NY State Senate Bill 2021-S8058A

Archive: Last Bill Status - In Senate Committee Health Committee

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 22, 2022	print number 8058a
Feb 22, 2022	amend (t) and recommit to health
Jan 21, 2022	referred to health

Bill Amendments

Original

A (Active)

2021-S8058 - Details

See Assembly Version of this Bill:: A9303
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§4401 & 4403, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2023-2024: S3524, A4410
2025-2026: S499, A1792

2021-S8058 - Summary

Enacts the "ensuring access to behavioral health act"; includes mental health services, substance use disorder treatment services and recovery support services to network adequacy requirements for insurance coverage.

2021-S8058 - Sponsor Memo

                                 
BILL NUMBER: S8058

SPONSOR: HARCKHAM
 
TITLE OF BILL:

An act to amend the public health law, in relation to including mental
health services, substance use disorder treatment services and recovery
support services to network adequacy requirements

 
SUMMARY OF PROVISIONS:

Section 1: Provides this act may be cited as the " ensuring access to
behavioral health act"

Section 2: Amends Subdivision 3 of section 4401 of the public health law
to include mental health services, substance use disorder treatment
services, and recovery support services to the definition of "comprehen-
sive health services".

Section 3: Amends Subdivision 5 of section 4403 of the public health law
to include mental health services, substance use disorder treatment
services, and recovery support services ensuring that health maintenance
organization maintains a network of health care providers that adequate-

ly meets the patients need. Including but not limited to ensuring that
there are a sufficient number of geographically accessible participating
providers, and there are opportunities to select from at least three
primary care providers pursuant to travel and distance-time standards
including access to providers in rural areas. Additionally, all opioid
treatment programs in all counties and the city of New York and all
authorized buprenorphine prescribers in all counties of the state and in
the city of New York must be covered.

Section 4: States the effective date.

 
JUSTIFICATION:

The CDC has reported an increase in opioid overdoses as well as an
increase in emergency room visits related to mental health. As the state
navigates through the increasing need for substance use disorder treat-
ment, recovery, and mental health services it is vital that we ensure
these services are easily accessible to those in need. Currently, insur-
ance companies with a network of providers are required to ensure that
the network is adequate to meet the health needs of the insured. Includ-
ing providing an appropriate choice of providers sufficient to render
the services covered under such policy or contract and capping the
distance the insured is required to travel to receive covered services.
This bill seeks to include mental health services, substance use disor-
der treatment services, and recovery support services under the defi-
nition of "comprehensive health services". This change would ensure that
insurance companies extend the network adequacy requirements expanding
access to behavioral health services.

 
PRIOR LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

To be determined.
 
EFFECTIVE DATE:
This act shall take effect immediately.

2021-S8058 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8058
 
                             I N  S E N A T E
 
                             January 21, 2022
                                ___________
 
 Introduced  by Sen. HARCKHAM -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, in relation to  including  mental
   health  services, substance use disorder treatment services and recov-
   ery support services to network adequacy requirements
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Short  title. This act shall be known and may be cited as
 the "ensuring access to behavioral health act".
   § 2. Subdivision 3 of section 4401 of the public health law, as  added
 by chapter 938 of the laws of 1976, is amended to read as follows:
   3.  "Comprehensive  health  services"  means all those health services
 which an enrolled population might require in order to be maintained  in
 good  health,  and shall include, but shall not be limited to, physician
 services (including consultant and referral  services),  in-patient  and
 out-patient  hospital  services,  MENTAL  HEALTH SERVICES, SUBSTANCE USE
 DISORDER TREATMENT SERVICES, RECOVERY SUPPORT SERVICES, diagnostic labo-
 ratory and therapeutic and diagnostic radiologic services, and emergency
 and preventive health services. Such term  may  be  further  defined  by
 agreement with enrolled populations providing additional benefits neces-
 sary, desirable or appropriate to meet their health care needs.
   §  3.  Paragraph  (a)  of  subdivision 5 of section 4403 of the public
 health law, as amended by chapter 586 of the laws of 1998, is amended to
 read as follows:
   (a) The commissioner, at the time of initial licensure, at least every
 three years thereafter, and upon application for  expansion  of  service
 area,  shall ensure that the health maintenance organization maintains a
 network of health care providers  adequate  to  meet  the  comprehensive
 health  needs,  INCLUDING MENTAL HEALTH SERVICES, SUBSTANCE USE DISORDER
 TREATMENT SERVICES,  INCLUDING  BUT  NOT  LIMITED  TO  OPIOID  TREATMENT
 PROGRAMS AND MEDICATION ASSISTED TREATMENT OPTIONS, AND RECOVERY SUPPORT
 SERVICES,  of  its  enrollees  and  to  provide an appropriate choice of
 providers  sufficient  to  provide  the  services  covered   under   its
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD14163-04-2

 S. 8058                             2
 
 enrollee's  contracts  by  determining  that  (i) there are a sufficient
 number of geographically accessible participating
  providers,  INCLUDING  ALL OPIOID TREATMENT PROGRAMS IN ALL COUNTIES OF
 THE STATE AND IN THE CITY OF NEW YORK AND ALL  AUTHORIZED  BUPRENORPHINE
 PRESCRIBERS  IN  ALL  COUNTIES OF THE STATE AND IN THE CITY OF NEW YORK;
 (ii) there are opportunities to select from at least three primary  care
 providers pursuant to travel and distance time standards, providing that
 such  standards  account  for  the  conditions of accessing providers in
 rural areas; (iii) there  are  sufficient  providers  in  each  area  of
 specialty  practice to meet the needs of the enrollment population; (iv)
 there is no exclusion of any appropriately licensed type of provider  as
 a  class;  and  (v)  contracts  entered  into with health care providers
 neither transfer financial risk to providers, in a  manner  inconsistent
 with the provisions of paragraph (c) of subdivision one of this section,
 nor  penalize providers for unfavorable case mix so as to jeopardize the
 quality of or  enrollees'  appropriate  access  to  medically  necessary
 services;  provided,  however,  that payment at less than prevailing fee
 for service rates or capitation shall not be deemed  or  presumed  prima
 facie to jeopardize quality or access.
   § 4. This act shall take effect immediately.

2021-S8058A (ACTIVE) - Details

See Assembly Version of this Bill:: A9303
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§4401 & 4403, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2023-2024: S3524, A4410
2025-2026: S499, A1792

2021-S8058A (ACTIVE) - Summary

2021-S8058A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8058A

SPONSOR: HARCKHAM
 
TITLE OF BILL:

An act to amend the public health law, in relation to including mental
health services, substance use disorder treatment services and recovery
support services to network adequacy requirements; and directs the
superintendent of financial services and the commissioner of health to
review data and update regulations regarding health maintenance organ-
izations and network adequacy requirements

 
PURPOSE:  Enacts the "ensuring access to behavioral health act"

 
SUMMARY OF PROVISIONS:

Section 1: Provides this act may be cited as the " ensuring access to
behavioral health act"

Section 2: Amends Subdivision 3 of section 4401 of the public health law
to include mental health services, substance use disorder treatment
services, and recovery support services to the definition of "comprehen-

sive health services".

Section 3: Amends Subdivision 5 of section 4403 of the public health law
to include mental health services, substance use disorder treatment
services, and recovery support services ensuring that health maintenance
organization maintains a network of health care providers that adequate-
ly meet the patient's need. Including but not limited to ensuring that
there are a sufficient number of geographically accessible participating
providers, and there are opportunities to select from at least three
primary care providers pursuant to travel and distance-time standards
including access to providers in rural areas. Additionally, all opioid
treatment programs in all counties and the city of New York and all
authorized buprenorphine prescribers in all counties of the state and in
the city of New York must be covered.

Section 4: Requires the superintendent of financial services, in consul-
tation with the office of addiction services and supports and the office
of mental health review data gathered through the mental health and
substance use disorder parity compliance program for every insurer,
corporation, municipal cooperative health benefit plan, health mainte-
nance organization or student health plan. After such review and review
of the national best practices for network adequacy for behavioral
health, the superintendent of financial services shall update any regu-
lations or guidance regarding network adequacy for all mental health and
substance use disorder services.

Section 5: Requires the commissioner of health, in consultation with the
independent substance use disorder and mental health ombudsman, shall
review and update network adequacy requirements for mental health and
substance use disorder services covered by managed care plans as part of
the periodic reviews of plans network adequacy required by subdivision
11-a of section 4403-f of the public health law; including telephonic
and telehealth services.

Section 6: States the effective date.

 
JUSTIFICATION:
The CDC has reported an increase in opioid overdoses as well as an
increase in emergency room visits related to mental health. As the state
navigates through the increasing need for substance use disorder treat-
ment, recovery, and mental health services it is vital that we ensure
these services are easily accessible to those in need.  Currently,
insurance companies with a network of providers are required to ensure
that the network is adequate to meet the health needs of the insured.
Including providing an appropriate choice of providers sufficient to
render the services covered under such policy or contract and capping
the distance the insured is required to travel to receive covered
services. This bill seeks to include mental health services, substance
use disorder treatment services, and recovery support services under the
definition of "comprehensive health services". This change would ensure
that insurance companies extend the network adequacy requirements
expanding access to behavioral health services.

 
PRIOR LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2021-S8058A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8058--A
 
                             I N  S E N A T E
 
                             January 21, 2022
                                ___________
 
 Introduced  by Sen. HARCKHAM -- read twice and ordered printed, and when
   printed to be committed  to  the  Committee  on  Health  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 AN  ACT  to amend the public health law, in relation to including mental
   health services, substance use disorder treatment services and  recov-
   ery support services to network adequacy requirements; and directs the
   superintendent of financial services and the commissioner of health to
   review data and update regulations regarding health maintenance organ-
   izations and network adequacy requirements
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Short title. This act shall be known and may  be  cited  as
 the "ensuring access to behavioral health act".
   §  2. Subdivision 3 of section 4401 of the public health law, as added
 by chapter 938 of the laws of 1976, is amended to read as follows:
   3. "Comprehensive health services" means  all  those  health  services
 which  an enrolled population might require in order to be maintained in
 good health, and shall include, but shall not be limited  to,  physician
 services  (including  consultant  and referral services), in-patient and
 out-patient hospital services, MENTAL  HEALTH  SERVICES,  SUBSTANCE  USE
 DISORDER TREATMENT SERVICES, RECOVERY SUPPORT SERVICES, diagnostic labo-
 ratory and therapeutic and diagnostic radiologic services, and emergency
 and  preventive  health  services.  Such  term may be further defined by
 agreement with enrolled populations providing additional benefits neces-
 sary, desirable or appropriate to meet their health care needs.
   § 3. Paragraph (a) of subdivision 5 of  section  4403  of  the  public
 health law, as amended by chapter 586 of the laws of 1998, is amended to
 read as follows:
   (a) The commissioner, at the time of initial licensure, at least every
 three  years  thereafter,  and upon application for expansion of service
 area, shall ensure that the health maintenance organization maintains  a
 network  of  health  care  providers  adequate to meet the comprehensive
 health needs, INCLUDING MENTAL HEALTH SERVICES, SUBSTANCE  USE  DISORDER
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD14163-05-2
 S. 8058--A                          2
 
 TREATMENT  SERVICES,  INCLUDING  BUT  NOT  LIMITED  TO  OPIOID TREATMENT
 PROGRAMS AND MEDICATION ASSISTED TREATMENT OPTIONS, AND RECOVERY SUPPORT
 SERVICES, of its enrollees and  to  provide  an  appropriate  choice  of
 providers   sufficient   to  provide  the  services  covered  under  its
 enrollee's contracts by determining that  (i)  there  are  a  sufficient
 number  of  geographically accessible participating providers, INCLUDING
 ALL OPIOID TREATMENT PROGRAMS IN ALL COUNTIES OF THE STATE  AND  IN  THE
 CITY  OF  NEW  YORK  AND ALL AUTHORIZED BUPRENORPHINE PRESCRIBERS IN ALL
 COUNTIES OF THE STATE AND IN THE CITY OF NEW YORK; (ii) there are oppor-
 tunities to select from at least three primary care  providers  pursuant
 to  travel  and  distance  time standards, providing that such standards
 account for the conditions of accessing providers in rural areas;  (iii)
 there  are  sufficient  providers  in each area of specialty practice to
 meet the needs of the enrollment population; (iv) there is no  exclusion
 of  any  appropriately  licensed  type  of  provider as a class; and (v)
 contracts entered into  with  health  care  providers  neither  transfer
 financial   risk  to  providers,  in  a  manner  inconsistent  with  the
 provisions of paragraph (c) of subdivision  one  of  this  section,  nor
 penalize  providers  for  unfavorable  case  mix so as to jeopardize the
 quality of or  enrollees'  appropriate  access  to  medically  necessary
 services;  provided,  however,  that payment at less than prevailing fee
 for service rates or capitation shall not be deemed  or  presumed  prima
 facie to jeopardize quality or access.
   §  4.   The superintendent of financial services, in consultation with
 the office of addiction services and supports and the office  of  mental
 health,  shall  review  data  gathered  through  the  mental  health and
 substance use disorder parity compliance program required under 11 NYCRR
 230.3 for every insurer, corporation organized pursuant to article 43 of
 the insurance law, municipal cooperative health benefit  plan  certified
 pursuant  to  article 47 of the insurance law, health maintenance organ-
 ization certified pursuant to article 44 of the public  health  law,  or
 student  health  plan established or maintained pursuant to section 1124
 of the insurance law. After such review  and  review  of  national  best
 practices for network adequacy for behavioral health, the superintendent
 of financial services shall update any regulations or guidance regarding
 network  adequacy  for  all  mental  health  and  substance use disorder
 services. Such  updated  regulations  or  guidance  shall  be  based  on
 national  best  practices  and  shall  include quantitative measures for
 geographic distance  and/or  travel  time,  appointment  wait  time  and
 provider/enrollee  ratios and any other appropriate metric determined by
 the superintendent to be necessary to ensure  access  to  needed  mental
 health  and  substance  use  disorder  services.  Such regulations shall
 include a review of the appropriate use  of  telephonic  and  telehealth
 services  to  supplement  in-person services, as well as the adequacy of
 the network to meet the needs of specific covered groups, including  but
 not  limited to, low-income persons, persons with limited English profi-
 ciency or illiteracy, diverse cultural  or  ethnic  backgrounds,  LGBTQ,
 persons with disabilities, and children and adults with serious, chronic
 or  complex  health  conditions,  including  co-occurring  mental health
 conditions and substance use disorders.
   § 5. The commissioner of health, in consultation with the  independent
 substance  use  disorder  and  mental health ombudsman, shall review and
 update network adequacy requirements for mental health and substance use
 disorder services covered by managed care plans as part of the  periodic
 reviews  of  plans  network  adequacy  required  by  subdivision 11-a of
 section 4403-f of the public health law. Such review and  updated  regu-
 S. 8058--A                          3
 
 lations  or  guidance shall include quantitative measures for geographic
 distance and/or travel time, appointment wait time and provider/enrollee
 ratios and any other appropriate metric determined by  the  commissioner
 of  health  to ensure access to mental health and substance use disorder
 services. Such updated regulations shall be based on national best prac-
 tices and shall include a review of the appropriate  use  of  telephonic
 and telehealth services to supplement in-person services, as well as the
 adequacy  of  the  network to meet the needs of specific covered groups,
 including but not limited to, low-income persons, persons  with  limited
 English  proficiency  or  illiteracy,  diverse  cultural or ethnic back-
 grounds, LGBTQ, persons with disabilities, and children and adults  with
 serious,  chronic  or  complex health conditions, including co-occurring
 mental health conditions and substance use disorders.
   § 6.  This act shall take effect immediately.

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Senate Bill S8058A

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2021-S8058 - Details

2021-S8058 - Summary

2021-S8058 - Sponsor Memo

2021-S8058 - Bill Text download pdf

2021-S8058A (ACTIVE) - Details

2021-S8058A (ACTIVE) - Summary

2021-S8058A (ACTIVE) - Sponsor Memo

2021-S8058A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S8058A

Share this bill

Sponsored By

Pete Harckham

Archive: Last Bill Status - In Senate Committee Health Committee

Bill Amendments

2021-S8058 - Details

2021-S8058 - Summary

2021-S8058 - Sponsor Memo

2021-S8058 - Bill Text download pdf

2021-S8058A (ACTIVE) - Details

2021-S8058A (ACTIVE) - Summary

2021-S8058A (ACTIVE) - Sponsor Memo

2021-S8058A (ACTIVE) - Bill Text download pdf

Comments