S T A T E O F N E W Y O R K
________________________________________________________________________
5486--A
Cal. No. 1284
2015-2016 Regular Sessions
I N S E N A T E
May 14, 2015
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Introduced by Sens. ORTT, AMEDORE, FELDER, HANNON, MURPHY -- read twice
and ordered printed, and when printed to be committed to the Committee
on Health -- reported favorably from said committee, ordered to first
and second report, amended on second report, ordered to a third read-
ing, and to be reprinted as amended, retaining its place in the order
of third reading
AN ACT to amend the social services law, the public health law and the
insurance law, in relation to prohibiting a provider of health care
coverage from requiring providers of behavioral health services to
offer all products offered by the provider of health care coverage
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 365-m of the social services law is amended by
2 adding a new subdivision 6 to read as follows:
3 6. (A) NO MANAGED CARE PROVIDER UNDER SECTION THREE HUNDRED
4 SIXTY-FOUR-J OF THIS TITLE SHALL BY CONTRACT OR WRITTEN POLICY OR PROCE-
5 DURE, REQUIRE A BEHAVIORAL HEALTH SERVICES PROVIDER TO PARTICIPATE IN
6 THE IN-NETWORK PORTION OF ANY PRODUCT OFFERED BY SUCH MANAGED CARE
7 PROVIDER, OTHER THAN PRODUCTS UNDER SUCH SECTION. BEHAVIORAL HEALTH
8 SERVICES PROVIDERS SHALL HAVE THE RIGHT TO SELECT BY EXECUTION OF A
9 SEPARATE AGREEMENT THE PRODUCTS OF SUCH MANAGED CARE PROVIDER IN WHICH
10 THE PROVIDER AGREES TO PARTICIPATE IN THE IN-NETWORK PORTION.
11 (B) AS USED IN THIS SUBDIVISION, "BEHAVIORAL HEALTH SERVICES" MEANS
12 INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES PROVIDED BY THOSE
13 LICENSED OR CERTIFIED PURSUANT TO ARTICLE THIRTY-ONE OR THIRTY-TWO OF
14 THE MENTAL HYGIENE LAW, OR PROGRAMS THAT ARE LICENSED PURSUANT TO BOTH
15 ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF
16 THE PUBLIC HEALTH LAW, OR CERTIFIED UNDER BOTH ARTICLE THIRTY-TWO OF THE
17 MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW.
18 S 2. Section 2511 of the public health law is amended by adding a new
19 subdivision 22 to read as follows:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10990-03-5
S. 5486--A 2
1 22. (A) NO APPROVED ORGANIZATION SHALL BY CONTRACT OR WRITTEN POLICY
2 OR PROCEDURE, REQUIRE A BEHAVIORAL HEALTH SERVICES PROVIDER TO PARTIC-
3 IPATE IN THE IN-NETWORK PORTION OF ANY PRODUCT OFFERED BY SUCH ORGANIZA-
4 TION, OTHER THAN PRODUCTS UNDER THIS TITLE. BEHAVIORAL HEALTH SERVICES
5 PROVIDERS SHALL HAVE THE RIGHT TO SELECT BY EXECUTION OF A SEPARATE
6 AGREEMENT THE PRODUCTS OF SUCH APPROVED ORGANIZATION IN WHICH THE
7 PROVIDER AGREES TO PARTICIPATE IN THE IN-NETWORK PORTION.
8 (B) AS USED IN THIS SUBDIVISION, "BEHAVIORAL HEALTH SERVICES" MEANS
9 INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES PROVIDED BY THOSE
10 LICENSED OR CERTIFIED PURSUANT TO ARTICLE THIRTY-ONE OR THIRTY-TWO OF
11 THE MENTAL HYGIENE LAW, OR PROGRAMS THAT ARE LICENSED PURSUANT TO BOTH
12 ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF
13 THIS CHAPTER, OR CERTIFIED UNDER BOTH ARTICLE THIRTY-TWO OF THE MENTAL
14 HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF THIS CHAPTER.
15 S 3. Section 4406-c of the public health law is amended by adding a
16 new subdivision 9 to read as follows:
17 9. (A) NO HEALTH CARE PLAN LICENSED PURSUANT TO THIS ARTICLE SHALL BY
18 CONTRACT OR WRITTEN POLICY OR PROCEDURE, REQUIRE A BEHAVIORAL HEALTH
19 SERVICES PROVIDER TO PARTICIPATE IN THE IN-NETWORK PORTION OF ANY PROD-
20 UCT OFFERED BY SUCH PLAN. BEHAVIORAL HEALTH SERVICES PROVIDERS SHALL
21 HAVE THE RIGHT TO SELECT BY EXECUTION OF A SEPARATE AGREEMENT THE
22 PRODUCTS OF SUCH PLAN IN WHICH THE PROVIDER AGREES TO PARTICIPATE IN THE
23 IN-NETWORK PORTION.
24 (B) AS USED IN THIS SUBDIVISION, "BEHAVIORAL HEALTH SERVICES" MEANS
25 INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES PROVIDED BY THOSE
26 LICENSED OR CERTIFIED PURSUANT TO ARTICLE THIRTY-ONE OR THIRTY-TWO OF
27 THE MENTAL HYGIENE LAW, OR PROGRAMS THAT ARE LICENSED PURSUANT TO BOTH
28 ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF
29 THIS CHAPTER, OR CERTIFIED UNDER BOTH ARTICLE THIRTY-TWO OF THE MENTAL
30 HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF THIS CHAPTER.
31 S 4. Section 3217-b of the insurance law is amended by adding a new
32 subsection (k) to read as follows:
33 (K) (1) NO INSURER SUBJECT TO THE PROVISIONS OF THIS ARTICLE SHALL BY
34 CONTRACT, WRITTEN POLICY OR PROCEDURE, REQUIRE A BEHAVIORAL HEALTH
35 SERVICES PROVIDER TO PARTICIPATE IN THE IN-NETWORK PORTION OF ANY PROD-
36 UCT OFFERED BY SUCH INSURER. BEHAVIORAL HEALTH SERVICES PROVIDERS SHALL
37 HAVE THE RIGHT TO SELECT BY EXECUTION OF A SEPARATE AGREEMENT THE
38 PRODUCTS OF SUCH INSURERS IN WHICH THE PROVIDER AGREES TO PARTICIPATE IN
39 THE IN-NETWORK PORTION.
40 (2) AS USED IN THIS SUBSECTION, "BEHAVIORAL HEALTH SERVICES" MEANS
41 INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES PROVIDED BY THOSE
42 LICENSED OR CERTIFIED PURSUANT TO ARTICLE THIRTY-ONE OR THIRTY-TWO OF
43 THE MENTAL HYGIENE LAW, OR PROGRAMS THAT ARE LICENSED PURSUANT TO BOTH
44 ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF
45 THE PUBLIC HEALTH LAW, OR CERTIFIED UNDER BOTH ARTICLE THIRTY-TWO OF THE
46 MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW.
47 S 5. Section 4325 of the insurance law is amended by adding a new
48 subsection (l) to read as follows:
49 (L) (1) NO CORPORATION ORGANIZED PURSUANT TO THIS ARTICLE SHALL BY
50 CONTRACT, WRITTEN POLICY OR PROCEDURE, REQUIRE A BEHAVIORAL HEALTH
51 SERVICES PROVIDER TO PARTICIPATE IN THE IN-NETWORK PORTION OF ANY PROD-
52 UCT OFFERED BY SUCH CORPORATION. BEHAVIORAL HEALTH SERVICES PROVIDERS
53 SHALL HAVE THE RIGHT TO SELECT BY EXECUTION OF A SEPARATE AGREEMENT THE
54 PRODUCTS OF SUCH CORPORATION IN WHICH THE PROVIDER AGREES TO PARTICIPATE
55 IN THE IN-NETWORK PORTION.
S. 5486--A 3
1 (2) AS USED IN THIS SUBSECTION, "BEHAVIORAL HEALTH SERVICES" MEANS
2 INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES PROVIDED BY THOSE
3 LICENSED OR CERTIFIED PURSUANT TO ARTICLE THIRTY-ONE OR THIRTY-TWO OF
4 THE MENTAL HYGIENE LAW, OR PROGRAMS THAT ARE LICENSED PURSUANT TO BOTH
5 ARTICLE THIRTY-ONE OF THE MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF
6 THE PUBLIC HEALTH LAW, OR CERTIFIED UNDER BOTH ARTICLE THIRTY-TWO OF THE
7 MENTAL HYGIENE LAW AND ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW.
8 S 6. This act shall take effect immediately.