Bill Text: NY S07071 | 2013-2014 | General Assembly | Introduced
Bill Title: Requires health insurance policies to provide coverage of both inpatient and outpatient opioid addiction treatment services.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Introduced - Dead) 2014-04-23 - REFERRED TO INSURANCE [S07071 Detail]
Download: New_York-2013-S07071-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 7071 I N S E N A T E April 23, 2014 ___________ Introduced by Sen. BALL -- 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 requiring health insurance coverage of inpatient treatment of opioid addiction THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 30 to read as follows: 3 (30)(A) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE 4 WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE 5 COVERAGE SHALL INCLUDE COVERAGE FOR BOTH INPATIENT AND OUTPATIENT OPIOID 6 ADDICTION SERVICES THAT ARE PROVIDED BY A QUALIFIED HEALTH PROFESSIONAL, 7 AS DEFINED IN THE REGULATIONS OF THE COMMISSIONER OF ALCOHOLISM AND 8 SUBSTANCE ABUSE SERVICES. 9 (B) THE ONLY PREREQUISITE FOR THE COVERAGE OF HOSPITAL OR NON-HOSPITAL 10 BASED OPIOID ADDICTION SERVICES, INCLUDING MEDICALLY MANAGED, MEDICALLY 11 SUPERVISED AND MEDICALLY MONITORED WITHDRAWAL, OR INPATIENT OR INTENSIVE 12 RESIDENTIAL REHABILITATION, OR INTENSIVE OR ROUTINE OUTPATIENT TREAT- 13 MENT, SHALL BE THAT A COVERED PERSON BE CERTIFIED AND REFERRED BY A 14 QUALIFIED HEALTH PROFESSIONAL. SUCH CERTIFICATION AND REFERRAL SHALL 15 CONTROL BOTH THE NATURE AND DURATION OF COVERED TREATMENT; PROVIDED, 16 HOWEVER, THAT SUCH COVERAGE SHALL BE TERMINATED WHEN THE ADMITTING OR 17 ATTENDING PHYSICIAN, OR A PHYSICIAN ASSISTANT OR NURSE PRACTITIONER 18 ACTING UNDER THE SUPERVISION OF A PHYSICIAN, PROVIDING OPIOID ADDICTION 19 SERVICES, REHABILITATION OR OUTPATIENT TREATMENT CERTIFIES THAT ADMIS- 20 SION OF THE COVERED PERSON IS NOT NECESSARY, EARLY DISCHARGE IS APPRO- 21 PRIATE OR ADDITIONAL INPATIENT DAYS OR SESSIONS ARE NECESSARY. 22 S 2. Subsection (l) of section 3221 of the insurance law is amended by 23 adding a new paragraph 19 to read as follows: 24 (19) (A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIV- 25 ERY IN THIS STATE WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR 26 COMPREHENSIVE-TYPE COVERAGE SHALL INCLUDE COVERAGE FOR BOTH INPATIENT 27 AND OUTPATIENT OPIOID ADDICTION SERVICES THAT ARE PROVIDED BY A QUALI- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD14649-02-4 S. 7071 2 1 FIED HEALTH PROFESSIONAL, AS DEFINED IN THE REGULATIONS OF THE COMMIS- 2 SIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES. 3 (B) THE ONLY PREREQUISITE FOR THE COVERAGE OF HOSPITAL OR NON-HOSPITAL 4 BASED OPIOID ADDICTION SERVICES, INCLUDING MEDICALLY MANAGED, MEDICALLY 5 SUPERVISED AND MEDICALLY MONITORED WITHDRAWAL, OR INPATIENT OR INTENSIVE 6 RESIDENTIAL REHABILITATION, OR INTENSIVE OR ROUTINE OUTPATIENT TREAT- 7 MENT, SHALL BE THAT A COVERED PERSON BE CERTIFIED AND REFERRED BY A 8 QUALIFIED HEALTH PROFESSIONAL. SUCH CERTIFICATION AND REFERRAL SHALL 9 CONTROL BOTH THE NATURE AND DURATION OF COVERED TREATMENT; PROVIDED, 10 HOWEVER, THAT SUCH COVERAGE SHALL BE TERMINATED WHEN THE ADMITTING OR 11 ATTENDING PHYSICIAN, OR A PHYSICIAN ASSISTANT OR NURSE PRACTITIONER 12 ACTING UNDER THE SUPERVISION OF A PHYSICIAN, PROVIDING OPIOID ADDICTION 13 SERVICES, REHABILITATION OR OUTPATIENT TREATMENT CERTIFIES THAT ADMIS- 14 SION OF THE COVERED PERSON IS NOT NECESSARY, EARLY DISCHARGE IS APPRO- 15 PRIATE OR ADDITIONAL INPATIENT DAYS OR SESSIONS ARE NECESSARY. 16 S 3. Section 4303 of the insurance law is amended by adding a new 17 subsection (oo) to read as follows: 18 (OO) (1) EVERY CONTRACT ISSUED BY A HOSPITAL SERVICE COMPANY OR HEALTH 19 SERVICE CORPORATION WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR 20 COMPREHENSIVE-TYPE COVERAGE SHALL INCLUDE COVERAGE FOR BOTH INPATIENT 21 AND OUTPATIENT OPIOID ADDICTION SERVICES THAT ARE PROVIDED BY A QUALI- 22 FIED HEALTH PROFESSIONAL, AS DEFINED IN THE REGULATIONS OF THE COMMIS- 23 SIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES. 24 (2) THE ONLY PREREQUISITE FOR THE COVERAGE OF HOSPITAL OR NON-HOSPITAL 25 BASED OPIOID ADDICTION SERVICES, INCLUDING MEDICALLY MANAGED, MEDICALLY 26 SUPERVISED AND MEDICALLY MONITORED WITHDRAWAL, OR INPATIENT OR INTENSIVE 27 RESIDENTIAL REHABILITATION, OR INTENSIVE OR ROUTINE OUTPATIENT TREAT- 28 MENT, SHALL BE THAT A COVERED PERSON BE CERTIFIED AND REFERRED BY A 29 QUALIFIED HEALTH PROFESSIONAL. SUCH CERTIFICATION AND REFERRAL SHALL 30 CONTROL BOTH THE NATURE AND DURATION OF COVERED TREATMENT, PROVIDED, 31 HOWEVER, THAT SUCH COVERAGE SHALL BE TERMINATED WHEN THE ADMITTING OR 32 ATTENDING PHYSICIAN, OR A PHYSICIAN ASSISTANT OR NURSE PRACTITIONER 33 ACTING UNDER THE SUPERVISION OF A PHYSICIAN, PROVIDING OPIOID ADDICTION 34 SERVICES, REHABILITATION OR OUTPATIENT TREATMENT CERTIFIES THAT ADMIS- 35 SION OF THE COVERED PERSON IS NOT NECESSARY, EARLY DISCHARGE IS APPRO- 36 PRIATE OR ADDITIONAL INPATIENT DAYS OR SESSIONS ARE NECESSARY. 37 S 4. This act shall take effect on the thirtieth day after it shall 38 have become a law.