Bill Text: NY S06574 | 2021-2022 | General Assembly | Amended

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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 1-0)

Status: (Introduced - Dead) 2022-05-24 - SUBSTITUTED BY A1171A [S06574 Detail]

Download: New_York-2021-S06574-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         6574--A

                               2021-2022 Regular Sessions

                    IN SENATE

                                       May 6, 2021
                                       ___________

        Introduced  by  Sen. KENNEDY -- read twice and ordered printed, and when
          printed to be committed 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)
    20  of  paragraph  four  of  subsection  (1)  of  section three thousand two
    21  hundred twenty-one of this article,] within the lawful scope of  his  or

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05221-03-1
        S. 6574--A                          2

     1  her practice, who is licensed pursuant to article one hundred fifty-four
     2  of  the  education  law,  a mental health counselor, marriage and family
     3  therapist, creative arts therapist or psychoanalyst licensed pursuant to
     4  article  one  hundred  sixty-three of the education law, a nurse practi-
     5  tioner licensed to practice in this state, or a professional corporation
     6  or university faculty practice  corporation  thereof.    Nothing  herein
     7  shall be construed to modify or expand the scope of practice of a mental
     8  health counselor, marriage and family therapist, creative arts therapist
     9  or psychoanalyst licensed pursuant to article one hundred sixty-three of
    10  the  education law. Further, nothing herein shall be construed to create
    11  a new mandated health benefit.
    12    § 2. Subparagraph (A) of paragraph 4 of subsection (l) of section 3221
    13  of the insurance law, as amended by section 11 of subpart A of  part  BB
    14  of chapter 57 of the laws of 2019, is amended to read as follows:
    15    (A)  Every insurer delivering a group policy or issuing a group policy
    16  for delivery, in this state, that provides reimbursement for psychiatric
    17  or psychological services or for the diagnosis and treatment  of  mental
    18  health  conditions,  however  defined  in  such  policy,  by physicians,
    19  psychiatrists or psychologists, shall [make available and  if  requested
    20  by  the  policyholder]  provide  the  same coverage to insureds for such
    21  services when performed by a licensed clinical social worker, within the
    22  lawful scope of his or her practice, who is licensed pursuant to article
    23  one hundred fifty-four of the education  law[.  Written  notice  of  the
    24  availability  of  such  coverage  shall be delivered to the policyholder
    25  prior to inception of such group policy and annually thereafter,  except
    26  that this notice shall not be required where a policy covers two hundred
    27  or  more  employees  or  where  the benefit structure was the subject of
    28  collective bargaining affecting persons who are employed  in  more  than
    29  one  state.]  and  mental  health counselors, marriage and family thera-
    30  pists, creative arts therapists and psychoanalysts licensed pursuant  to
    31  article  one hundred sixty-three of the education law, within the lawful
    32  scope of his or her practice. Nothing herein shall be construed to modi-
    33  fy or expand the  scope  of  practice  of  a  mental  health  counselor,
    34  marriage  and family therapist, creative arts therapist or psychoanalyst
    35  licensed pursuant to article one hundred sixty-three  of  the  education
    36  law. Further, nothing herein shall be construed to create a new mandated
    37  health benefit.
    38    § 3. Subparagraph (D) of paragraph 4 of subsection (l) of section 3221
    39  of the insurance law is REPEALED.
    40    § 4. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of
    41  section 3221 of the insurance law, as amended by section 13 of subpart A
    42  of  part  BB  of  chapter  57 of the laws of 2019, is amended to read as
    43  follows:
    44    (ii) where the policy provides coverage  for  physician  services,  it
    45  shall include benefits for outpatient care provided by a psychiatrist or
    46  psychologist  licensed  to  practice  in  this state, or a mental health
    47  counselor, marriage and family therapist,  creative  arts  therapist  or
    48  psychoanalyst  licensed  pursuant  to article one hundred sixty-three of
    49  the education law, or a licensed clinical social worker [who  meets  the
    50  requirements  of  subparagraph (D) of paragraph four of this subsection]
    51  within the lawful scope of his or her practice, who is licensed pursuant
    52  to article one hundred fifty-four of the education law, a nurse  practi-
    53  tioner licensed to practice in this state, or a professional corporation
    54  or university faculty practice corporation thereof. Nothing herein shall
    55  be  construed  to  modify  or  expand  the scope of practice of a mental
    56  health counselor, marriage and family therapist, creative arts therapist
        S. 6574--A                          3

     1  or psychoanalyst licensed pursuant to article one hundred sixty-three of
     2  the education law. Further, nothing herein shall be construed to  create
     3  a new mandated health benefit.
     4    §  5.  Paragraph  2 of subsection (g) of section 4303 of the insurance
     5  law, as added by section 22 of subpart A of part BB of chapter 57 of the
     6  laws of 2019, is amended to read as follows:
     7    (2) where the contract provides coverage for physician  services  such
     8  contract  shall  provide  benefits  for  outpatient  care  provided by a
     9  psychiatrist or psychologist licensed to practice in this  state,  or  a
    10  mental  health  counselor,  marriage and family therapist, creative arts
    11  therapist or psychoanalyst licensed   pursuant to  article  one  hundred
    12  sixty-three  of  the education law, or a licensed clinical social worker
    13  [who meets the requirements of subsection (n) of  this  section]  within
    14  the  lawful  scope  of  his or her practice, who is licensed pursuant to
    15  article one hundred fifty-four of the education law, a nurse practition-
    16  er licensed to practice [on] in this state, or professional  corporation
    17  or university faculty practice corporation thereof. Nothing herein shall
    18  be  construed  to  modify  or  expand  the scope of practice of a mental
    19  health counselor, marriage and family therapist, creative arts therapist
    20  or psychoanalyst licensed pursuant to article one hundred sixty-three of
    21  the education law. Further, nothing herein shall be construed to  create
    22  a new mandated health benefit.
    23    § 6. Subsection (i) of section 4303 of the insurance law is REPEALED.
    24    §  7.  Subsection (n) of section 4303 of the insurance law, as amended
    25  by section 30 of subpart A of part BB of chapter 57 of the laws of 2019,
    26  is amended to read as follows:
    27    (n) [In addition  to  the  requirements  of  subsection  (i)  of  this
    28  section, every] Every health service or medical expense indemnity corpo-
    29  ration  issuing  a  group  contract  pursuant to this section or a group
    30  remittance contract for delivery in this state which  contract  provides
    31  reimbursement  to  subscribers  or physicians, psychiatrists or psychol-
    32  ogists for psychiatric or psychological services or  for  the  diagnosis
    33  and  treatment  of  mental  health  conditions,  however defined in such
    34  contract, must provide the same coverage to persons  covered  under  the
    35  group  contract  for such services when performed by a licensed clinical
    36  social worker, within the lawful scope of his or her  practice,  who  is
    37  licensed  pursuant  to  [subdivision two of section seven thousand seven
    38  hundred four of the education law and in addition shall have either  (i)
    39  three  or  more  additional years experience in psychotherapy, which for
    40  the purposes of this subsection shall mean the use of verbal methods  in
    41  interpersonal  relationships  with  the  intent of assisting a person or
    42  persons to modify  attitudes  and  behavior  which  are  intellectually,
    43  socially  or emotionally maladaptive, under supervision, satisfactory to
    44  the state board for social work, in a facility, licensed or incorporated
    45  by an appropriate governmental department, providing services for  diag-
    46  nosis  or  treatment  of mental health conditions, or (ii) three or more
    47  additional years experience  in  psychotherapy  under  the  supervision,
    48  satisfactory  to  the  state board for social work, of a psychiatrist, a
    49  licensed and registered psychologist or a licensed clinical social work-
    50  er qualified for  reimbursement  pursuant  to  subsection  (i)  of  this
    51  section,  or  (iii)  a  combination of the experience specified in para-
    52  graphs (i) and (ii) totaling three  years,  satisfactory  to  the  state
    53  board  for social work.] article one hundred fifty-four of the education
    54  law and a mental health counselor, marriage and family therapist,  crea-
    55  tive  arts  therapist  or psychoanalyst licensed pursuant to article one
    56  hundred sixty-three of  the  education  law.  Nothing  herein  shall  be
        S. 6574--A                          4

     1  construed  to  modify or expand the scope of practice of a mental health
     2  counselor, marriage and family therapist,  creative  arts  therapist  or
     3  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. The state board for social work shall
     6  maintain a list of all licensed clinical social  workers  qualified  for
     7  reimbursement  under  this subsection. The state board for mental health
     8  practitioners shall maintain a list of all licensed mental health  coun-
     9  selors,  marriage  and  family  therapists,  creative arts therapists or
    10  psychoanalysts qualified for reimbursement under this subsection.
    11    § 8. This act shall take effect on the first of January next  succeed-
    12  ing  the  date upon which it shall have become a law; provided, however,
    13  that the amendments made to item (i) of subparagraph (A) of paragraph 35
    14  of subsection (i) of section 3216 of the insurance law made  by  section
    15  one  of  this  act  shall  take  effect on the same date and in the same
    16  manner as part AA of chapter 57 of the laws of 2021  takes  effect;  and
    17  provided further, shall apply to policies and contracts issued, renewed,
    18  modified, altered or amended on or after such effective date.