BILL NUMBER:  S7550

 TITLE OF BILL :

An act to amend the social services law, in relation to establishing
mental health parity in public health insurance plans


 PURPOSE :

Provides that the benefits provided in Family Health Plus for the
treatment of mental health and substance abuse disorders be comparable
to medical services.

 SUMMARY OF PROVISIONS :

Section 1. Provides that mental health and substance abuse benefits
provided in Family Health Plus shall be comparable to medical benefits
provided as part of the Family Health Plus program.

Section 2. Authorizes the Commissioner to seek any necessary waivers
to implement this chapter.

Section 3. Provides for an effective date of April 1 of the year next
succeeding enactment.

              

 JUSTIFICATION :

Timothy's Law (Chapter 748 of the Laws of 2006), one of the 42 state
mental health parity laws in the US, took effect January 1, 2007 and
applies to most insurance policies in New York on the day they are
issued, renewed, modified, altered, or amended. Before the law passed,
health plans were permitted to discriminate against those with mental
health needs by charging much higher co-payments and deductibles for
inpatient and outpatient mental health care compared with the fees
they charge consumers for regular medical office visits. Top health
plans also recently began to restrict coverage for mental health
conditions, exclude coverage for chronic mental illnesses, and impose
life time limits on inpatient psychiatric care.  Timothy's Law
remedied many of these barriers to care.

Further, Federal law recently added mental health parity requirements
to the Child Health Insurance plans (effective April 1, 2009) and
Medicare (effective on a phased in schedule over the next few years)
as well as self-insured plans and other large employers, including
parity in coverage for the treatment of chemical dependency (effective
with plan years beginning after October 3, 2009 except for certain
collectively bargained plans that are subject to special rules
regarding effective date).

These changes and equity and the comparability provisions of Timothy's
Law do not presently apply to the Family Health Plus Program. This
program already provides coverage for inpatient and outpatient mental
health and alcohol and substance abuse services, but unlike other
health insurance programs that may not limit such services, these
benefits are limited in Family Health Plus.

This legislation simply assures that such coverage is comparable to
that which is provided for other medical conditions under these
programs, and does not place greater restrictions on coverage for
mental health conditions or addictions than apply for other needs.

Recent studies confirm the efficacy and cast effectiveness of such
coverage, and, furthermore demonstrate that the costs associated with
the enactment of mental health parity legislation are minimal.
Actuarial analyses and emerging data from states with parity laws
demonstrate that equitable insurance coverage for mental illnesses is
indeed affordable. Studies demonstrate that the cost of adopting
mental health parity is negligible - often below one per cent. The NYS
insurance department projected costs for Timothy's Law premium
subsidies for small employers to be about one percent for the premium
component attributable to the entire mental health benefit among
private insurers and Health Maintenance Organizations in NYS.

The comparability required under this legislation would cost a mere
fraction of that sum, since (unlike commercial health plans
previously) the Family Health Plus Program already provide mental
health and addiction treatment coverage. Further, the cost to the
taxpayer will be reduced, since those who may would need benefits
beyond the Family Health Plus limited benefit are at times forced onto
Medicaid.

Finally, costs are incurred by individuals, employers, all levels of
government, and society as a whole as a result of untreated mental
illnesses that can also cause or contribute to accidents, job
dissatisfaction, interpersonal conflict, turnover, disability,
workers' compensation, involvement with the criminal justice system,
disrupted lives and families, and increased dependency on public
resources. By providing comparable coverage for mental health and
substance abuse services for all using the Family Health Plus Program,
mental illness and substance abuse can be diagnosed and treated
quickly and thoroughly, thus placing less of a burden on public
resources and businesses.

 LEGISLATIVE HISTORY :

New bill.

 FISCAL IMPLICATIONS :

Minimal.

 EFFECTIVE DATE :
April 1st of the year next succeeding enactment.