Senate Bill S5909

2021-2022 Legislative Session

Relates to prohibiting the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of mental health conditions

download bill text pdf

Sponsored By

Archive: Last Bill Status Via A3276 - Passed Senate


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2021-S5909 (ACTIVE) - Details

See Assembly Version of this Bill:
A3276
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2019-2020: A11145
2023-2024: S2282, A6704

2021-S5909 (ACTIVE) - Summary

Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of mental health conditions.

2021-S5909 (ACTIVE) - Sponsor Memo

2021-S5909 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5909
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                              March 22, 2021
                                ___________
 
 Introduced  by Sen. KAMINSKY -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to prohibiting the appli-
   cation of fail-first or step therapy protocols  to  coverage  for  the
   diagnosis and treatment of mental health conditions

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subparagraphs  (A),  (C)  and  (E)  of  paragraph  35  of
 subsection (i) of section 3216 of the insurance law, 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:
   (A)  Every  policy delivered or issued for delivery in this state that
 provides coverage for inpatient hospital care or coverage for  physician
 services  shall  provide  coverage  for  the  diagnosis and treatment of
 mental health conditions as follows:
   (i) where the policy provides coverage for  inpatient  hospital  care,
 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, for care provided in other states, to simi-
 larly licensed or certified hospitals or facilities; and
   (ii) where the policy provides coverage for physician services,  bene-
 fits  for  outpatient  care  provided  by a psychiatrist or psychologist
 licensed to practice in this state, a licensed  clinical  social  worker
 who  meets  the  requirements  of  subparagraph (D) of paragraph four of
 subsection (1) of section three thousand two hundred twenty-one of  this
 article,  a  nurse practitioner licensed to practice in this state, or a
 professional corporation  or  university  faculty  practice  corporation
 thereof, INCLUDING OUTPATIENT DRUG COVERAGE.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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