S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4293

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            February 1, 2013
                               ___________

Introduced by M. of A. CURRAN -- read once and referred to the Committee
  on Insurance

AN  ACT  to  amend the insurance law, in relation to allowing reimburse-
  ments for certain services provided by licensed mental health  counse-
  lors

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 4 of subsection (i) of section 3216 of the insur-
ance law is amended to read as follows:
  (4) If a policy provides for reimbursement for psychiatric or  psycho-
logical  services  or for diagnosis and treatment of mental, nervous, or
emotional disorders or ailments, however  defined  in  the  policy,  the
insured  shall be entitled to reimbursement for such services, diagnosis
or treatment whether performed by  a  physician,  psychiatrist  [or],  a
certified and registered psychologist, OR A LICENSED MENTAL HEALTH COUN-
SELOR  when  the  services rendered are within the lawful scope of their
practice.
  S 2. Paragraph 4 of subsection (l) of section 3221  of  the  insurance
law,  subparagraphs (A) and (D) as amended by chapter 230 of the laws of
2004 and subparagraph (B) as amended by chapter 420 of the laws of 2002,
is amended to read as follows:
  (4) (A) Every insurer delivering a group policy  or  issuing  a  group
policy  for  delivery,  in  this state, which provides reimbursement for
psychiatric or psychological services or for the diagnosis and treatment
of mental, nervous or emotional disorders and ailments, however  defined
in such policy, by physicians, psychiatrists or psychologists, must make
available and if requested by the policyholder provide the same coverage
to  insureds  for  such  services  when performed by a licensed clinical
social worker, within the lawful scope of his or her  practice,  who  is
licensed pursuant to article one hundred fifty-four of the education law
OR A LICENSED MENTAL HEALTH COUNSELOR, WITHIN THE LAWFUL SCOPE OF HIS OR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08431-01-3
              

A. 4293                             2

HER   PRACTICE,   WHO  IS  LICENSED  PURSUANT  TO  ARTICLE  ONE  HUNDRED
SIXTY-THREE OF THE EDUCATION LAW.  Written notice of the availability of
such coverage shall be delivered to the policyholder prior to  inception
of  such  group  policy and annually thereafter, except that this notice
shall not be required where a policy covers two hundred or more  employ-
ees  or  where  the  benefit  structure  was  the  subject of collective
bargaining affecting persons who are employed in more than one state.
  (B) The state board for social work  shall  maintain  a  list  of  all
licensed  clinical social workers qualified for reimbursement under this
paragraph. THE STATE BOARD OF MENTAL HEALTH PRACTITIONERS SHALL MAINTAIN
A LIST OF ALL LICENSED MENTAL HEALTH COUNSELORS QUALIFIED FOR REIMBURSE-
MENT UNDER THIS PARAGRAPH.
  (C) Such coverage shall be made available at the inception of all  new
policies and, with respect to all other policies at any subsequent annu-
al anniversary date of the policy subject to evidence of insurability.
  (D)  In addition to the requirements of subparagraph (A) of this para-
graph, every insurer issuing a group policy for delivery in  this  state
which  policy  provides  reimbursement  to  insureds  for psychiatric or
psychological services or for the diagnosis  and  treatment  of  mental,
nervous  or  emotional  disorders  and ailments, however defined in such
policy, by physicians, psychiatrists or psychologists, must provide  the
same coverage to insureds for such services when performed by a licensed
clinical  social worker, within the lawful scope of his or her practice,
who is licensed pursuant to subdivision two of  section  seven  thousand
seven  hundred  four  of  the  education law OR A LICENSED MENTAL HEALTH
COUNSELOR, WITHIN THE LAWFUL SCOPE  OF  HIS  OR  HER  PRACTICE,  WHO  IS
LICENSED  PURSUANT  TO  SUBDIVISION THREE OF SECTION EIGHT THOUSAND FOUR
HUNDRED TWO OF THE EDUCATION LAW and in addition shall have  either  (i)
three  or  more  additional years experience in psychotherapy, which for
the purposes of this subparagraph shall mean the use of  verbal  methods
in  interpersonal relationships with the intent of assisting a person or
persons to modify  attitudes  and  behavior  which  are  intellectually,
socially  or emotionally maladaptive, under supervision, satisfactory to
the state board for social work OR THE  STATE  BOARD  OF  MENTAL  HEALTH
PRACTITIONERS, in a facility, licensed or incorporated by an appropriate
governmental  department,  providing services for diagnosis or treatment
of mental, nervous or emotional disorders or ailments, or (ii) three  or
more additional years experience in psychotherapy under the supervision,
satisfactory  to  the  state board for social work OR THE STATE BOARD OF
MENTAL HEALTH PRACTITIONERS, of a psychiatrist, a  licensed  and  regis-
tered psychologist [or], a licensed clinical social worker OR A LICENSED
MENTAL   HEALTH   COUNSELOR  qualified  for  reimbursement  pursuant  to
subsection (h) of this section, or (iii) a combination of the experience
specified in items (i) and (ii)  OF  THIS  SUBPARAGRAPH  totaling  three
years,  satisfactory  to  the  state  board for social work OR THE STATE
BOARD OF MENTAL HEALTH PRACTITIONERS.  The state board for  social  work
shall  maintain a list of all licensed clinical social workers qualified
for reimbursement under this subparagraph.   THE STATE BOARD  OF  MENTAL
HEALTH PRACTITIONERS SHALL MAINTAIN A LIST OF ALL LICENSED MENTAL HEALTH
COUNSELORS QUALIFIED FOR REIMBURSEMENT UNDER THIS SUBPARAGRAPH.
  S 3. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of
section 3221 of the insurance law, as amended by chapter 502 of the laws
of 2007, is amended to read as follows:
  (ii)  where  the  policy  provides coverage for physician services, it
shall include benefits for outpatient care provided by a psychiatrist or
psychologist licensed to practice in this  state,  a  licensed  clinical

A. 4293                             3

social  worker  OR  A  LICENSED  MENTAL  HEALTH  COUNSELOR who meets the
requirements of subparagraph (D) of paragraph four of  this  subsection,
or a professional corporation or university faculty practice corporation
thereof.  Such benefits may be limited to not less than twenty visits in
any contract year, plan year, or calendar year.
  S 4. Subparagraph (G) of paragraph 4 of subsection (f) of section 4235
of the insurance law, as relettered by chapter 456 of the laws of  1993,
is amended to read as follows:
  (G)  psychiatric  or  psychological  services or for the diagnosis and
treatment of mental, nervous, or emotional disorders or ailments, howev-
er defined in such policy, a subscriber to such policy shall be entitled
to reimbursement for such psychiatric or psychological services or diag-
nosis or treatment whether performed by a physician, psychiatrist  [or],
a  certified  and  registered  psychologist  OR A LICENSED MENTAL HEALTH
COUNSELOR when the services rendered are  within  the  lawful  scope  of
their  practice,  and  when such policy or any certificate issued there-
under is delivered or issued for  delivery  without  this  state  by  an
authorized  insurer,  covered  persons  residing  in this state shall be
entitled to reimbursement for such diagnosis and treatment by  a  physi-
cian, psychiatrist or a certified and registered psychologist as herein-
above provided; and
  S  5.  Paragraph  1  of  subsection (h) and subsections (i) and (n) of
section 4303 of the insurance law, paragraph  1  of  subsection  (h)  as
amended  by  chapter 502 of the laws of 2007 and subsections (i) and (n)
as amended by chapter 230 of the laws of 2004, are amended  to  read  as
follows:
  (1) A medical expense indemnity corporation or a health service corpo-
ration,  which provides group, group remittance or school blanket cover-
age for physician services, shall provide as part of its contract broad-
based coverage for the diagnosis and treatment  of  mental,  nervous  or
emotional  disorders  or  ailments, however defined in such contract, at
least equal to the coverage provided for  other  health  conditions  and
shall  include:  benefits for outpatient care provided by a psychiatrist
or psychologist licensed to practice in this state, a licensed  clinical
social  worker  OR  A  LICENSED  MENTAL  HEALTH  COUNSELOR who meets the
requirements of subsection (n) of this section, or a professional corpo-
ration or university faculty practice corporation thereof,  which  bene-
fits may be limited to not less than twenty visits in any contract year,
plan  year or calendar year. Such coverage may be provided on a contract
year, plan year or calendar year basis and shall be consistent with  the
provision  of  other  benefits  under the contract. Such coverage may be
subject to annual deductibles, co-pays and coinsurance as may be  deemed
appropriate  by  the  superintendent  and shall be consistent with those
imposed on other benefits under the contract. In  the  event  the  group
remittance  group or contract holder is provided coverage provided under
this paragraph and under subparagraph (B) of paragraph one of subsection
(g) of this section from the same health service corporation, or under a
contract which is jointly underwritten  by  two  health  service  corpo-
rations  or by a health service corporation and a medical expense indem-
nity corporation, the aggregate of the  benefits  for  out-patient  care
obtained  under  subparagraph  (B) of paragraph one of subsection (g) of
this section and this paragraph may be limited to not less  than  twenty
visits in any contract year, plan year or calendar year.
  (i)  A  medical expense indemnity corporation or health service corpo-
ration which provides coverage for physicians, psychiatrists or psychol-
ogists for psychiatric or psychological services or  for  the  diagnosis

A. 4293                             4

and  treatment  of  mental, nervous or emotional disorders and ailments,
however defined in such contract, must make available and  if  requested
by  all  persons  holding individual contracts in a group whose premiums
are paid by a remitting agent or by the contract holder in the case of a
group  contract  issued  pursuant to section four thousand three hundred
five of this article, provide the same coverage for such  services  when
performed  by a licensed clinical social worker, within the lawful scope
of his or her practice, who is licensed pursuant to article one  hundred
fifty-four  of  the education law OR A LICENSED MENTAL HEALTH COUNSELOR,
WITHIN THE LAWFUL SCOPE OF HIS OR HER PRACTICE, WHO IS LICENSED PURSUANT
TO ARTICLE ONE HUNDRED SIXTY-THREE OF THE EDUCATION LAW. The state board
for social work shall maintain a list of all  licensed  clinical  social
workers  qualified  for  reimbursement  under this subsection. THE STATE
BOARD OF MENTAL HEALTH  PRACTITIONERS  SHALL  MAINTAIN  A  LIST  OF  ALL
LICENSED  CLINICAL SOCIAL WORKERS QUALIFIED FOR REIMBURSEMENT UNDER THIS
SUBSECTION. Such coverage shall be made available at  the  inception  of
all new contracts and, with respect to all other contracts, at any anni-
versary  date subject to evidence of insurability. Written notice of the
availability of such coverage shall be delivered to the group  remitting
agent  or  group contract holder prior to inception of such contract and
annually thereafter, except that this notice shall not be required where
a policy covers two hundred or  more  employees  or  where  the  benefit
structure was the subject of collective bargaining affecting persons who
are employed in more than one state.
  (n) In addition to the requirements of subsection (i) of this section,
every  health service or medical expense indemnity corporation issuing a
group contract pursuant to this section or a group  remittance  contract
for  delivery  in  this  state  which contract provides reimbursement to
subscribers or physicians, psychiatrists or psychologists for  psychiat-
ric  or  psychological  services  or  for the diagnosis and treatment of
mental, nervous or emotional disorders and ailments, however defined  in
such  contract,  must provide the same coverage to persons covered under
the group contract for such services when performed by a licensed  clin-
ical  social worker, within the lawful scope of his or her practice, who
is licensed pursuant to subdivision two of section seven thousand  seven
hundred four of the education law OR A LICENSED MENTAL HEALTH COUNSELOR,
WITHIN THE LAWFUL SCOPE OF HIS OR HER PRACTICE, WHO IS LICENSED PURSUANT
TO  SUBDIVISION  THREE OF SECTION EIGHT THOUSAND FOUR HUNDRED TWO OF THE
EDUCATION LAW and in addition shall have either (i) three or more  addi-
tional years experience in psychotherapy, which for the purposes of this
subsection  shall  mean  the  use  of  verbal  methods  in interpersonal
relationships with the intent of assisting a person or persons to modify
attitudes and behavior which are intellectually, socially or emotionally
maladaptive, under supervision, satisfactory  to  the  state  board  for
social  work  OR  THE  STATE  BOARD OF MENTAL HEALTH PRACTITIONERS, in a
facility,  licensed  or  incorporated  by  an  appropriate  governmental
department,  providing  services  for  diagnosis or treatment of mental,
nervous or emotional disorders or ailments, or (ii) three or more  addi-
tional  years  experience in psychotherapy under the supervision, satis-
factory to the state board for social work OR THE STATE BOARD OF  MENTAL
HEALTH  PRACTITIONERS,  of  a  psychiatrist,  a  licensed and registered
psychologist or a licensed clinical social  worker  OR  LICENSED  MENTAL
HEALTH  PRACTITIONER  qualified for reimbursement pursuant to subsection
(i) of this section, or (iii) a combination of the experience  specified
in  [paragraphs]  ITEMS (i) and (ii) OF THIS SUBPARAGRAPH totaling three
years, satisfactory to the state board for  social  work  OR  THE  STATE

A. 4293                             5

BOARD  OF  MENTAL HEALTH PRACTITIONERS.  The state board for social work
shall maintain a list of all licensed clinical social workers  qualified
for  reimbursement  under  this  subsection.  THE  STATE BOARD OF MENTAL
HEALTH PRACTITIONERS SHALL MAINTAIN A LIST OF ALL LICENSED MENTAL HEALTH
COUNSELORS QUALIFIED FOR REIMBURSEMENT UNDER THIS SUBSECTION.
  S  6.  This  act shall take effect on the ninetieth day after it shall
have become a law.