Senate Bill S7662A

2013-2014 Legislative Session

Relates to insurance coverage for substance abuse disorder

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Assembly Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Actions
Votes

Bill Amendments

co-Sponsors

2013-S7662 - Details

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

2013-S7662 - Summary

Relates to insurance coverage for substance abuse disorder; requires health plans to use a health care provider who specializes in behavioral health or substance use disorder treatment to supervise and oversee the medical management decisions relating to substance abuse treatment.

2013-S7662 - Sponsor Memo

2013-S7662 - Bill Text download pdf

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

                                  7662

                            I N  S E N A T E

                              May 23, 2014
                               ___________

Introduced by Sens. SEWARD, HANNON, MARTINS, RITCHIE, BOYLE, BALL, BONA-
  CIC,  CARLUCCI,  FELDER,  GALLIVAN,  GOLDEN,  GRIFFO,  LANZA,  LARKIN,
  LITTLE, MARCELLINO, MARCHIONE, MAZIARZ, NOZZOLIO, O'MARA, RANZENHOFER,
  ROBACH, SAVINO, VALESKY, YOUNG -- read twice and ordered printed,  and
  when printed to be committed to the Committee on Insurance

AN  ACT  to  amend  the  insurance  law, in relation to requiring health
  insurance coverage for substance abuse 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.  The insurance law is amended by adding a new section 3242
to read as follows:
  S 3242. COVERAGE FOR SUBSTANCE ABUSE DISORDER. (A)  (1)  EVERY  POLICY
DELIVERED  OR  ISSUED  FOR DELIVERY BY A HEALTH PLAN IN THIS STATE WHICH
PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR  COMPREHENSIVE-TYPE  COVERAGE
SHALL INCLUDE SPECIFIC COVERAGE FOR DRUG AND ALCOHOL ABUSE AND DEPENDEN-
CY  TREATMENT  SERVICES  PURSUANT TO THE FEDERAL PAUL WELLSTONE AND PETE
DOMENICI MENTAL HEALTH PARITY AND ADDICTION  EQUITY  ACT  OF  2008,  AND
APPLICABLE STATE STATUTES WHICH REQUIRES PARITY BETWEEN MENTAL HEALTH OR
SUBSTANCE  USE  DISORDER  BENEFITS  AND  MEDICAL/SURGICAL  BENEFITS WITH
RESPECT TO FINANCIAL REQUIREMENTS AND TREATMENT.
  (2) DETERMINATION OF COVERAGE FOR SUBSTANCE ABUSE OR DEPENDENCY TREAT-
MENT SERVICES BY A HEALTH PLAN SHALL BE MADE THROUGH A  MEDICAL  MANAGE-
MENT REVIEW PROCESS WHICH:
  (A)  UTILIZES  A HEALTH CARE PROVIDER WHO SPECIALIZES IN SUBSTANCE USE
DISORDER; AND
  (B) UTILIZES ONLY CLINICAL REVIEW CRITERIA CONTAINED IN  THE  AMERICAN
SOCIETY  OF  ADDICTION  MEDICINE'S PATIENT PLACEMENT CRITERIA OR ANOTHER
CARE CRITERIA OR COMPENDIA DEEMED APPROPRIATE AND APPROVED FOR SUCH  USE
BY THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES IN CONSULTATION
WITH THE COMMISSIONER OF HEALTH AND THE SUPERINTENDENT OF THE DEPARTMENT
OF FINANCIAL SERVICES.
  (3)  THE  LOCATION OF COVERED TREATMENT PURSUANT TO THIS SECTION SHALL
BE SUBJECT TO THE INSURER'S REQUIREMENTS RELATING TO THE USE OF  PARTIC-

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

co-Sponsors

2013-S7662A (ACTIVE) - Details

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

2013-S7662A (ACTIVE) - Summary

Relates to insurance coverage for substance abuse disorder; requires health plans to use a health care provider who specializes in behavioral health or substance use disorder treatment to supervise and oversee the medical management decisions relating to substance abuse treatment.

2013-S7662A (ACTIVE) - Sponsor Memo

2013-S7662A (ACTIVE) - Bill Text download pdf

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

                                 7662--A

                            I N  S E N A T E

                              May 23, 2014
                               ___________

Introduced by Sens. SEWARD, HANNON, MARTINS, RITCHIE, BOYLE, BALL, BONA-
  CIC,  CARLUCCI,  FELDER,  GALLIVAN,  GOLDEN,  GRIFFO,  LANZA,  LARKIN,
  LAVALLE, LITTLE, MARCELLINO,  MARCHIONE,  MAZIARZ,  NOZZOLIO,  O'MARA,
  RANZENHOFER,  ROBACH, SAVINO, VALESKY, YOUNG -- read twice and ordered
  printed, and when printed to be committed to the Committee  on  Insur-
  ance  --  reported  favorably from said committee and committed to the
  Committee on Rules --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the insurance law and the public health law, in relation
  to  requiring  health  insurance coverage for substance abuse disorder
  treatment services and creating a workgroup to study and  make  recom-
  mendations

  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 SPECIFIC COVERAGE FOR DRUG AND
ALCOHOL ABUSE AND DEPENDENCY TREATMENT SERVICES PURSUANT TO THE  FEDERAL
PAUL  WELLSTONE  AND  PETE  DOMENICI  MENTAL HEALTH PARITY AND ADDICTION
EQUITY ACT OF 2008, AND APPLICABLE STATE STATUTES WHICH REQUIRES  PARITY
BETWEEN   MENTAL   HEALTH   OR   SUBSTANCE  USE  DISORDER  BENEFITS  AND
MEDICAL/SURGICAL BENEFITS WITH RESPECT  TO  FINANCIAL  REQUIREMENTS  AND
TREATMENT.
  (B) DETERMINATION OF COVERAGE FOR SUBSTANCE ABUSE OR DEPENDENCY TREAT-
MENT  SERVICES  BY A HEALTH PLAN SHALL BE MADE THROUGH A MEDICAL MANAGE-
MENT REVIEW PROCESS WHICH:
  (I) UTILIZES A HEALTH CARE  PROVIDER  WHO  SPECIALIZES  IN  BEHAVIORAL
HEALTH AND WHO HAS EXPERIENCE IN THE DELIVERY OF SUBSTANCE ABUSE COURSES
OF  TREATMENT  TO SUPERVISE AND OVERSEE THE MEDICAL MANAGEMENT DECISIONS
RELATING TO SUBSTANCE ABUSE TREATMENT; AND
  (II) UTILIZES ONLY CLINICAL REVIEW  CRITERIA  CONTAINED  IN  THE  MOST
RECENT  EDITION  OF THE AMERICAN SOCIETY OF ADDICTION MEDICINE'S PATIENT
PLACEMENT CRITERIA OR OTHER RECOGNIZED AND  PEER  REVIEWED  CRITERIA  OR

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

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