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Senate Bill S5263

2025-2026 Legislative Session

Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization

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Current Bill Status - In Senate Committee Rules Committee

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2025-S5263 (ACTIVE) - Details

See Assembly Version of this Bill:
A8864
Current Committee:
Senate Rules
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2017-2018: S8064
2019-2020: S333
2021-2022: S1915
2023-2024: S4842

2025-S5263 (ACTIVE) - Summary

Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization.

2025-S5263 (ACTIVE) - Sponsor Memo

2025-S5263 (ACTIVE) - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5263
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             February 20, 2025
                                ___________
 
 Introduced  by  Sen.  ASHBY  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to providing that  cover-
   age  for  outpatient diagnosis and treatment of substance use disorder
   shall not be subject to preauthorization

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subparagraph  (A)  of  paragraph  31 of subsection (i) of
 section 3216 of the insurance law, as amended by section 6 of subpart  A
 of  part  BB  of  chapter  57 of the laws of 2019, is amended to read as
 follows:
   (A) Every policy that  provides  medical,  major  medical  or  similar
 comprehensive-type  coverage  shall  provide outpatient coverage for the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion and rehabilitation services. Such coverage shall not BE SUBJECT  TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations  to outpatient substance use disorder benefits that are more
 restrictive than the predominant financial  requirements  and  treatment
 limitations  applied  to substantially all medical and surgical benefits
 covered by the policy.
   § 2. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221
 of the insurance law, as amended by section 16 of subpart A of  part  BB
 of chapter 57 of the laws of 2019, is amended to read as follows:
   (A)  Every  policy  that  provides  medical,  major medical or similar
 comprehensive-type coverage shall provide outpatient  coverage  for  the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and rehabilitation services. Such coverage shall not BE SUBJECT TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations to outpatient substance use disorder benefits that are  more
 restrictive  than  the  predominant financial requirements and treatment

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08834-02-5
 S. 5263                             2

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