  coverage  shall  not  apply  financial requirements or treatment limita-
    45  tions, including utilization review requirements, to inpatient substance
    46  use disorder benefits that are more  restrictive  than  the  predominant
    47  financial requirements and treatment limitations applied to substantial-
    48  ly all medical and surgical benefits covered by the contract.
    49    §  6.  Paragraph  1 of subsection (l) of section 4303 of the insurance
    50  law, as amended by section 27 of subpart A of part BB of chapter  57  of
    51  the laws of 2019, is amended to read as follows:
    52    (1)  Every  contract  that  provides medical, major medical or similar
    53  comprehensive-type coverage shall provide outpatient  coverage  for  the
    54  diagnosis and treatment of substance use disorder, including detoxifica-
    55  tion  and  rehabilitation  services, and shall provide reimbursement for
    56  transportation to and from such outpatient diagnosis  and  treatment  of
        A. 9111                             3

     1  substance  use  disorder.    Such  coverage  shall  not  apply financial
     2  requirements or treatment limitations to outpatient substance use disor-
     3  der benefits that are more restrictive than  the  predominant  financial
     4  requirements  and  treatment  limitations  applied  to substantially all
     5  medical and surgical benefits covered by the contract.
     6    § 7. This act shall take effect on the ninetieth day  after  it  shall
     7  have  become  a law; provided, however, that if part BB of chapter 57 of
     8  the laws of 2019 has not taken effect on or before such date  then  this
     9  act  shall  take  effect on the same date and in the same manner as such
    10  part takes effect; and shall apply to all policies and contracts issued,
    11  renewed, modified, altered or amended on or after such date.