senate Bill S7882

2013-2014 Legislative Session

Relates to insurance coverage for diagnosis and treatment of substance use disorder benefits

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Archive: Last Bill Status - In Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jun 16, 2014 referred to rules

Co-Sponsors

S7882 - Details

See Assembly Version of this Bill:
A9943B
Current Committee:
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221, 4303, 4902, 4903 & 4904, Ins L; amd §§4902, 4903 & 4904, Pub Health L

S7882 - Summary

Relates to insurance coverage for diagnosis and treatment of substance use disorder benefits; creates a workgroup to study and make recommendations on improving access to and the availability of chemical dependency or substance use disorder treatment services.

S7882 - Sponsor Memo

S7882 - Bill Text download pdf

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

                                  7882

                            I N  S E N A T E

                              June 16, 2014
                               ___________

Introduced  by  Sens.  SEWARD, HANNON -- read twice and ordered printed,
  and when printed to be committed to the Committee on Rules

AN ACT to amend the insurance law and the public health law, in relation
  to requiring health insurance coverage for diagnosis and treatment  of
  substance  use disorder treatment services and creating a workgroup to
  study and make recommendations

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

  Section  1.    Subsection  (i) of section 3216 of the insurance law is
amended by adding a new paragraph 30 to read as follows:
  (30) (A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR-MEDICAL OR  SIMILAR
COMPREHENSIVE-TYPE  COVERAGE  SHALL  INCLUDE  COVERAGE FOR DIAGNOSIS AND
TREATMENT OF SUBSTANCE USE DISORDER BENEFITS  PURSUANT  TO  THE  FEDERAL
PAUL  WELLSTONE  AND  PETE  DOMENICI  MENTAL HEALTH PARITY AND ADDICTION
EQUITY ACT OF 2008, AS AMENDED, OR OTHER APPLICABLE  FEDERAL  AND  STATE
STATUTES  AND  RULES  AND  REGULATIONS PROMULGATED THERETO WHICH REQUIRE
PARITY BETWEEN MENTAL HEALTH OR  SUBSTANCE  USE  DISORDER  BENEFITS  AND
MEDICAL/SURGICAL  BENEFITS  WITH  RESPECT  TO FINANCIAL REQUIREMENTS AND
TREATMENT  OR  WHICH  REQUIRE  COVERAGE  OF  SUCH  TREATMENT,  WHICHEVER
PROVIDES  A  BENEFIT  THAT  IS  MORE ADVANTAGEOUS TO THE POLICYHOLDER AS
DETERMINED BY THE SUPERINTENDENT. SUCH COVERAGE SHALL INCLUDE BOTH INPA-
TIENT AND OUTPATIENT TREATMENT, INCLUDING DETOXIFICATION  AND  REHABILI-
TATION SERVICES.
  (B)  IN THE EVENT OF AN ADVERSE DETERMINATION FOR SUBSTANCE USE DISOR-
DER TREATMENT SERVICES, THE HEALTH PLAN SHALL CONTINUE TO PROVIDE COVER-
AGE AND REIMBURSE FOR ALL SUCH SERVICES UNTIL THE INSURED HAS  EXHAUSTED
ALL  APPEALS,  BOTH  INTERNAL  AND  EXTERNAL,  OR OTHERWISE NOTIFIES THE
HEALTH PLAN IN WRITING THAT HE OR SHE HAS DECIDED TO  NOT  MOVE  FORWARD
WITH  THE APPEALS PROCESS.  THE HEALTH PLAN SHALL ENSURE THAT AN INSURED
SHALL NOT INCUR ANY GREATER OUT-OF-POCKET COSTS FOR SUBSTANCE USE DISOR-
DER TREATMENT SERVICES RENDERED  WHILE  THE  PROVIDER  IS  APPEALING  AN
ADVERSE  DETERMINATION  FOR  SUCH  SERVICES  THAN THE INSURED WOULD HAVE
INCURRED IF SUCH SERVICES WERE APPROVED BY THE UTILIZATION REVIEW AGENT.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15361-11-4

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