S T A T E O F N E W Y O R K
________________________________________________________________________
1171--A
2021-2022 Regular Sessions
I N A S S E M B L Y
January 7, 2021
___________
Introduced by M. of A. BRONSON, CLARK, LUNSFORD, MEEKS, WALLACE,
BUTTENSCHON, ROZIC, SANTABARBARA, LUPARDO, HUNTER, GUNTHER, STECK,
STIRPE, JONES, MAGNARELLI, FAHY, McMAHON, BARRETT, WOERNER, WEPRIN,
GOTTFRIED, CRUZ, CARROLL -- read once and referred to the Committee on
Insurance -- committee discharged, bill amended, ordered reprinted as
amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to health insurance
coverage of outpatient care provided by a mental health practitioner
and a clinical social worker; and to repeal certain provisions of such
law relating thereto
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Items (i) and (ii) of subparagraph (A) of paragraph 35 of
subsection (i) of section 3216 of the insurance law, item (i) as amended
by section 12 of part AA of chapter 57 of the laws of 2021 and item (ii)
as added by section 8 of subpart A of part BB of chapter 57 of the laws
of 2019, are amended to read as follows:
(i) where the policy provides coverage for inpatient hospital care,
SUCH POLICY SHALL INCLUDE benefits for inpatient care in a hospital as
defined by subdivision ten of section 1.03 of the mental hygiene law and
benefits for outpatient care provided in a facility issued an operating
certificate by the commissioner of mental health pursuant to the
provisions of article thirty-one of the mental hygiene law, or in a
facility operated by the office of mental health, or in a crisis
stabilization center licensed pursuant to section 36.01 of the mental
hygiene law, or, for care provided in other states, to similarly
licensed or certified hospitals or facilities; and
(ii) where the policy provides coverage for physician services, SUCH
POLICY SHALL INCLUDE benefits for outpatient care provided by a psychia-
trist or psychologist licensed to practice in this state, a licensed
clinical social worker [who meets the requirements of subparagraph (D)
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05221-02-1
A. 1171--A 2
of paragraph four of subsection (1) of section three thousand two
hundred twenty-one of this article,] WITHIN THE LAWFUL SCOPE OF HIS OR
HER PRACTICE, WHO IS LICENSED PURSUANT TO ARTICLE ONE HUNDRED FIFTY-FOUR
OF THE EDUCATION LAW, A MENTAL HEALTH COUNSELOR, MARRIAGE AND FAMILY
THERAPIST, CREATIVE ARTS THERAPIST OR PSYCHOANALYST LICENSED PURSUANT TO
ARTICLE ONE HUNDRED SIXTY-THREE OF THE EDUCATION LAW, a nurse practi-
tioner licensed to practice in this state, or a professional corporation
or university faculty practice corporation thereof. NOTHING HEREIN
SHALL BE CONSTRUED TO MODIFY OR EXPAND THE SCOPE OF PRACTICE OF A MENTAL
HEALTH COUNSELOR, MARRIAGE AND FAMILY THERAPIST, CREATIVE ARTS THERAPIST
OR PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE HUNDRED SIXTY-THREE OF
THE EDUCATION LAW. FURTHER, NOTHING HEREIN SHALL BE CONSTRUED TO CREATE
A NEW MANDATED HEALTH BENEFIT.
§ 2. Subparagraph (A) of paragraph 4 of subsection (l) of section 3221
of the insurance law, as amended by section 11 of subpart A of part BB
of chapter 57 of the laws of 2019, is amended to read as follows:
(A) Every insurer delivering a group policy or issuing a group policy
for delivery, in this state, that provides reimbursement for psychiatric
or psychological services or for the diagnosis and treatment of mental
health conditions, however defined in such policy, by physicians,
psychiatrists or psychologists, shall [make available and if requested
by the policyholder] provide the same coverage to insureds for such
services when performed by a licensed clinical social worker, within the
lawful scope of his or her practice, who is licensed pursuant to article
one hundred fifty-four of the education law[. Written notice of the
availability of such coverage shall be delivered to the policyholder
prior to inception of such group policy and annually thereafter, except
that this notice shall not be required where a policy covers two hundred
or more employees or where the benefit structure was the subject of
collective bargaining affecting persons who are employed in more than
one state.] AND MENTAL HEALTH COUNSELORS, MARRIAGE AND FAMILY THERA-
PISTS, CREATIVE ARTS THERAPISTS AND PSYCHOANALYSTS LICENSED PURSUANT TO
ARTICLE ONE HUNDRED SIXTY-THREE OF THE EDUCATION LAW, WITHIN THE LAWFUL
SCOPE OF HIS OR HER PRACTICE. NOTHING HEREIN SHALL BE CONSTRUED TO MODI-
FY OR EXPAND THE SCOPE OF PRACTICE OF A MENTAL HEALTH COUNSELOR,
MARRIAGE AND FAMILY THERAPIST, CREATIVE ARTS THERAPIST OR PSYCHOANALYST
LICENSED PURSUANT TO ARTICLE ONE HUNDRED SIXTY-THREE OF THE EDUCATION
LAW. FURTHER, NOTHING HEREIN SHALL BE CONSTRUED TO CREATE A NEW MANDATED
HEALTH BENEFIT.
§ 3. Subparagraph (D) of paragraph 4 of subsection (l) of section 3221
of the insurance law is REPEALED.
§ 4. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of
section 3221 of the insurance law, as amended by section 13 of subpart A
of part BB of chapter 57 of the laws of 2019, is amended to read as
follows:
(ii) where the policy provides coverage for physician services, it
shall include benefits for outpatient care provided by a psychiatrist or
psychologist licensed to practice in this state, OR A MENTAL HEALTH
COUNSELOR, MARRIAGE AND FAMILY THERAPIST, CREATIVE ARTS THERAPIST OR
PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE HUNDRED SIXTY-THREE OF
THE EDUCATION LAW, OR a licensed clinical social worker [who meets the
requirements of subparagraph (D) of paragraph four of this subsection]
WITHIN THE LAWFUL SCOPE OF HIS OR HER PRACTICE, WHO IS LICENSED PURSUANT
TO ARTICLE ONE HUNDRED FIFTY-FOUR OF THE EDUCATION LAW, a nurse practi-
tioner licensed to practice in this state, or a professional corporation
or university faculty practice corporation thereof. NOTHING HEREIN SHALL
A. 1171--A 3
BE CONSTRUED TO MODIFY OR EXPAND THE SCOPE OF PRACTICE OF A MENTAL
HEALTH COUNSELOR, MARRIAGE AND FAMILY THERAPIST, CREATIVE ARTS THERAPIST
OR PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE HUNDRED SIXTY-THREE OF
THE EDUCATION LAW. FURTHER, NOTHING HEREIN SHALL BE CONSTRUED TO CREATE
A NEW MANDATED HEALTH BENEFIT.
§ 5. Paragraph 2 of subsection (g) of section 4303 of the insurance
law, as added by section 22 of subpart A of part BB of chapter 57 of the
laws of 2019, is amended to read as follows:
(2) where the contract provides coverage for physician services SUCH
CONTRACT SHALL PROVIDE benefits for outpatient care provided by a
psychiatrist or psychologist licensed to practice in this state, OR A
MENTAL HEALTH COUNSELOR, MARRIAGE AND FAMILY THERAPIST, CREATIVE ARTS
THERAPIST OR PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE HUNDRED
SIXTY-THREE OF THE EDUCATION LAW, OR a licensed clinical social worker
[who meets the requirements of subsection (n) of this section] WITHIN
THE LAWFUL SCOPE OF HIS OR HER PRACTICE, WHO IS LICENSED PURSUANT TO
ARTICLE ONE HUNDRED FIFTY-FOUR OF THE EDUCATION LAW, a nurse practition-
er licensed to practice [on] IN this state, or professional corporation
or university faculty practice corporation thereof. NOTHING HEREIN SHALL
BE CONSTRUED TO MODIFY OR EXPAND THE SCOPE OF PRACTICE OF A MENTAL
HEALTH COUNSELOR, MARRIAGE AND FAMILY THERAPIST, CREATIVE ARTS THERAPIST
OR PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE HUNDRED SIXTY-THREE OF
THE EDUCATION LAW. FURTHER, NOTHING HEREIN SHALL BE CONSTRUED TO CREATE
A NEW MANDATED HEALTH BENEFIT.
§ 6. Subsection (i) of section 4303 of the insurance law is REPEALED.
§ 7. Subsection (n) of section 4303 of the insurance law, as amended
by section 30 of subpart A of part BB of chapter 57 of the laws of 2019,
is amended to read as follows:
(n) [In addition to the requirements of subsection (i) of this
section, every] EVERY health service or medical expense indemnity corpo-
ration issuing a group contract pursuant to this section or a group
remittance contract for delivery in this state which contract provides
reimbursement to subscribers or physicians, psychiatrists or psychol-
ogists for psychiatric or psychological services or for the diagnosis
and treatment of mental health conditions, however defined in such
contract, must provide the same coverage to persons covered under the
group contract for such services when performed by a licensed clinical
social worker, within the lawful scope of his or her practice, who is
licensed pursuant to [subdivision two of section seven thousand seven
hundred four of the education law and in addition shall have either (i)
three or more additional years experience in psychotherapy, which for
the purposes of this subsection shall mean the use of verbal methods in
interpersonal relationships with the intent of assisting a person or
persons to modify attitudes and behavior which are intellectually,
socially or emotionally maladaptive, under supervision, satisfactory to
the state board for social work, in a facility, licensed or incorporated
by an appropriate governmental department, providing services for diag-
nosis or treatment of mental health conditions, or (ii) three or more
additional years experience in psychotherapy under the supervision,
satisfactory to the state board for social work, of a psychiatrist, a
licensed and registered psychologist or a licensed clinical social work-
er qualified for reimbursement pursuant to subsection (i) of this
section, or (iii) a combination of the experience specified in para-
graphs (i) and (ii) totaling three years, satisfactory to the state
board for social work.] ARTICLE ONE HUNDRED FIFTY-FOUR OF THE EDUCATION
LAW AND A MENTAL HEALTH COUNSELOR, MARRIAGE AND FAMILY THERAPIST, CREA-
A. 1171--A 4
TIVE ARTS THERAPIST OR PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE
HUNDRED SIXTY-THREE OF THE EDUCATION LAW. NOTHING HEREIN SHALL BE
CONSTRUED TO MODIFY OR EXPAND THE SCOPE OF PRACTICE OF A MENTAL HEALTH
COUNSELOR, MARRIAGE AND FAMILY THERAPIST, CREATIVE ARTS THERAPIST OR
PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE HUNDRED SIXTY-THREE OF
THE EDUCATION LAW. FURTHER, NOTHING HEREIN SHALL BE CONSTRUED TO CREATE
A NEW MANDATED HEALTH BENEFIT. The state board for social work shall
maintain a list of all licensed clinical social workers qualified for
reimbursement under this subsection. THE STATE BOARD FOR MENTAL HEALTH
PRACTITIONERS SHALL MAINTAIN A LIST OF ALL LICENSED MENTAL HEALTH COUN-
SELORS, MARRIAGE AND FAMILY THERAPISTS, CREATIVE ARTS THERAPISTS OR
PSYCHOANALYSTS QUALIFIED FOR REIMBURSEMENT UNDER THIS SUBSECTION.
§ 8. This act shall take effect on the first of January next succeed-
ing the date upon which it shall have become a law; provided, however,
that the amendments made to item (i) of subparagraph (A) of paragraph 35
of subsection (i) of section 3216 of the insurance law made by section
one of this act shall take effect on the same date and in the same
manner as part AA of chapter 57 of the laws of 2021 takes effect; and
provided further, shall apply to policies and contracts issued, renewed,
modified, altered or amended on or after such effective date.