Senate Bill S8064

2017-2018 Legislative Session

Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization

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Archive: Last Bill Status - In Senate Committee Insurance 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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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 23, 2018	referred to insurance

co-Sponsors

2017-S8064 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S333
2021-2022: S1915
2023-2024: S4842
2025-2026: S5263

2017-S8064 (ACTIVE) - Summary

Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization.

2017-S8064 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S8064

SPONSOR: AKSHAR
 
TITLE OF BILL:  An act to amend the insurance law, in relation to
providing that coverage for outpatient diagnosis and treatment of
substance use disorder shall not be subject to preauthorization

 
PURPOSE:

To amend the Insurance Law by prohibiting preauthorization for coverage
of outpatient diagnosis and treatment of substance use disorder.

 
SUMMARY OF PROVISIONS:

Sections one, two and three of this bill amends various sections of the
insurance law, as amended by chapter 41 of the laws of 2014, by stating
that coverage for outpatient diagnosis and treatment of substance use
disorder provided by policies providing medical coverage shall not be
subject to preauthorization.

Section four provides that the act shall take effect immediately after

its enactment, and shall apply to policies and contracts issued,
renewed, modified, altered or amended on or after such date.

 
JUSTIFICATION:

The aim of this bill is to work towards removing one of the many exist-
ent barriers to substance use treatment. In 2016, the Senate's Task
Force on Heroin and Opioid Addiction released a report with recommenda-
tions. Many of the recommendations were adopted that year, including
provisions which made it easier of people to access treatment, by among
other things, requiring health plan coverage, without preauthorization,
of in-network inpatient treatment by OASAS certified providers. The
state also adopted legislation to prohibit for the first 14 days of
treatment concurrent utilization review.

This legislation builds upon those reforms, by prohibiting preauthori-
zation for outpatient treatment of substance use disorder, making it
easier to access treatment and maintain sobriety.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

To be determined, provided savings should accrue as those ready for
recovery can access outpatient care quickly and avoid the costly conse-
quences of returning to abusing substances.

 
EFFECTIVE DATE:
This act shall take effect immediately, and shall apply to policies and
contracts issued, renewed, modified, altered or amended on or after such
date.

2017-S8064 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8064
 
                             I N  S E N A T E
 
                              March 23, 2018
                                ___________
 
 Introduced  by  Sens.  AKSHAR, AMEDORE, HANNON, JACOBS -- 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 providing that cover-
   age for outpatient diagnosis and treatment of substance  use  disorder
   shall not be subject to preauthorization

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (A) of  paragraph  31  of  subsection  (i)  of
 section 3216 of the insurance law, as added by chapter 41 of the laws of
 2014, is amended to read as follows:
   (A)  Every  policy  that  provides  medical,  major medical or similar
 comprehensive-type coverage must provide  outpatient  coverage  for  the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and rehabilitation services. Such coverage shall not BE SUBJECT TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations to outpatient substance use disorder benefits that are  more
 restrictive  than  the  predominant financial requirements and treatment
 limitations applied to substantially all medical and  surgical  benefits
 covered  by  the  policy.    Further,  such  coverage  shall be provided
 consistent with the federal Paul  Wellstone  and  Pete  Domenici  Mental
 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
   § 2. Subparagraph (A) of paragraph 7 of subsection (1) of section 3221
 of  the  insurance law, as amended by chapter 41 of the laws of 2014, is
 amended to read as follows:
   (A) Every policy that  provides  medical,  major  medical  or  similar
 comprehensive-type  coverage  must  provide  outpatient coverage for the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion and rehabilitation services. Such coverage shall not BE SUBJECT  TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations  to outpatient substance use disorder benefits that are more
 restrictive than the predominant financial  requirements  and  treatment
 limitations  applied  to substantially all medical and surgical benefits
 covered by the  policy.    Further,  such  coverage  shall  be  provided
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD14728-01-8

 S. 8064                             2
 
 consistent  with  the  federal  Paul  Wellstone and Pete Domenici Mental
 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
   §  3.  Paragraph  1 of subsection (l) of section 4303 of the insurance
 law, as amended by chapter 41 of the laws of 2014, is amended to read as
 follows:
   (1) Every contract that provides medical,  major  medical  or  similar
 comprehensive-type  coverage  must  provide  outpatient coverage for the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion and rehabilitation services. Such coverage shall not BE SUBJECT  TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations  to outpatient substance use disorder benefits that are more
 restrictive than the predominant financial  requirements  and  treatment
 limitations  applied  to substantially all medical and surgical benefits
 covered by the contract.   Further,  such  coverage  shall  be  provided
 consistent  with  the  federal  Paul  Wellstone and Pete Domenici Mental
 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
   § 4. This act shall  take  effect  immediately,  and  shall  apply  to
 polices  and  contracts issued, renewed, modified, altered or amended on
 or after such date.

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Senate Bill S8064

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Archive: Last Bill Status - In Senate Committee Insurance Committee

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co-Sponsors

2017-S8064 (ACTIVE) - Details

2017-S8064 (ACTIVE) - Summary

2017-S8064 (ACTIVE) - Sponsor Memo

2017-S8064 (ACTIVE) - Bill Text download pdf

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Sponsored By

Fred Akshar

Archive: Last Bill Status - In Senate Committee Insurance Committee

Actions

co-Sponsors

George Amedore

Kemp Hannon

Chris Jacobs

Elaine Phillips

2017-S8064 (ACTIVE) - Details

2017-S8064 (ACTIVE) - Summary

2017-S8064 (ACTIVE) - Sponsor Memo

2017-S8064 (ACTIVE) - Bill Text download pdf

Comments