Assembly Bill A1921A

2025-2026 Legislative Session

Provides outpatient insurance coverage for non-opioid treatment of chronic pain

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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Actions

Bill Amendments

co-Sponsors

2025-A1921 - Details

Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2023-2024 Legislative Session:
A9716

2025-A1921 - Summary

Provides outpatient insurance coverage for non-opioid treatment of chronic pain including complementary and integrative treatments and non-opioid drugs.

2025-A1921 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1921
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2025
                                ___________
 
 Introduced by M. of A. PAULIN -- read once and referred to the Committee
   on Insurance
 
 AN  ACT  to  amend the insurance law, in relation to providing insurance
   coverage for chronic pain
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 40 to read as follows:
   (40) (A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
 COMPREHENSIVE-TYPE COVERAGE THAT PROVIDES COVERAGE FOR  PAIN  MANAGEMENT
 SERVICES  SHALL  PROVIDE OUTPATIENT COVERAGE FOR NON-OPIOID TREATMENT OF
 CHRONIC PAIN INCLUDING COMPLEMENTARY AND INTEGRATIVE TREATMENTS.  ACCESS
 TO  NON-OPIOID  TREATMENT  SHALL  BE COMPARABLE TO THAT OF OTHER COVERED
 SERVICES. COVERAGE SHALL BE COMPARABLE FOR SERVICES PROVIDED BY LICENSED
 PROFESSIONALS.
   (B) COVERAGE UNDER THIS SUBSECTION SHALL NOT APPLY FINANCIAL  REQUIRE-
 MENTS  OR  TREATMENT LIMITATIONS TO NON-OPIOID TREATMENT OF CHRONIC PAIN
 THAT ARE MORE RESTRICTIVE THAN EITHER OF THE FOLLOWING: THE  PREDOMINANT
 FINANCIAL REQUIREMENTS AND TREATMENT LIMITATIONS APPLIED TO SUBSTANTIAL-
 LY  ALL  MEDICAL  BENEFITS  COVERED  BY  THE CONTRACT; AND THE FINANCIAL
 REQUIREMENTS AND  TREATMENT  LIMITATIONS  APPLIED  TO  ANY  OPIOID-BASED
 TREATMENT OF CHRONIC PAIN.
   (C)  FOR THE PURPOSES OF THIS PARAGRAPH THE FOLLOWING TERMS SHALL HAVE
 THE FOLLOWING MEANINGS:
   (I) "FINANCIAL REQUIREMENT" MEANS  DEDUCTIBLE,  CO-PAYMENTS,  CO-INSU-
 RANCE AND OUT-OF-POCKET EXPENSES;
   (II)  "PREDOMINANT"  MEANS  THAT  A FINANCIAL REQUIREMENT OR TREATMENT
 LIMITATION IS THE MOST COMMON OR FREQUENT  OF  SUCH  TYPE  OF  LIMIT  OR
 REQUIREMENT;
   (III)  "TREATMENT  LIMITATION" MEANS LIMITS ON THE FREQUENCY OF TREAT-
 MENT, NUMBER OF VISITS, DAYS OF COVERAGE, OR OTHER SIMILAR LIMITS ON THE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05350-01-5
              

co-Sponsors

2025-A1921A (ACTIVE) - Details

Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2023-2024 Legislative Session:
A9716

2025-A1921A (ACTIVE) - Summary

Provides outpatient insurance coverage for non-opioid treatment of chronic pain including complementary and integrative treatments and non-opioid drugs.

2025-A1921A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1921--A
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2025
                                ___________
 
 Introduced  by  M.  of A. PAULIN, LEVENBERG -- 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 providing insurance
   coverage for non-opioid treatment of chronic pain

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 40 to read as follows:
   (40) (A) EVERY POLICY THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
 COMPREHENSIVE-TYPE COVERAGE THAT PROVIDES COVERAGE FOR  PAIN  MANAGEMENT
 SERVICES  SHALL  PROVIDE OUTPATIENT COVERAGE FOR NON-OPIOID TREATMENT OF
 CHRONIC PAIN INCLUDING  COMPLEMENTARY  AND  INTEGRATIVE  TREATMENTS  AND
 NON-OPIOID  DRUGS  APPROVED  BY THE UNITED STATES FOOD AND DRUG ADMINIS-
 TRATION (FDA) FOR THE TREATMENT OF ACUTE  OR  CHRONIC  PAIN.  ACCESS  TO
 NON-OPIOID  TREATMENT  SHALL  BE  COMPARABLE  TO  THAT  OF OTHER COVERED
 SERVICES. COVERAGE SHALL BE COMPARABLE FOR SERVICES PROVIDED BY LICENSED
 PROFESSIONALS.
   (B) COVERAGE UNDER THIS SUBSECTION SHALL NOT APPLY FINANCIAL  REQUIRE-
 MENTS  OR  TREATMENT LIMITATIONS TO NON-OPIOID TREATMENT OF CHRONIC PAIN
 THAT ARE MORE RESTRICTIVE THAN EITHER OF THE FOLLOWING: THE  PREDOMINANT
 FINANCIAL REQUIREMENTS AND TREATMENT LIMITATIONS APPLIED TO SUBSTANTIAL-
 LY  ALL  MEDICAL  BENEFITS  COVERED  BY  THE CONTRACT; AND THE FINANCIAL
 REQUIREMENTS AND  TREATMENT  LIMITATIONS  APPLIED  TO  ANY  OPIOID-BASED
 TREATMENT  OF  CHRONIC  PAIN.  COVERAGE  UNDER  THIS PARAGRAPH SHALL NOT
 DISADVANTAGE OR DISCOURAGE ANY NON-OPIOID DRUG APPROVED  BY  THE  UNITED
 STATES  FOOD  AND DRUG ADMINISTRATION (FDA) FOR THE TREATMENT OF CHRONIC
 OR ACUTE PAIN RELATIVE TO ANY OPIOID DRUG FOR THE TREATMENT  OF  CHRONIC
 OR  ACUTE  PAIN,  WHERE  IMPERMISSIBLE  DISADVANTAGING OR DISCOURAGEMENT
 INCLUDES, WITHOUT LIMITATION: DESIGNATING ANY SUCH NON-OPIOID DRUG AS  A
 NON-PREFERRED  DRUG  IF  ANY  OPIOID OR NARCOTIC DRUG IS DESIGNATED AS A
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05350-02-5
              

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