Bill Text: NY A00670 | 2019-2020 | General Assembly | Amended


Bill Title: Requires blanket health insurance policies to provide coverage for outpatient treatment by mental health practitioners (mental health counsellors, marriage and family therapists, creative arts therapists and psychoanalysts) licensed pursuant to article 163 of the education law.

Spectrum: Partisan Bill (Democrat 26-0)

Status: (Engrossed) 2019-06-19 - RETURNED TO ASSEMBLY [A00670 Detail]

Download: New_York-2019-A00670-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         670--A

                               2019-2020 Regular Sessions

                   IN ASSEMBLY

                                       (Prefiled)

                                     January 9, 2019
                                       ___________

        Introduced  by  M. of A. BRONSON, WALLACE, BUTTENSCHON, ROZIC, SANTABAR-
          BARA, LUPARDO, RYAN, HUNTER, GUNTHER, STECK,  ROMEO,  STIRPE,  LIFTON,
          JONES,  McDONALD,  MAGNARELLI, BURKE, FAHY, McMAHON, BARRETT, WOERNER,
          ORTIZ, WEPRIN -- read once and referred to the Committee on  Insurance
          --  reported  and  referred  to the Committee on Codes -- reported and
          referred to the Committee on Ways and Means --  committee  discharged,
          bill  amended,  ordered  reprinted  as amended and recommitted to said
          committee

        AN ACT to amend the insurance  law,  in  relation  to  health  insurance
          coverage  of  outpatient care provided by a mental health practitioner
          and a clinical social worker; and to repeal certain provisions of such
          law relating thereto

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Items (i) and (ii) of subparagraph (A) of paragraph 35 of
     2  subsection (i) of section 3216 of the insurance law, as added by section
     3  8 of subpart A of part BB of chapter 57 of the laws of 2019, are amended
     4  to read as follows:
     5    (i) where the policy provides coverage for  inpatient  hospital  care,
     6  such  policy  shall include benefits for inpatient care in a hospital as
     7  defined by subdivision ten of section 1.03 of the mental hygiene law and
     8  benefits for outpatient care provided in a facility issued an  operating
     9  certificate  by  the  commissioner  of  mental  health  pursuant  to the
    10  provisions of article thirty-one of the mental  hygiene  law,  or  in  a
    11  facility  operated by the office of mental health, or, for care provided
    12  in other states, to similarly licensed or certified hospitals or facili-
    13  ties; and
    14    (ii) where the policy provides coverage for physician  services,  such
    15  policy shall include benefits for outpatient care provided by a psychia-
    16  trist  or  psychologist  licensed  to practice in this state, a licensed

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04132-07-9

        A. 670--A                           2

     1  clinical social worker [who meets the requirements of  subparagraph  (D)
     2  of  paragraph  four  of  subsection  (1)  of  section three thousand two
     3  hundred twenty-one of this article,] within the lawful scope of  his  or
     4  her practice, who is licensed pursuant to article one hundred fifty-four
     5  of  the  education  law,  a mental health counselor, marriage and family
     6  therapist, creative arts therapist or psychoanalyst licensed pursuant to
     7  article one hundred sixty-three of the education law,  a  nurse  practi-
     8  tioner licensed to practice in this state, or a professional corporation
     9  or  university  faculty  practice  corporation thereof.   Nothing herein
    10  shall be construed to modify or expand the scope of practice of a mental
    11  health counselor, marriage and family therapist, creative arts therapist
    12  or psychoanalyst licensed pursuant to article one hundred sixty-three of
    13  the education law.
    14    § 2. Subparagraph (A) of paragraph 4 of subsection (l) of section 3221
    15  of the insurance law, as amended by section 11 of subpart A of  part  BB
    16  of chapter 57 of the laws of 2019, is amended to read as follows:
    17    (A)  Every insurer delivering a group policy or issuing a group policy
    18  for delivery, in this state, that provides reimbursement for psychiatric
    19  or psychological services or for the diagnosis and treatment  of  mental
    20  health  conditions,  however  defined  in  such  policy,  by physicians,
    21  psychiatrists or psychologists, shall [make available and  if  requested
    22  by  the  policyholder]  provide  the  same coverage to insureds for such
    23  services when performed by a licensed clinical social worker, within the
    24  lawful scope of his or her practice, who is licensed pursuant to article
    25  one hundred fifty-four of the education  law[.  Written  notice  of  the
    26  availability  of  such  coverage  shall be delivered to the policyholder
    27  prior to inception of such group policy and annually thereafter,  except
    28  that this notice shall not be required where a policy covers two hundred
    29  or  more  employees  or  where  the benefit structure was the subject of
    30  collective bargaining affecting persons who are employed  in  more  than
    31  one  state.]  and  mental  health counselors, marriage and family thera-
    32  pists, creative arts therapists and psychoanalysts licensed pursuant  to
    33  article  one hundred sixty-three of the education law, within the lawful
    34  scope of his or her practice. Nothing herein shall be construed to modi-
    35  fy or expand the  scope  of  practice  of  a  mental  health  counselor,
    36  marriage  and family therapist, creative arts therapist or psychoanalyst
    37  licensed pursuant to article one hundred sixty-three  of  the  education
    38  law.
    39    § 3. Subparagraph (D) of paragraph 4 of subsection (l) of section 3221
    40  of  the  insurance law, as amended by section 12 of subpart A of part BB
    41  of chapter 57 of the laws of 2019, is REPEALED.
    42    § 4. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of
    43  section 3221 of the insurance law, as amended by section 13 of subpart A
    44  of part BB of chapter 57 of the laws of 2019,  is  amended  to  read  as
    45  follows:
    46    (ii)  where  the  policy  provides coverage for physician services, it
    47  shall include benefits for outpatient care provided by a psychiatrist or
    48  psychologist licensed to practice in this  state,  or  a  mental  health
    49  counselor,  marriage  and  family  therapist, creative arts therapist or
    50  psychoanalyst licensed pursuant to article one  hundred  sixty-three  of
    51  the  education  law, or a licensed clinical social worker [who meets the
    52  requirements of subparagraph (D) of paragraph four of  this  subsection]
    53  within the lawful scope of his or her practice, who is licensed pursuant
    54  to  article one hundred fifty-four of the education law, a nurse practi-
    55  tioner licensed to practice in this state, or a professional corporation
    56  or university faculty practice corporation thereof. Nothing herein shall

        A. 670--A                           3

     1  be construed to modify or expand the  scope  of  practice  of  a  mental
     2  health counselor, marriage and family therapist, creative arts therapist
     3  or psychoanalyst licensed pursuant to article one hundred sixty-three of
     4  the education law.
     5    §  5.  Paragraph  2 of subsection (g) of section 4303 of the insurance
     6  law, as added by section 22 of subpart A of part BB of chapter 57 of the
     7  laws of 2019, is amended to read as follows:
     8    (2) where the contract provides coverage for physician  services  such
     9  contract  shall  provide  benefits  for  outpatient  care  provided by a
    10  psychiatrist or psychologist licensed to practice in this  state,  or  a
    11  mental  health  counselor,  marriage and family therapist, creative arts
    12  therapist or psychoanalyst licensed   pursuant to  article  one  hundred
    13  sixty-three  of  the education law, or a licensed clinical social worker
    14  [who meets the requirements of subsection (n) of  this  section]  within
    15  the  lawful  scope  of  his or her practice, who is licensed pursuant to
    16  article one hundred fifty-four of the education law, a nurse practition-
    17  er licensed to practice [on] in this state, or professional  corporation
    18  or university faculty practice corporation thereof. Nothing herein shall
    19  be  construed  to  modify  or  expand  the scope of practice of a mental
    20  health counselor, marriage and family therapist, creative arts therapist
    21  or psychoanalyst licensed pursuant to article one hundred sixty-three of
    22  the education law.
    23    § 6. Subsection (i) of section 4303 of the insurance law,  as  amended
    24  by section 25 of subpart A of part BB of chapter 57 of the laws of 2019,
    25  is REPEALED.
    26    §  7.  Subsection (n) of section 4303 of the insurance law, as amended
    27  by section 30 of subpart A of part BB of chapter 57 of the laws of 2019,
    28  is amended to read as follows:
    29    (n) [In addition  to  the  requirements  of  subsection  (i)  of  this
    30  section, every] Every health service or medical expense indemnity corpo-
    31  ration  issuing  a  group  contract  pursuant to this section or a group
    32  remittance contract for delivery in this state which  contract  provides
    33  reimbursement  to  subscribers  or physicians, psychiatrists or psychol-
    34  ogists for psychiatric or psychological services or  for  the  diagnosis
    35  and  treatment  of  mental  health  conditions,  however defined in such
    36  contract, must provide the same coverage to persons  covered  under  the
    37  group  contract  for such services when performed by a licensed clinical
    38  social worker, within the lawful scope of his or her  practice,  who  is
    39  licensed  pursuant  to  [subdivision two of section seven thousand seven
    40  hundred four of the education law and in addition shall have either  (i)
    41  three  or  more  additional years experience in psychotherapy, which for
    42  the purposes of this subsection shall mean the use of verbal methods  in
    43  interpersonal  relationships  with  the  intent of assisting a person or
    44  persons to modify  attitudes  and  behavior  which  are  intellectually,
    45  socially  or emotionally maladaptive, under supervision, satisfactory to
    46  the state board for social work, in a facility, licensed or incorporated
    47  by an appropriate governmental department, providing services for  diag-
    48  nosis  or  treatment  of mental health conditions, or (ii) three or more
    49  additional years experience  in  psychotherapy  under  the  supervision,
    50  satisfactory  to  the  state board for social work, of a psychiatrist, a
    51  licensed and registered psychologist or a licensed clinical social work-
    52  er qualified for  reimbursement  pursuant  to  subsection  (i)  of  this
    53  section,  or  (iii)  a  combination of the experience specified in para-
    54  graphs (i) and (ii) totaling three  years,  satisfactory  to  the  state
    55  board  for social work.] article one hundred fifty-four of the education
    56  law and a mental health counselor, marriage and family therapist,  crea-

        A. 670--A                           4

     1  tive  arts  therapist  or psychoanalyst licensed pursuant to article one
     2  hundred sixty-three of  the  education  law.  Nothing  herein  shall  be
     3  construed  to  modify or expand the scope of practice of a mental health
     4  counselor,  marriage  and  family  therapist, creative arts therapist or
     5  psychoanalyst licensed pursuant to article one  hundred  sixty-three  of
     6  the education law. The state board for social work shall maintain a list
     7  of  all  licensed  clinical  social  workers qualified for reimbursement
     8  under this subsection. The state board for mental  health  practitioners
     9  shall maintain a list of all licensed mental health counselors, marriage
    10  and family therapists, creative arts therapists or psychoanalysts quali-
    11  fied for reimbursement under this subsection.
    12    §  8. This act shall take effect on the first of January next succeed-
    13  ing the date upon which it shall have become a law and  shall  apply  to
    14  policies  and contracts issued, renewed, modified, altered or amended on
    15  or after such effective date; provided, however, that:
    16    (a) if section 8 of subpart A of part BB of chapter 57 of the laws  of
    17  2019 shall not have taken effect on or before such date then section one
    18  of  this  act shall take effect on the same date and in the  same manner
    19  as such chapter of the laws of 2019 takes effect;
    20    (b) if section 11 of subpart A of part BB of chapter 57 of the laws of
    21  2019 shall not have taken effect on or before such date then section two
    22  of this act shall take effect on the same date and in the same manner as
    23  such chapter of the laws of 2019 takes effect;
    24    (c) if section 13 of subpart A of part BB of chapter 57 of the laws of
    25  2019 shall not have taken effect on or before  such  date  then  section
    26  four  of  this  act  shall  take effect on the same date and in the same
    27  manner as such chapter of the laws of 2019 takes effect;
    28    (d) if section 22 of subpart A of part BB of chapter 57 of the laws of
    29  2019 shall not have taken effect on or before  such  date  then  section
    30  five  of  this  act  shall  take effect on the same date and in the same
    31  manner as such chapter of the laws of 2019 takes effect; and
    32    (e) if section 30 of subpart A of part BB of chapter 57 of the laws of
    33  2019 shall not have taken effect on or before  such  date  then  section
    34  seven  of  this  act  shall take effect on the same date and in the same
    35  manner as such chapter of the laws of 2019 takes effect.
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