Bill Text: NY A00902 | 2021-2022 | General Assembly | Introduced
Bill Title: Requires insurance and Medicaid coverage for inpatient and outpatient substance abuse treatment for a period of not less than forty-five days.
Spectrum: Slight Partisan Bill (Democrat 6-3)
Status: (Introduced - Dead) 2022-01-05 - referred to insurance [A00902 Detail]
Download: New_York-2021-A00902-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 902 2021-2022 Regular Sessions IN ASSEMBLY (Prefiled) January 6, 2021 ___________ Introduced by M. of A. JONES, GUNTHER, ABINANTI, MONTESANO, WALSH, DICK- ENS, BYRNE -- Multi-Sponsored by -- M. of A. COOK, THIELE -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law and the social services law, in relation to requiring insurance and Medicaid coverage for inpatient and outpatient substance abuse treatment for a period of not less than forty-five days 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, for a period of not less than forty-five 9 days. Such inpatient coverage shall include unlimited medically neces- 10 sary treatment for substance use disorder treatment services provided in 11 residential settings. Further, such inpatient coverage shall not apply 12 financial requirements or treatment limitations, including utilization 13 review requirements, to inpatient substance use disorder benefits that 14 are more restrictive than the predominant financial requirements and 15 treatment limitations applied to substantially all medical and surgical 16 benefits covered by the policy. 17 § 2. Subparagraph (A) of paragraph 31 of subsection (i) of section 18 3216 of the insurance law, as amended by section 6 of subpart A of part 19 BB of chapter 57 of the laws of 2019, is amended to read as follows: 20 (A) Every policy that provides medical, major medical or similar 21 comprehensive-type coverage shall provide outpatient coverage for the EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD05509-01-1A. 902 2 1 diagnosis and treatment of substance use disorder, including detoxifica- 2 tion and rehabilitation services, for a period of not less than forty- 3 five days. Such coverage shall not apply financial requirements or 4 treatment limitations to outpatient substance use disorder benefits that 5 are more restrictive than the predominant financial requirements and 6 treatment limitations applied to substantially all medical and surgical 7 benefits covered by the policy. 8 § 3. Subparagraph (A) of paragraph 6 of subsection (l) of section 3221 9 of the insurance law, as amended by section 15 of subpart A of part BB 10 of chapter 57 of the laws of 2019, is amended to read as follows: 11 (A) Every policy that provides hospital, major medical or similar 12 comprehensive coverage shall provide inpatient coverage for the diagno- 13 sis and treatment of substance use disorder, including detoxification 14 and rehabilitation services, for a period of not less than forty-five 15 days. Such inpatient coverage shall include unlimited medically neces- 16 sary treatment for substance use disorder treatment services provided in 17 residential settings. Further, such inpatient coverage shall not apply 18 financial requirements or treatment limitations, including utilization 19 review requirements, to inpatient substance use disorder benefits that 20 are more restrictive than the predominant financial requirements and 21 treatment limitations applied to substantially all medical and surgical 22 benefits covered by the policy. 23 § 4. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221 24 of the insurance law, as amended by section 16 of subpart A of part BB 25 of chapter 57 of the laws of 2019, is amended to read as follows: 26 (A) Every policy that provides medical, major medical or similar 27 comprehensive-type coverage shall provide outpatient coverage for the 28 diagnosis and treatment of substance use disorder, including detoxifica- 29 tion and rehabilitation services, for a period of not less than forty- 30 five days. Such coverage shall not apply financial requirements or 31 treatment limitations to outpatient substance use disorder benefits that 32 are more restrictive than the predominant financial requirements and 33 treatment limitations applied to substantially all medical and surgical 34 benefits covered by the policy. 35 § 5. Paragraph 1 of subsection (k) of section 4303 of the insurance 36 law, as amended by section 26 of subpart A of part BB of chapter 57 of 37 the laws of 2019, is amended to read as follows: 38 (1) Every contract that provides hospital, major medical or similar 39 comprehensive coverage shall provide inpatient coverage for the diagno- 40 sis and treatment of substance use disorder, including detoxification 41 and rehabilitation services, for a period of not less than forty-five 42 days. Such inpatient coverage shall include unlimited medically neces- 43 sary treatment for substance use disorder treatment services provided in 44 residential settings. Further, such inpatient coverage shall not apply 45 financial requirements or treatment limitations, including utilization 46 review requirements, to inpatient substance use disorder benefits that 47 are more restrictive than the predominant financial requirements and 48 treatment limitations applied to substantially all medical and surgical 49 benefits covered by the contract. 50 § 6. Paragraph 1 of subsection (l) of section 4303 of the insurance 51 law, as amended by section 27 of subpart A of part BB of chapter 57 of 52 the laws of 2019, is amended to read as follows: 53 (1) Every contract that provides medical, major medical or similar 54 comprehensive-type coverage shall provide outpatient coverage for the 55 diagnosis and treatment of substance use disorder, including detoxifica- 56 tion and rehabilitation services, for a period of not less than forty-A. 902 3 1 five days. Such coverage shall not apply financial requirements or 2 treatment limitations to outpatient substance use disorder benefits that 3 are more restrictive than the predominant financial requirements and 4 treatment limitations applied to substantially all medical and surgical 5 benefits covered by the contract. 6 § 7. Paragraph (c) of subdivision 2 of section 365-a of the social 7 services law, as amended by section 12-a of part C of chapter 60 of the 8 laws of 2014, is amended to read as follows: 9 (c) out-patient hospital or clinic services in facilities operated in 10 compliance with applicable provisions of this chapter, the public health 11 law, the mental hygiene law and other laws, including any provisions 12 thereof requiring an operating certificate or license, including facili- 13 ties authorized by the appropriate licensing authority to provide inte- 14 grated mental health services, and/or alcoholism and substance abuse 15 services, and/or physical health services, and/or services to persons 16 with developmental disabilities, when such services are provided at a 17 single location or service site, or where such facilities are not 18 conveniently accessible, in any hospital located within the state and 19 care and services in a day treatment program operated by the department 20 of mental hygiene or by a voluntary agency under an agreement with such 21 department in that part of a public institution operated and approved 22 pursuant to law as an intermediate care facility for persons with devel- 23 opmental disabilities; and provided, that alcoholism and substance abuse 24 services shall be covered for a period of not less than forty-five days; 25 and provided further, that the commissioners of health, mental health, 26 alcoholism and substance abuse services and the office for people with 27 developmental disabilities may issue regulations, including emergency 28 regulations promulgated prior to October first, two thousand fifteen 29 that are required to facilitate the establishment of integrated services 30 clinics. Any such regulations promulgated under this paragraph shall be 31 described in the annual report required pursuant to section forty-five-c 32 of part A of chapter fifty-six of the laws of two thousand thirteen; 33 § 8. Paragraph (n) of subdivision 2 of section 365-a of the social 34 services law, as amended by chapter 558 of the laws of 1999, is amended 35 to read as follows: 36 (n) care, treatment, maintenance and rehabilitation services that 37 would otherwise qualify for reimbursement pursuant to this chapter to 38 persons suffering from alcoholism in alcoholism facilities or chemical 39 dependence, as such term is defined in section 1.03 of the mental 40 hygiene law, in inpatient chemical dependence facilities, services, or 41 programs operated in compliance with applicable provisions of this chap- 42 ter and the mental hygiene law, and certified by the office of alcohol- 43 ism and substance abuse services, provided however that such services 44 shall be limited to such periods of time as may be determined necessary 45 in accordance with a utilization review procedure established by the 46 commissioner of the office of alcoholism and substance abuse services 47 and that such services shall be covered for a period of not less than 48 forty-five days, and provided further, that this paragraph shall not 49 apply to any hospital or part of a hospital as defined in section two 50 thousand eight hundred one of the public health law. 51 § 9. This act shall take effect immediately and shall apply to all 52 policies and contracts issued, renewed, modified, altered or amended on 53 or after such date.
