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Assembly Bill A9693

2023-2024 Legislative Session

Prohibits the retrospective denial of payment for substance use disorder treatment services

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Archive: Last Bill Status - In Assembly Committee

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2023-A9693 (ACTIVE) - Details

See Senate Version of this Bill:
S9702
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Add §3246, Ins L
Versions Introduced in 2025-2026 Legislative Session:
A3767, S2644

2023-A9693 (ACTIVE) - Summary

Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.

2023-A9693 (ACTIVE) - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9693
 
                           I N  A S S E M B L Y
 
                               April 3, 2024
                                ___________
 
 Introduced by M. of A. WEPRIN -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the insurance law, in relation to prohibiting the retro-
   spective  denial  of  payment  for  substance  use  disorder treatment
   services
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1.  The insurance law is amended by adding a new section 3246
 to read as follows:
   § 3246. RETROSPECTIVE DENIAL OF  PAYMENT  OF  SUBSTANCE  USE  DISORDER
 TREATMENT  SERVICES.  NOTWITHSTANDING  ANY  OTHER  PROVISION OF LAW, ANY
 RETROSPECTIVE DENIAL OF PAYMENT  OF  SUBSTANCE  USE  DISORDER  TREATMENT
 SERVICES PROVIDED THAT ARE BASED ON THE INSURED INDIVIDUAL'S ELIGIBILITY
 SHALL  BE  PROHIBITED  AFTER  THE PROVIDER HAS VERIFIED WITH THE INSURER
 THAT THE INSURED HAS COVERAGE FOR SUCH TREATMENT AT THE TIME SUCH TREAT-
 MENT WAS INITIATED. THE INSURER SHALL IMMEDIATELY NOTIFY  THE  TREATMENT
 PROVIDER  WHEN  AN INSURED HAS LOST COVERAGE BASED ON TERMINATION OF THE
 INSURED'S EMPLOYMENT AND PROVIDED,  FURTHER,  THAT  DENIAL  OF  COVERAGE
 SHALL  BE  BASED  ON TERMINATION OF EMPLOYMENT AND SHALL NOT BE BASED ON
 SUSPENSION OF EMPLOYMENT. FAILURE OF THE INSURER TO  IMMEDIATELY  NOTIFY
 THE  TREATMENT PROVIDER OF SUCH TERMINATION OF EMPLOYMENT SHALL PRECLUDE
 ANY RETROSPECTIVE REVIEW BASED  ON  THE  INSURED'S  ELIGIBILITY.    THIS
 SECTION  SHALL  BE  APPLICABLE  TO  THE  NEW YORK STATE HEALTH INSURANCE
 PROGRAM.
   § 2. This act shall take effect immediately.
 
 
 
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD14954-01-4

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