Bill Text: NY S05426 | 2019-2020 | General Assembly | Introduced
Bill Title: Mandates commercial insurance coverage of peer support services as part of treatment for substance use disorder.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2020-01-08 - REFERRED TO INSURANCE [S05426 Detail]
Download: New_York-2019-S05426-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 5426 2019-2020 Regular Sessions IN SENATE April 30, 2019 ___________ Introduced by Sen. HARCKHAM -- 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 mandating commercial insurance coverage of peer support services as part of treatment for substance use disorder The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subparagraph (A) of paragraph 31 of subsection (i) of 2 section 3216 of the insurance law, as added by chapter 41 of the laws of 3 2014, is amended to read as follows: 4 (A) Every policy that provides medical, major medical or similar 5 comprehensive-type coverage must provide outpatient coverage for the 6 diagnosis and treatment of substance use disorder, including detoxifica- 7 tion and rehabilitation services and also including peer support 8 services provided by a certified recovery peer advocate as defined by 9 the office of alcoholism and substance abuse services. Such coverage 10 shall not apply financial requirements or treatment limitations to 11 outpatient substance use disorder benefits that are more restrictive 12 than the predominant financial requirements and treatment limitations 13 applied to substantially all medical and surgical benefits covered by 14 the policy. Further, such coverage shall be provided consistent with 15 the federal Paul Wellstone and Pete Domenici Mental Health Parity and 16 Addiction Equity Act of 2008 (29 U.S.C. § 1185a). 17 § 2. Subparagraph (A) of paragraph 31 of subsection (i) of section 18 3216 of the insurance law, as amended by section 6 of subpart A of part 19 BB of chapter 57 of the laws of 2019, is amended to read as follows: 20 (A) Every policy that provides medical, major medical or similar 21 comprehensive-type coverage shall provide outpatient coverage for the 22 diagnosis and treatment of substance use disorder, including detoxifica- 23 tion and rehabilitation services and also including peer support 24 services provided by a certified recovery peer advocate as defined by EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD11397-01-9S. 5426 2 1 the office of alcoholism and substance abuse services. Such coverage 2 shall not apply financial requirements or treatment limitations to 3 outpatient substance use disorder benefits that are more restrictive 4 than the predominant financial requirements and treatment limitations 5 applied to substantially all medical and surgical benefits covered by 6 the policy. 7 § 3. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221 8 of the insurance law, as amended by chapter 41 of the laws of 2014, is 9 amended to read as follows: 10 (A) Every policy that provides medical, major medical or similar 11 comprehensive-type coverage must provide outpatient coverage for the 12 diagnosis and treatment of substance use disorder, including detoxifica- 13 tion and rehabilitation services and also including peer support 14 services provided by a certified recovery peer advocate as defined by 15 the office of alcoholism and substance abuse services. Such coverage 16 shall not apply financial requirements or treatment limitations to 17 outpatient substance use disorder benefits that are more restrictive 18 than the predominant financial requirements and treatment limitations 19 applied to substantially all medical and surgical benefits covered by 20 the policy. Further, such coverage shall be provided consistent with 21 the federal Paul Wellstone and Pete Domenici Mental Health Parity and 22 Addiction Equity Act of 2008 (29 U.S.C. § 1185a). 23 § 4. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221 24 of the insurance law, as amended by section 16 of subpart A of part BB 25 of chapter 57 of the laws of 2019, is amended to read as follows: 26 (A) Every policy that provides medical, major medical or similar 27 comprehensive-type coverage shall provide outpatient coverage for the 28 diagnosis and treatment of substance use disorder, including detoxifica- 29 tion and rehabilitation services and also including peer support 30 services provided by a certified recovery peer advocate as defined by 31 the office of alcoholism and substance abuse services. Such coverage 32 shall not apply financial requirements or treatment limitations to 33 outpatient substance use disorder benefits that are more restrictive 34 than the predominant financial requirements and treatment limitations 35 applied to substantially all medical and surgical benefits covered by 36 the policy. 37 § 5. Paragraph 1 of subsection (l) of section 4303 of the insurance 38 law, as amended by chapter 41 of the laws of 2014, is amended to read as 39 follows: 40 (1) Every contract that provides medical, major medical or similar 41 comprehensive-type coverage must provide outpatient coverage for the 42 diagnosis and treatment of substance use disorder, including detoxifica- 43 tion and rehabilitation services and also including peer support 44 services provided by a certified recovery peer advocate as defined by 45 the office of alcoholism and substance abuse services. Such coverage 46 shall not apply financial requirements or treatment limitations to 47 outpatient substance use disorder benefits that are more restrictive 48 than the predominant financial requirements and treatment limitations 49 applied to substantially all medical and surgical benefits covered by 50 the contract. Further, such coverage shall be provided consistent with 51 the federal Paul Wellstone and Pete Domenici Mental Health Parity and 52 Addiction Equity Act of 2008 (29 U.S.C. § 1185a). 53 § 6. Paragraph 1 of subsection (l) of section 4303 of the insurance 54 law, as amended by section 27 of subpart A of part BB of chapter 57 of 55 the laws of 2019, is amended to read as follows:S. 5426 3 1 (1) Every contract that provides medical, major medical or similar 2 comprehensive-type coverage shall provide outpatient coverage for the 3 diagnosis and treatment of substance use disorder, including detoxifica- 4 tion and rehabilitation services and also including peer support 5 services provided by a certified recovery peer advocate as defined by 6 the office of alcoholism and substance abuse services. Such coverage 7 shall not apply financial requirements or treatment limitations to 8 outpatient substance use disorder benefits that are more restrictive 9 than the predominant financial requirements and treatment limitations 10 applied to substantially all medical and surgical benefits covered by 11 the contract. 12 § 7. This act shall take effect on the thirtieth day after it shall 13 have become a law; provided that the amendments to subparagraph (A) of 14 paragraph (31) of subsection (i) of section 3216 of the insurance law 15 made by section two of this act, the amendments to subparagraph (A) of 16 paragraph (7) of subsection (l) of section 3221 of the insurance law 17 made by section four of this act and the amendments to paragraph (1) of 18 subsection (l) of section 4303 of the insurance law made by section six 19 of this act shall take effect on the same date and in the same manner as 20 subpart A of part BB of chapter 57 of the laws of 2019, takes effect.
