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

                                  5026

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 10, 2015
                               ___________

Introduced   by   M.   of   A.   LIFTON,  JAFFEE,  KAVANAGH,  O'DONNELL,
  PEOPLES-STOKES, MARKEY, ROSENTHAL -- Multi-Sponsored by --  M.  of  A.
  CLARK, COLTON, GALEF, GUNTHER -- read once and referred to the Commit-
  tee on Insurance

AN ACT to amend the insurance law, in relation to providing coverage for
  family  members  of  children who require psychiatric or psychological
  services

  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 32 to read as follows:
  (32) (A) EVERY INSURER ISSUING A POLICY OF ACCIDENT AND HEALTH  INSUR-
ANCE  FOR DELIVERY IN THIS STATE WHICH PROVIDES COVERAGE FOR PSYCHIATRIC
OR PSYCHOLOGICAL SERVICES OR DIAGNOSIS OR TREATMENT OF  MENTAL,  NERVOUS
OR  EMOTIONAL  DISORDERS  OR  AILMENTS  SHALL MAKE AVAILABLE AND PROVIDE
COVERAGE FOR FAMILY SESSIONS WHEN THE INSURED IS UNDER EIGHTEEN YEARS OF
AGE. IN THIS PARAGRAPH, "FAMILY SESSIONS" MEANS THERAPY SESSIONS  DETER-
MINED AS NECESSARY BY A LICENSED PSYCHOLOGICAL PROFESSIONAL IN THE STATE
INVOLVING ANY FAMILY MEMBER OF AN INSURED.
  (B) THE COVERAGE REQUIRED BY THIS PARAGRAPH SHALL INCLUDE TREATMENT AS
A  FAMILY MEMBER PURSUANT TO SUCH FAMILY MEMBER'S OWN POLICY OR CONTRACT
PROVIDED SUCH FAMILY MEMBER (I) DOES NOT EXCEED THE ALLOWABLE NUMBER  OF
FAMILY VISITS PROVIDED BY THE APPLICABLE POLICY OR CONTRACT, AND (II) IS
OTHERWISE ENTITLED TO COVERAGE PURSUANT TO SUCH FAMILY MEMBER'S APPLICA-
BLE POLICY OR CONTRACT.
  S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19)  (A)  EVERY  GROUP  OR BLANKET POLICY WHICH PROVIDES COVERAGE FOR
PSYCHIATRIC OR PSYCHOLOGICAL  SERVICES  OR  DIAGNOSIS  OR  TREATMENT  OF
MENTAL,  NERVOUS OR EMOTIONAL DISORDERS OR AILMENTS SHALL MAKE AVAILABLE
AND PROVIDE COVERAGE FOR FAMILY SESSIONS WHEN THE INSURED IS UNDER EIGH-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03972-01-5
              

A. 5026                             2

TEEN YEARS OF AGE. IN THIS PARAGRAPH, "FAMILY  SESSIONS"  MEANS  THERAPY
SESSIONS  DETERMINED  AS  NECESSARY  BY A LICENSED PSYCHOLOGICAL PROFES-
SIONAL IN THE STATE INVOLVING ANY FAMILY MEMBER OF AN INSURED.
  (B) THE COVERAGE REQUIRED BY THIS PARAGRAPH SHALL INCLUDE TREATMENT AS
A  FAMILY MEMBER PURSUANT TO SUCH FAMILY MEMBER'S OWN POLICY OR CONTRACT
PROVIDED SUCH FAMILY MEMBER (I) DOES NOT EXCEED THE ALLOWABLE NUMBER  OF
FAMILY VISITS PROVIDED BY THE APPLICABLE POLICY OR CONTRACT, AND (II) IS
OTHERWISE ENTITLED TO COVERAGE PURSUANT TO SUCH FAMILY MEMBER'S APPLICA-
BLE POLICY OR CONTRACT.
  S  3.  Subsection (i) of section 4303 of the insurance law, as amended
by chapter 230 of the laws of 2004, is amended to read as follows:
  (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
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[,]: (A) 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. The state board for social work
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 anniversary date subject to evidence of  insura-
bility.  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[.];
AND (B) MAKE AVAILABLE AND PROVIDE COVERAGE FOR FAMILY SESSIONS WHEN THE
INSURED IS UNDER EIGHTEEN YEARS OF AGE.
  (I)  IN  THIS  SUBSECTION,  "FAMILY  SESSIONS"  MEANS THERAPY SESSIONS
DETERMINED AS NECESSARY BY A LICENSED PSYCHOLOGICAL PROFESSIONAL IN  THE
STATE INVOLVING ANY FAMILY MEMBER OF AN INSURED.
  (II)  THE COVERAGE REQUIRED BY THIS SUBSECTION SHALL INCLUDE TREATMENT
AS A FAMILY MEMBER PURSUANT  TO  SUCH  FAMILY  MEMBER'S  OWN  POLICY  OR
CONTRACT  PROVIDED  SUCH FAMILY MEMBER (1) DOES NOT EXCEED THE ALLOWABLE
NUMBER OF FAMILY VISITS PROVIDED BY THE APPLICABLE POLICY  OR  CONTRACT,
AND  (2)  IS  OTHERWISE  ENTITLED  TO  COVERAGE  PURSUANT TO SUCH FAMILY
MEMBER'S APPLICABLE POLICY OR CONTRACT.
  S 4. This act shall take effect on the one hundred twentieth day after
it shall have become a law, except that any rule or regulation necessary
for the timely implementation of this act on its effective date shall be
promulgated on or before such date.