S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6396
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 6, 2017
                                ___________
 
 Introduced  by M. of A. ROZIC, COLTON, ENGLEBRIGHT, ORTIZ, SIMON -- read
   once and referred to the Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to  coverage  for  eating
   disorders
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Subparagraph (B)  of  paragraph  5  of  subsection  (1)  of
 section 3221 of the insurance law, as amended by chapter 502 of the laws
 of 2007, is amended to read as follows:
   (B)  (i)  Every insurer delivering a group or school blanket policy or
 issuing a group or school blanket policy for delivery,  in  this  state,
 which  provides  coverage  for  inpatient  hospital care or coverage for
 physician services, shall provide comparable  coverage  for  adults  and
 children  with  biologically based mental illness OR AN EATING DISORDER.
 Such group policies issued or delivered in this state shall also provide
 such comparable coverage for children with  serious  emotional  disturb-
 ances.  Such  coverage  shall be provided under the terms and conditions
 otherwise applicable under the policy, including network limitations  or
 variations,  exclusions,  co-pays,  coinsurance,  deductibles  or  other
 specific cost sharing  mechanisms.  Provided  further,  where  a  policy
 provides both in-network and out-of-network benefits, the out-of-network
 benefits  may  have different coinsurance, co-pays, or deductibles, than
 the in-network benefits, regardless of whether  the  policy  is  written
 under one license or two licenses.
   (ii)  For  purposes  of  this  paragraph, the term "biologically based
 mental illness" means a mental, nervous, or emotional condition that  is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the  functioning of the person with the illness. Such biologically based
 mental illnesses are defined as schizophrenia/psychotic disorders, major

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06526-01-7
              

 A. 6396                             2
 
 depression, bipolar disorder, delusional disorders, panic disorder[,] OR
 obsessive compulsive disorders[, bulimia, and anorexia].
   (III) FOR PURPOSES OF THIS PARAGRAPH, THE TERM "EATING DISORDER" MEANS
 PICA,  RUMINATION  DISORDER,  AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER,
 ANOREXIA NERVOSA, BULIMIA NERVOSA, BINGE EATING DISORDER,  OTHER  SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN  THE  MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL MANUAL OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION WHERE
 DIAGNOSED BY A LICENSED PHYSICIAN, PSYCHIATRIST, PSYCHOLOGIST,  CLINICAL
 SOCIAL  WORKER,  LICENSED  MARITAL AND FAMILY THERAPIST, OR PROFESSIONAL
 COUNSELOR DULY LICENSED IN THE STATE  WHERE  HE  OR  SHE  PRACTICES  AND
 ACTING  WITHIN  THEIR APPLICABLE SCOPE OF PRACTICE IN THE STATE WHERE HE
 OR SHE PRACTICES.
   § 2. Paragraph 2 of subsection (g) of section 4303  of  the  insurance
 law,  as  amended by chapter 502 of the laws of 2007, is amended to read
 as follows:
   (2) (A) A hospital service corporation  or  a  health  service  corpo-
 ration,  which provides group, group remittance or school blanket cover-
 age for inpatient hospital care, shall provide comparable  coverage  for
 adults  and children with biologically based mental illness OR AN EATING
 DISORDER. Such hospital service corporation  or  health  service  corpo-
 ration  shall  also  provide  such comparable coverage for children with
 serious emotional disturbances. Such coverage shall  be  provided  under
 the  terms  and  conditions  otherwise  applicable  under  the contract,
 including network limitations or variations, exclusions, co-pays,  coin-
 surance, deductibles or other specific cost sharing mechanisms. Provided
 further,  where  a  contract provides both in-network and out-of-network
 benefits, the out-of-network benefits may  have  different  coinsurance,
 co-pays,  or  deductibles,  than  the in-network benefits, regardless of
 whether the contract is written under one license or two licenses.
   (B) For purposes of this  subsection,  the  term  "biologically  based
 mental  illness" means a mental, nervous, or emotional condition that is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the functioning of the person with the illness. Such biologically  based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression, bipolar disorder, delusional disorders, panic disorder[,] OR
 obsessive compulsive disorders[, anorexia, and bulimia].
   (C)  FOR PURPOSES OF THIS SUBSECTION, THE TERM "EATING DISORDER" MEANS
 PICA, RUMINATION DISORDER, AVOIDANT/RESTRICTIVE  FOOD  INTAKE  DISORDER,
 ANOREXIA  NERVOSA,  BULIMIA NERVOSA, BINGE EATING DISORDER, OTHER SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN THE MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL  MANUAL  OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION WHERE
 DIAGNOSED  BY A LICENSED PHYSICIAN, PSYCHIATRIST, PSYCHOLOGIST, CLINICAL
 SOCIAL WORKER, LICENSED MARITAL AND FAMILY  THERAPIST,  OR  PROFESSIONAL
 COUNSELOR  DULY  LICENSED  IN  THE  STATE  WHERE HE OR SHE PRACTICES AND
 ACTING WITHIN THEIR APPLICABLE SCOPE OF PRACTICE IN THE STATE  WHERE  HE
 OR SHE PRACTICES.
   §  3.  Paragraph  2 of subsection (h) of section 4303 of the insurance
 law, as amended by chapter 502 of the laws of 2007, is amended  to  read
 as follows:
   (2)  (A)  A  medical expense indemnity corporation or a health service
 corporation, which provides group, group remittance  or  school  blanket
 coverage  for  physician services, shall provide comparable coverage for
 adults and children with biologically based mental illness OR AN  EATING

 A. 6396                             3
 
 DISORDER.  Such  medical expense indemnity corporation or health service
 corporation shall also provide such  comparable  coverage  for  children
 with  serious  emotional  disturbances.  Such coverage shall be provided
 under  the terms and conditions otherwise applicable under the contract,
 including network limitations or variations, exclusions, co-pays,  coin-
 surance, deductibles or other specific cost sharing mechanisms. Provided
 further,  where  a  contract provides both in-network and out-of-network
 benefits, the out-of-network benefits may  have  different  coinsurance,
 co-pays,  or  deductibles,  than  the in-network benefits, regardless of
 whether the contract is written under one license or two licenses.
   (B) For purposes of this  subsection,  the  term  "biologically  based
 mental  illness" means a mental, nervous, or emotional condition that is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the functioning of the person with the illness. Such biologically  based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression, bipolar disorder, delusional disorders, panic disorder[,] OR
 obsessive compulsive disorder[, anorexia, and bulimia].
   (C)  FOR PURPOSES OF THIS SUBSECTION, THE TERM "EATING DISORDER" MEANS
 PICA, RUMINATION DISORDER, AVOIDANT/RESTRICTIVE  FOOD  INTAKE  DISORDER,
 ANOREXIA  NERVOSA,  BULIMIA NERVOSA, BINGE EATING DISORDER, OTHER SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN THE MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL  MANUAL  OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION WHERE
 DIAGNOSED  BY A LICENSED PHYSICIAN, PSYCHIATRIST, PSYCHOLOGIST, CLINICAL
 SOCIAL WORKER, LICENSED MARITAL AND FAMILY  THERAPIST,  OR  PROFESSIONAL
 COUNSELOR  DULY  LICENSED  IN  THE  STATE  WHERE HE OR SHE PRACTICES AND
 ACTING WITHIN THEIR APPLICABLE SCOPE OF PRACTICE IN THE STATE  WHERE  HE
 OR SHE PRACTICES.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law; provided, however, that the provisions  of  this  act
 shall apply to policies and contracts issued, renewed, modified, altered
 or amended on or after such effective date.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6396--A
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 6, 2017
                                ___________
 
 Introduced  by  M.  of A. ROZIC, DE LA ROSA, COLTON, ENGLEBRIGHT, ORTIZ,
   SIMON, FAHY, HARRIS, BLAKE, JAFFEE, D'URSO,  MAYER,  GUNTHER,  CRESPO,
   RIVERA, ABINANTI, BARRETT, SEPULVEDA -- Multi-Sponsored by -- M. of A.
   COOK,  CROUCH,  GIGLIO,  HIKIND,  LUPINACCI,  NOLAN  --  read once and
   referred to the Committee on Insurance -- committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee
 
 AN ACT to amend the insurance law, in relation to  coverage  for  eating
   disorders
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (B)  of  paragraph  5  of  subsection  (1)  of
 section 3221 of the insurance law, as amended by chapter 502 of the laws
 of 2007, is amended to read as follows:
   (B)  (i)  Every insurer delivering a group or school blanket policy or
 issuing a group or school blanket policy for delivery,  in  this  state,
 which  provides  coverage  for  inpatient  hospital care or coverage for
 physician services, shall provide comparable  coverage  for  adults  and
 children  with  biologically based mental illness OR AN EATING DISORDER.
 Such group policies issued or delivered in this state shall also provide
 such comparable coverage for children with  serious  emotional  disturb-
 ances.  Such  coverage  shall be provided under the terms and conditions
 otherwise applicable under the policy, including network limitations  or
 variations,  exclusions,  co-pays,  coinsurance,  deductibles  or  other
 specific cost sharing  mechanisms.  Provided  further,  where  a  policy
 provides both in-network and out-of-network benefits, the out-of-network
 benefits  may  have different coinsurance, co-pays, or deductibles, than
 the in-network benefits, regardless of whether  the  policy  is  written
 under one license or two licenses.
   (ii)  For  purposes  of  this  paragraph, the term "biologically based
 mental illness" means a mental, nervous, or emotional condition that  is

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

                                                            LBD06526-02-7

 A. 6396--A                          2
 
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the  functioning of the person with the illness. Such biologically based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression, bipolar disorder, delusional disorders, panic disorder[,] OR
 obsessive compulsive disorders[, bulimia, and anorexia].
   (III) FOR PURPOSES OF THIS PARAGRAPH, THE TERM "EATING DISORDER" MEANS
 PICA,  RUMINATION  DISORDER,  AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER,
 ANOREXIA NERVOSA, BULIMIA NERVOSA, BINGE EATING DISORDER,  OTHER  SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN  THE  MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL MANUAL OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION.
   § 2. Paragraph 2 of subsection (g) of section 4303  of  the  insurance
 law,  as  amended by chapter 502 of the laws of 2007, is amended to read
 as follows:
   (2) (A) A hospital service corporation  or  a  health  service  corpo-
 ration,  which provides group, group remittance or school blanket cover-
 age for inpatient hospital care, shall provide comparable  coverage  for
 adults  and children with biologically based mental illness OR AN EATING
 DISORDER. Such hospital service corporation  or  health  service  corpo-
 ration  shall  also  provide  such comparable coverage for children with
 serious emotional disturbances. Such coverage shall  be  provided  under
 the  terms  and  conditions  otherwise  applicable  under  the contract,
 including network limitations or variations, exclusions, co-pays,  coin-
 surance, deductibles or other specific cost sharing mechanisms. Provided
 further,  where  a  contract provides both in-network and out-of-network
 benefits, the out-of-network benefits may  have  different  coinsurance,
 co-pays,  or  deductibles,  than  the in-network benefits, regardless of
 whether the contract is written under one license or two licenses.
   (B) For purposes of this  subsection,  the  term  "biologically  based
 mental  illness" means a mental, nervous, or emotional condition that is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the functioning of the person with the illness. Such biologically  based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression, bipolar disorder, delusional disorders, panic disorder[,] OR
 obsessive compulsive disorders[, anorexia, and bulimia].
   (C)  FOR PURPOSES OF THIS SUBSECTION, THE TERM "EATING DISORDER" MEANS
 PICA, RUMINATION DISORDER, AVOIDANT/RESTRICTIVE  FOOD  INTAKE  DISORDER,
 ANOREXIA  NERVOSA,  BULIMIA NERVOSA, BINGE EATING DISORDER, OTHER SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN THE MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL  MANUAL  OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION.
   §  3.  Paragraph  2 of subsection (h) of section 4303 of the insurance
 law, as amended by chapter 502 of the laws of 2007, is amended  to  read
 as follows:
   (2)  (A)  A  medical expense indemnity corporation or a health service
 corporation, which provides group, group remittance  or  school  blanket
 coverage  for  physician services, shall provide comparable coverage for
 adults and children with biologically based mental illness OR AN  EATING
 DISORDER.  Such  medical expense indemnity corporation or health service
 corporation shall also provide such  comparable  coverage  for  children
 with  serious  emotional  disturbances.  Such coverage shall be provided
 under the terms and conditions otherwise applicable under the  contract,
 including  network limitations or variations, exclusions, co-pays, coin-
 surance, deductibles or other specific cost sharing mechanisms. Provided

 A. 6396--A                          3
 
 further, where a contract provides both  in-network  and  out-of-network
 benefits,  the  out-of-network  benefits may have different coinsurance,
 co-pays, or deductibles, than the  in-network  benefits,  regardless  of
 whether the contract is written under one license or two licenses.
   (B)  For  purposes  of  this  subsection, the term "biologically based
 mental illness" means a mental, nervous, or emotional condition that  is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the  functioning of the person with the illness. Such biologically based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression, bipolar disorder, delusional disorders, panic disorder[,] OR
 obsessive compulsive disorder[, anorexia, and bulimia].
   (C) FOR PURPOSES OF THIS SUBSECTION, THE TERM "EATING DISORDER"  MEANS
 PICA,  RUMINATION  DISORDER,  AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER,
 ANOREXIA NERVOSA, BULIMIA NERVOSA, BINGE EATING DISORDER,  OTHER  SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN  THE  MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL MANUAL OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION.
   § 4. This act shall take effect on the ninetieth day  after  it  shall
 have  become  a  law; provided, however, that the provisions of this act
 shall apply to policies and contracts issued, renewed, modified, altered
 or amended on or after such effective date.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6396--C
                                                         Cal. No. 458
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 6, 2017
                                ___________
 
 Introduced  by  M.  of A. ROZIC, DE LA ROSA, COLTON, ENGLEBRIGHT, ORTIZ,
   SIMON, FAHY, HARRIS, BLAKE, JAFFEE, D'URSO,  MAYER,  GUNTHER,  CRESPO,
   RIVERA,  ABINANTI,  BARRETT,  SEPULVEDA,  BRONSON, L. ROSENTHAL, RAIA,
   JOHNS -- Multi-Sponsored by -- M. of A. COOK, CROUCH,  GALEF,  GIGLIO,
   HIKIND,  M. L. MILLER,  NOLAN,  RA  --  read  once and referred to the
   Committee on Insurance -- committee discharged, bill amended,  ordered
   reprinted as amended and recommitted to said committee -- reported and
   referred  to  the  Committee  on  Codes  --  reported  from committee,
   advanced to a third reading, amended and ordered reprinted,  retaining
   its place on the order of third reading -- ordered to a third reading,
   amended  and  ordered  reprinted,  retaining its place on the order of
   third reading
 
 AN ACT to amend the insurance law, in relation to  coverage  for  eating
   disorders
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (B)  of  paragraph  5  of  subsection  (1)  of
 section 3221 of the insurance law, as amended by chapter 502 of the laws
 of 2007, is amended to read as follows:
   (B)  (i)  Every insurer delivering a group or school blanket policy or
 issuing a group or school blanket policy for delivery,  in  this  state,
 which  provides  coverage  for  inpatient  hospital care or coverage for
 physician services, shall provide comparable  coverage  for  adults  and
 children  with  biologically  based  mental illness. Such group policies
 issued or delivered in this state shall  also  provide  such  comparable
 coverage for children with serious emotional disturbances. Such coverage
 shall  be  provided  under the terms and conditions otherwise applicable
 under the policy, including network limitations  or  variations,  exclu-
 sions,  co-pays, coinsurance, deductibles or other specific cost sharing
 mechanisms. Provided further, where a policy  provides  both  in-network
 and  out-of-network  benefits,  the  out-of-network  benefits  may  have
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD06526-06-8

 A. 6396--C                          2
 
 different coinsurance, co-pays,  or  deductibles,  than  the  in-network
 benefits,  regardless of whether the policy is written under one license
 or two licenses.
   (ii)  For  purposes  of  this  paragraph, the term "biologically based
 mental illness" means a mental, nervous, or emotional condition that  is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the  functioning of the person with the illness. Such biologically based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression, bipolar  disorder,  delusional  disorders,  panic  disorder,
 obsessive  compulsive  disorders[,  bulimia,  and anorexia] OR AN EATING
 DISORDER.
   (III) FOR PURPOSES OF THIS PARAGRAPH, THE TERM "EATING DISORDER" MEANS
 PICA, RUMINATION DISORDER, AVOIDANT/RESTRICTIVE  FOOD  INTAKE  DISORDER,
 ANOREXIA  NERVOSA,  BULIMIA NERVOSA, BINGE EATING DISORDER, OTHER SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN THE MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL  MANUAL  OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION.
   §  2.  Paragraph  2 of subsection (g) of section 4303 of the insurance
 law, as amended by chapter 502 of the laws of 2007, is amended  to  read
 as follows:
   (2)  (A)  A  hospital  service  corporation or a health service corpo-
 ration, which provides group, group remittance or school blanket  cover-
 age  for  inpatient hospital care, shall provide comparable coverage for
 adults and children with biologically based mental illness. Such  hospi-
 tal service corporation or health service corporation shall also provide
 such  comparable  coverage  for children with serious emotional disturb-
 ances. Such coverage shall be provided under the  terms  and  conditions
 otherwise  applicable  under the contract, including network limitations
 or variations, exclusions, co-pays, coinsurance,  deductibles  or  other
 specific  cost  sharing  mechanisms.  Provided further, where a contract
 provides both in-network and out-of-network benefits, the out-of-network
 benefits may have different coinsurance, co-pays, or  deductibles,  than
 the  in-network  benefits, regardless of whether the contract is written
 under one license or two licenses.
   (B) For purposes of this  subsection,  the  term  "biologically  based
 mental  illness" means a mental, nervous, or emotional condition that is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the functioning of the person with the illness. Such biologically  based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression,  bipolar  disorder,  delusional  disorders,  panic disorder,
 obsessive compulsive disorders[, anorexia, and  bulimia]  OR  AN  EATING
 DISORDER.
   (C)  FOR PURPOSES OF THIS SUBSECTION, THE TERM "EATING DISORDER" MEANS
 PICA, RUMINATION DISORDER, AVOIDANT/RESTRICTIVE  FOOD  INTAKE  DISORDER,
 ANOREXIA  NERVOSA,  BULIMIA NERVOSA, BINGE EATING DISORDER, OTHER SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN THE MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL  MANUAL  OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION.
   §  3.  Paragraph  2 of subsection (h) of section 4303 of the insurance
 law, as amended by chapter 502 of the laws of 2007, is amended  to  read
 as follows:
   (2)  (A)  A  medical expense indemnity corporation or a health service
 corporation, which provides group, group remittance  or  school  blanket
 coverage  for  physician services, shall provide comparable coverage for

 A. 6396--C                          3
 
 adults and children with biologically based mental illness. Such medical
 expense indemnity corporation or health service corporation  shall  also
 provide  such  comparable  coverage  for children with serious emotional
 disturbances. Such coverage shall be provided under the terms and condi-
 tions otherwise applicable under the contract, including network limita-
 tions  or  variations,  exclusions, co-pays, coinsurance, deductibles or
 other specific  cost  sharing  mechanisms.  Provided  further,  where  a
 contract  provides both in-network and out-of-network benefits, the out-
 of-network benefits may have different coinsurance, co-pays, or  deduct-
 ibles,  than the in-network benefits, regardless of whether the contract
 is written under one license or two licenses.
   (B) For purposes of this  subsection,  the  term  "biologically  based
 mental  illness" means a mental, nervous, or emotional condition that is
 caused by a biological disorder of the brain and results in a clinically
 significant, psychological syndrome or pattern that substantially limits
 the functioning of the person with the illness. Such biologically  based
 mental illnesses are defined as schizophrenia/psychotic disorders, major
 depression,  bipolar  disorder,  delusional  disorders,  panic disorder,
 obsessive compulsive disorder[, anorexia,  and  bulimia]  OR  AN  EATING
 DISORDER.
   (C)  FOR PURPOSES OF THIS SUBSECTION, THE TERM "EATING DISORDER" MEANS
 PICA, RUMINATION DISORDER, AVOIDANT/RESTRICTIVE  FOOD  INTAKE  DISORDER,
 ANOREXIA  NERVOSA,  BULIMIA NERVOSA, BINGE EATING DISORDER, OTHER SPECI-
 FIED FEEDING OR EATING DISORDER, AND ANY OTHER EATING DISORDER CONTAINED
 IN THE MOST RECENT VERSION OF THE DIAGNOSTIC AND STATISTICAL  MANUAL  OF
 MENTAL DISORDERS PUBLISHED BY THE AMERICAN PSYCHIATRIC ASSOCIATION.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law; provided, however, that the provisions  of  this  act
 shall apply to policies and contracts issued, renewed, modified, altered
 or amended on or after such effective date.