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.