S T A T E O F N E W Y O R K
________________________________________________________________________
8002
I N S E N A T E
March 19, 2018
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Introduced by Sens. AMEDORE, HANNON, AKSHAR, JACOBS -- read twice and
ordered printed, and when printed to be committed to the Committee on
Alcoholism and Drug Abuse
AN ACT to amend the mental hygiene law, in relation to directing the
office of alcoholism and substance abuse services to provide an
ombudsman for substance use disorder insurance coverage
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 19.07 of the mental hygiene law is amended by
adding a new subdivision (l) to read as follows:
(L) (1) THE OFFICE SHALL ESTABLISH, EITHER DIRECTLY OR THROUGH
CONTRACT, AN OMBUDSMAN FOR SUBSTANCE USE DISORDER INSURANCE COVERAGE.
SUCH OMBUDSMAN SHALL HAVE EXPERTISE IN SUBSTANCE USE DISORDER TREATMENT
AND ADVOCACY, EXPERIENCE WITH INSURANCE COVERAGE REQUIREMENTS, AND SUCH
OTHER QUALIFICATIONS AS SHALL BE DETERMINED BY THE COMMISSIONER, IN
CONSULTATION WITH THE SUPERINTENDENT OF FINANCIAL SERVICES.
(2) THE OMBUDSMAN FOR SUBSTANCE USE DISORDER INSURANCE COVERAGE SHALL:
(I) IDENTIFY, ACCEPT, INVESTIGATE, REFER AND RESOLVE COMPLAINTS THAT
ARE MADE BY OR ON BEHALF OF CONSUMERS RELATIVE TO HEALTH INSURANCE
COVERAGE OF AND ACCESS TO INITIAL AND CONTINUING SUBSTANCE USE DISORDER
CARE, INCLUDING MEDICATION ASSISTED TREATMENT, BOTH INPATIENT AND OUTPA-
TIENT;
(II) ACCEPT, INVESTIGATE, REFER AND RESOLVE COMPLAINTS THAT ARE MADE
BY TREATMENT PROVIDERS RELATIVE TO HEALTH INSURANCE COVERAGE OF AND
REIMBURSEMENT FOR INITIAL OR CONTINUING SUBSTANCE USE DISORDER CARE,
INCLUDING MEDICATION ASSISTED TREATMENT, BOTH INPATIENT AND OUTPATIENT;
(III) ACCEPT, INVESTIGATE, REFER AND RESOLVE COMPLAINTS THAT ARE MADE
BY OR ON BEHALF OF CONSUMERS OR BY PROVIDERS RELATIVE TO NETWORK ADEQUA-
CY FOR ACCESS TO AND CONTINUING SUBSTANCE USE DISORDER CARE, INCLUDING
MEDICATION ASSISTED TREATMENT, BOTH INPATIENT AND OUTPATIENT; AND
(IV) MAKE RECOMMENDATIONS TO THE COMMISSIONER AND THE SUPERINTENDENT
OF FINANCIAL SERVICES BIENNIALLY BEGINNING OCTOBER FIRST, TWO THOUSAND
NINETEEN, ON REGULATORY AND/OR STATUTORY CHANGES NECESSARY TO ENSURE
ACCESS TO APPROPRIATE CARE, AND SUCH RECOMMENDATIONS SHALL BE SHARED
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD14734-02-8
S. 8002 2
WITH THE LEGISLATURE UPON ISSUANCE. SUCH RECOMMENDATIONS MAY ALSO
INCLUDE WHETHER THE OMBUDSMAN ROLE SHOULD BE EXTENDED TO INCLUDE BROADER
BEHAVIORAL HEALTH INSURANCE COMPLAINTS AND CONCERNS.
§ 2. This act shall take effect on the ninetieth day after it shall
have become a law.