Assembly Bill A6704

2023-2024 Legislative Session

Prohibits 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

Current Bill Status - In Assembly 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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2023-A6704 (ACTIVE) - Details

See Senate Version of this Bill:
S2282
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2019-2020: A11145
2021-2022: A3276, S5909

2023-A6704 (ACTIVE) - Summary

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

2023-A6704 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6704
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                May 5, 2023
                                ___________
 
 Introduced  by M. of A. GUNTHER -- read once and referred to the Commit-
   tee 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, items (i)
 and (ii) of subparagraph (A) as amended by chapter 818 of  the  laws  of
 2022, 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,
 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 within the lawful scope of his or  her  practice,
 who is licensed pursuant to article one hundred fifty-four of the educa-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06700-01-3
              

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