Bill Text: NY A01171 | 2021-2022 | General Assembly | Amended

New York Assembly Bill 1171 (Prior Session Legislation)

Bill Title: Requires blanket health insurance policies to provide coverage for outpatient treatment by mental health practitioners (mental health counsellors, marriage and family therapists, creative arts therapists and psychoanalysts) licensed pursuant to article 163 of the education law.

Spectrum: Partisan Bill (Democrat 26-0)

Status: (Passed) 2022-12-30 - approval memo.99 [A01171 Detail]

Download: New_York-2021-A01171-Amended.html


                STATE OF NEW YORK
        ________________________________________________________________________

                                         1171--A

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                     January 7, 2021
                                       ___________

        Introduced  by  M.  of  A.  BRONSON,  CLARK,  LUNSFORD,  MEEKS, WALLACE,
          BUTTENSCHON, ROZIC, SANTABARBARA,  LUPARDO,  HUNTER,  GUNTHER,  STECK,
          STIRPE,  JONES,  MAGNARELLI,  FAHY, McMAHON, BARRETT, WOERNER, WEPRIN,
          GOTTFRIED, CRUZ, CARROLL -- read once and referred to the Committee on
          Insurance -- committee discharged, bill amended, ordered reprinted  as
          amended and recommitted to said committee

        AN  ACT  to  amend  the  insurance  law, in relation to health insurance
          coverage of outpatient care provided by a mental  health  practitioner
          and a clinical social worker; and to repeal certain provisions of such
          law relating thereto

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

     1    Section 1. Items (i) and (ii) of subparagraph (A) of paragraph  35  of
     2  subsection (i) of section 3216 of the insurance law, item (i) as amended
     3  by section 12 of part AA of chapter 57 of the laws of 2021 and item (ii)
     4  as  added by section 8 of subpart A of part BB of chapter 57 of the laws
     5  of 2019, are amended to read as follows:
     6    (i) where the policy provides coverage for  inpatient  hospital  care,
     7  such  policy  shall include benefits for inpatient care in a hospital as
     8  defined by subdivision ten of section 1.03 of the mental hygiene law and
     9  benefits for outpatient care provided in a facility issued an  operating
    10  certificate  by  the  commissioner  of  mental  health  pursuant  to the
    11  provisions of article thirty-one of the mental  hygiene  law,  or  in  a
    12  facility  operated  by  the  office  of  mental  health,  or in a crisis
    13  stabilization center licensed pursuant to section 36.01  of  the  mental
    14  hygiene  law,  or,  for  care  provided  in  other  states, to similarly
    15  licensed or certified hospitals or facilities; and
    16    (ii) where the policy provides coverage for physician  services,  such
    17  policy shall include benefits for outpatient care provided by a psychia-
    18  trist  or  psychologist  licensed  to practice in this state, a licensed
    19  clinical social worker [who meets the requirements of  subparagraph  (D)

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05221-02-1

        A. 1171--A                          2

     1  of  paragraph  four  of  subsection  (1)  of  section three thousand two
     2  hundred twenty-one of this article,] within the lawful scope of  his  or
     3  her practice, who is licensed pursuant to article one hundred fifty-four
     4  of  the  education  law,  a mental health counselor, marriage and family
     5  therapist, creative arts therapist or psychoanalyst licensed pursuant to
     6  article one hundred sixty-three of the education law,  a  nurse  practi-
     7  tioner licensed to practice in this state, or a professional corporation
     8  or  university  faculty  practice  corporation thereof.   Nothing herein
     9  shall be construed to modify or expand the scope of practice of a mental
    10  health counselor, marriage and family therapist, creative arts therapist
    11  or psychoanalyst licensed pursuant to article one hundred sixty-three of
    12  the education law. Further, nothing herein shall be construed to  create
    13  a new mandated health benefit.
    14    § 2. Subparagraph (A) of paragraph 4 of subsection (l) of section 3221
    15  of  the  insurance law, as amended by section 11 of subpart A of part BB
    16  of chapter 57 of the laws of 2019, is amended to read as follows:
    17    (A) Every insurer delivering a group policy or issuing a group  policy
    18  for delivery, in this state, that provides reimbursement for psychiatric
    19  or  psychological  services or for the diagnosis and treatment of mental
    20  health conditions,  however  defined  in  such  policy,  by  physicians,
    21  psychiatrists  or  psychologists, shall [make available and if requested
    22  by the policyholder] provide the same  coverage  to  insureds  for  such
    23  services when performed by a licensed clinical social worker, within the
    24  lawful scope of his or her practice, who is licensed pursuant to article
    25  one  hundred  fifty-four  of  the  education law[. Written notice of the
    26  availability of such coverage shall be  delivered  to  the  policyholder
    27  prior  to inception of such group policy and annually thereafter, except
    28  that this notice shall not be required where a policy covers two hundred
    29  or more employees or where the benefit  structure  was  the  subject  of
    30  collective  bargaining  affecting  persons who are employed in more than
    31  one state.] and mental health counselors,  marriage  and  family  thera-
    32  pists,  creative arts therapists and psychoanalysts licensed pursuant to
    33  article one hundred sixty-three of the education law, within the  lawful
    34  scope of his or her practice. Nothing herein shall be construed to modi-
    35  fy  or  expand  the  scope  of  practice  of  a mental health counselor,
    36  marriage and family therapist, creative arts therapist or  psychoanalyst
    37  licensed  pursuant  to  article one hundred sixty-three of the education
    38  law. Further, nothing herein shall be construed to create a new mandated
    39  health benefit.
    40    § 3. Subparagraph (D) of paragraph 4 of subsection (l) of section 3221
    41  of the insurance law is REPEALED.
    42    § 4. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of
    43  section 3221 of the insurance law, as amended by section 13 of subpart A
    44  of part BB of chapter 57 of the laws of 2019,  is  amended  to  read  as
    45  follows:
    46    (ii)  where  the  policy  provides coverage for physician services, it
    47  shall include benefits for outpatient care provided by a psychiatrist or
    48  psychologist licensed to practice in this  state,  or  a  mental  health
    49  counselor,  marriage  and  family  therapist, creative arts therapist or
    50  psychoanalyst licensed pursuant to article one  hundred  sixty-three  of
    51  the  education  law, or a licensed clinical social worker [who meets the
    52  requirements of subparagraph (D) of paragraph four of  this  subsection]
    53  within the lawful scope of his or her practice, who is licensed pursuant
    54  to  article one hundred fifty-four of the education law, a nurse practi-
    55  tioner licensed to practice in this state, or a professional corporation
    56  or university faculty practice corporation thereof. Nothing herein shall

        A. 1171--A                          3

     1  be construed to modify or expand the  scope  of  practice  of  a  mental
     2  health counselor, marriage and family therapist, creative arts therapist
     3  or psychoanalyst licensed pursuant to article one hundred sixty-three of
     4  the  education law. Further, nothing herein shall be construed to create
     5  a new mandated health benefit.
     6    § 5. Paragraph 2 of subsection (g) of section 4303  of  the  insurance
     7  law, as added by section 22 of subpart A of part BB of chapter 57 of the
     8  laws of 2019, is amended to read as follows:
     9    (2)  where  the contract provides coverage for physician services such
    10  contract shall provide  benefits  for  outpatient  care  provided  by  a
    11  psychiatrist  or  psychologist  licensed to practice in this state, or a
    12  mental health counselor, marriage and family  therapist,  creative  arts
    13  therapist  or  psychoanalyst  licensed   pursuant to article one hundred
    14  sixty-three of the education law, or a licensed clinical  social  worker
    15  [who  meets  the  requirements of subsection (n) of this section] within
    16  the lawful scope of his or her practice, who  is  licensed  pursuant  to
    17  article one hundred fifty-four of the education law, a nurse practition-
    18  er  licensed to practice [on] in this state, or professional corporation
    19  or university faculty practice corporation thereof. Nothing herein shall
    20  be construed to modify or expand the  scope  of  practice  of  a  mental
    21  health counselor, marriage and family therapist, creative arts therapist
    22  or psychoanalyst licensed pursuant to article one hundred sixty-three of
    23  the  education law. Further, nothing herein shall be construed to create
    24  a new mandated health benefit.
    25    § 6. Subsection (i) of section 4303 of the insurance law is REPEALED.
    26    § 7. Subsection (n) of section 4303 of the insurance law,  as  amended
    27  by section 30 of subpart A of part BB of chapter 57 of the laws of 2019,
    28  is amended to read as follows:
    29    (n)  [In  addition  to  the  requirements  of  subsection  (i) of this
    30  section, every] Every health service or medical expense indemnity corpo-
    31  ration issuing a group contract pursuant to  this  section  or  a  group
    32  remittance  contract  for delivery in this state which contract provides
    33  reimbursement to subscribers or physicians,  psychiatrists  or  psychol-
    34  ogists  for  psychiatric  or psychological services or for the diagnosis
    35  and treatment of mental  health  conditions,  however  defined  in  such
    36  contract,  must  provide  the same coverage to persons covered under the
    37  group contract for such services when performed by a  licensed  clinical
    38  social  worker,  within  the lawful scope of his or her practice, who is
    39  licensed pursuant to [subdivision two of section  seven  thousand  seven
    40  hundred  four of the education law and in addition shall have either (i)
    41  three or more additional years experience in  psychotherapy,  which  for
    42  the  purposes of this subsection shall mean the use of verbal methods in
    43  interpersonal relationships with the intent of  assisting  a  person  or
    44  persons  to  modify  attitudes  and  behavior  which are intellectually,
    45  socially or emotionally maladaptive, under supervision, satisfactory  to
    46  the state board for social work, in a facility, licensed or incorporated
    47  by  an appropriate governmental department, providing services for diag-
    48  nosis or treatment of mental health conditions, or (ii)  three  or  more
    49  additional  years  experience  in  psychotherapy  under the supervision,
    50  satisfactory to the state board for social work, of  a  psychiatrist,  a
    51  licensed and registered psychologist or a licensed clinical social work-
    52  er  qualified  for  reimbursement  pursuant  to  subsection  (i) of this
    53  section, or (iii) a combination of the  experience  specified  in  para-
    54  graphs  (i)  and  (ii)  totaling  three years, satisfactory to the state
    55  board for social work.] article one hundred fifty-four of the  education
    56  law  and a mental health counselor, marriage and family therapist, crea-

        A. 1171--A                          4

     1  tive arts therapist or psychoanalyst licensed pursuant  to  article  one
     2  hundred  sixty-three  of  the  education  law.  Nothing  herein shall be
     3  construed to modify or expand the scope of practice of a  mental  health
     4  counselor,  marriage  and  family  therapist, creative arts therapist or
     5  psychoanalyst licensed pursuant to article one  hundred  sixty-three  of
     6  the education law.  Further, nothing herein shall be construed to create
     7  a  new  mandated  health  benefit. The state board for social work shall
     8  maintain a list of all licensed clinical social  workers  qualified  for
     9  reimbursement  under  this subsection. The state board for mental health
    10  practitioners shall maintain a list of all licensed mental health  coun-
    11  selors,  marriage  and  family  therapists,  creative arts therapists or
    12  psychoanalysts qualified for reimbursement under this subsection.
    13    § 8. This act shall take effect on the first of January next  succeed-
    14  ing  the  date upon which it shall have become a law; provided, however,
    15  that the amendments made to item (i) of subparagraph (A) of paragraph 35
    16  of subsection (i) of section 3216 of the insurance law made  by  section
    17  one  of  this  act  shall  take  effect on the same date and in the same
    18  manner as part AA of chapter 57 of the laws of 2021  takes  effect;  and
    19  provided further, shall apply to policies and contracts issued, renewed,
    20  modified, altered or amended on or after such effective date.