Bill Text: NY S02901 | 2019-2020 | General Assembly | Introduced

---

Bill Title: Relates to substance use disorder coverage.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2020-01-08 - REFERRED TO INSURANCE [S02901 Detail]

Download: New_York-2019-S02901-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________
                                          2901
                               2019-2020 Regular Sessions
                    IN SENATE
                                    January 30, 2019
                                       ___________
        Introduced  by Sens. KAPLAN, ORTT -- read twice and ordered printed, and
          when printed to be committed to the Committee on Insurance
        AN ACT to amend the insurance law, in relation to substance use disorder
          coverage
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section 1. The opening paragraph of subparagraph (A) of paragraph 5 of
     2  subsection (1) of section 3221 of the insurance law, as amended by chap-
     3  ter 502 of the laws of 2007, is amended to read as follows:
     4    Every insurer delivering a group or school blanket policy or issuing a
     5  group  or  school  blanket  policy  for  delivery,  in this state, which
     6  provides coverage for inpatient hospital care or coverage for  physician
     7  services  shall  provide as part of such policy broad-based coverage for
     8  the diagnosis and treatment  of  mental,  nervous  [or],  emotional,  or
     9  substance  use disorders or ailments, however defined in such policy, at
    10  least equal to the coverage provided for other health conditions and:
    11    § 2. The opening paragraph of subsection (g) of section  4303  of  the
    12  insurance law, as amended by chapter 502 of the laws of 2007, is amended
    13  to read as follows:
    14    A  hospital service corporation or a health service corporation, which
    15  provides group, group remittance or school blanket  coverage  for  inpa-
    16  tient  hospital  care, shall provide as part of its contract broad-based
    17  coverage for the  diagnosis  and  treatment  of  mental,  nervous  [or],
    18  emotional,  or  substance  use disorders or ailments, however defined in
    19  such contract, at least equal to the coverage provided for other  health
    20  conditions and shall include:
    21    §  3.  Paragraph  1 of subsection (h) of section 4303 of the insurance
    22  law, as amended by chapter 502 of the laws of 2007, is amended  to  read
    23  as follows:
    24    (1) A medical expense indemnity corporation or a health service corpo-
    25  ration,  which provides group, group remittance or school blanket cover-
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01624-01-9
        S. 2901                             2
     1  age for physician services, shall provide as part of its contract broad-
     2  based coverage for the diagnosis and treatment of mental, nervous  [or],
     3  emotional,  or  substance  use disorders or ailments, however defined in
     4  such  contract, at least equal to the coverage provided for other health
     5  conditions and shall include: benefits for outpatient care provided by a
     6  psychiatrist or psychologist licensed  to  practice  in  this  state,  a
     7  licensed clinical social worker who meets the requirements of subsection
     8  (n) of this section, or a professional corporation or university faculty
     9  practice  corporation thereof, which benefits may be limited to not less
    10  than twenty visits in any contract year, plan  year  or  calendar  year.
    11  Such  coverage may be provided on a contract year, plan year or calendar
    12  year basis and shall be consistent with the provision of other  benefits
    13  under  the contract. Such coverage may be subject to annual deductibles,
    14  co-pays and coinsurance as may be deemed appropriate by the  superinten-
    15  dent  and shall be consistent with those imposed on other benefits under
    16  the contract. In the event the group remittance group or contract holder
    17  is provided coverage provided under this paragraph  and  under  subpara-
    18  graph  (B)  of  paragraph one of subsection (g) of this section from the
    19  same health service corporation, or under a contract  which  is  jointly
    20  underwritten  by  two health service corporations or by a health service
    21  corporation and a medical expense indemnity corporation,  the  aggregate
    22  of  the benefits for out-patient care obtained under subparagraph (B) of
    23  paragraph one of subsection (g) of this section and this  paragraph  may
    24  be  limited  to  not  less than twenty visits in any contract year, plan
    25  year or calendar year.
    26    § 4. Paragraph 4 of subsection (i) of section 3216  of  the  insurance
    27  law is amended to read as follows:
    28    (4)  If a policy provides for reimbursement for psychiatric or psycho-
    29  logical services or for diagnosis and treatment of mental, nervous, [or]
    30  emotional, or substance use disorders or ailments,  however  defined  in
    31  the  policy,  the  insured  shall  be entitled to reimbursement for such
    32  services, diagnosis or  treatment  whether  performed  by  a  physician,
    33  psychiatrist  or  a  certified  and  registered  psychologist,  when the
    34  services rendered are within the lawful scope of their practice.
    35    § 5. This act shall take effect on the first of January next  succeed-
    36  ing  the date on which it shall have become a law and shall apply to all
    37  policies and contracts issued, renewed, modified, altered or amended  on
    38  or after such date.