S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8268
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               June 11, 2019
                                ___________
 
 Introduced  by  M.  of  A. L. ROSENTHAL -- read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance law, in relation  to  mandating  insurance
   coverage for medical devices to treat withdrawal symptoms
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Subparagraph (A) of  paragraph  30  of  subsection  (i)  of
 section  3216 of the insurance law, as amended by section 5 of subpart A
 of part BB of chapter 57 of the laws of 2019,  is  amended  to  read  as
 follows:
   (A)  Every  policy  that  provides  hospital, major medical or similar
 comprehensive coverage shall provide inpatient coverage for the  diagno-
 sis  and  treatment  of substance use disorder, including detoxification
 and rehabilitation services, INCLUDING THE USE OF  MEDICATIONS,  MEDICAL
 DEVICES AND PRODUCTS APPROVED AND/OR CLEARED BY THE FOOD AND DRUG ADMIN-
 ISTRATION  FOR  THE  TREATMENT  OF  WITHDRAWAL  SYMPTOMS. Such inpatient
 coverage shall  include  unlimited  medically  necessary  treatment  for
 substance  use  disorder  treatment  services  provided  in  residential
 settings. Further, such inpatient coverage  shall  not  apply  financial
 requirements  or  treatment  limitations,  including  utilization review
 requirements, to inpatient 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.
   § 2. Paragraph 30 of subsection (i) of section 3216 of  the  insurance
 law, as amended by section 7 of subpart B of part J of chapter 57 of the
 laws of 2019, is renumbered paragraph 30-a.
   §  3. Paragraph 7-a of subsection (l) of section 3221 of the insurance
 law, as added by section 2 of part B of chapter 69 of the laws of  2016,
 is amended to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06895-06-9
              

 A. 8268                             2
 
   (7-a)  Every  policy  that  provides medical, major medical or similar
 comprehensive-type large group coverage shall provide coverage for medi-
 cation  for  the  detoxification  or  maintenance  treatment,  INCLUDING
 MEDICAL DEVICES OR PRODUCTS FOR THE TREATMENT OF WITHDRAWAL SYMPTOMS, of
 a  substance  use  disorder approved by the food and drug administration
 for the detoxification or maintenance treatment of substance use  disor-
 der.
   §  4.  Subsection (l-1) of section 4303 of the insurance law, as added
 by section 3 of part B of chapter 69 of the laws of 2016, is amended  to
 read as follows:
   (l-1)  Every contract that provides medical, major medical, or similar
 comprehensive-type large group coverage shall provide coverage for medi-
 cation  for  the  detoxification  or  maintenance  treatment,  INCLUDING
 MEDICAL DEVICES OR PRODUCTS FOR THE TREATMENT OF WITHDRAWAL SYMPTOMS, of
 a  substance  use  disorder approved by the food and drug administration
 for the detoxification or maintenance treatment of substance use  disor-
 der.
   §  5.  Subparagraph  (A)  of paragraph 31 of subsection (i) of section
 3216 of the insurance law, as amended by section 6 of subpart A of  part
 BB of chapter 57 of the laws of 2019, is amended to read as follows:
   (A)  Every  policy  that  provides  medical,  major medical or similar
 comprehensive-type coverage shall provide outpatient  coverage  for  the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and  rehabilitation  services,  INCLUDING  THE USE OF MEDICATIONS,
 MEDICAL DEVICES AND PRODUCTS APPROVED AND/OR CLEARED  BY  THE  FOOD  AND
 DRUG  ADMINISTRATION  FOR  THE  TREATMENT OF WITHDRAWAL SYMPTOMS.   Such
 coverage 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.
   §  6.    This  act  shall take effect on the same date and in the same
 manner as subpart A of part BB of chapter 57 of the laws of 2019,  takes
 effect  and shall apply to policies and contracts issued, renewed, modi-
 fied, altered or amended on and after such date; provided, however, that
 section two of this act shall take effect on the same date  and  in  the
 same  manner  as  section  7 of subpart B of part J of chapter 57 of the
 laws of 2019, takes effect.