The New York State Senate

 
                     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.