Bill Text: NY S06212 | 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 2-0)

Status: (Introduced) 2019-06-19 - SUBSTITUTED BY A670A [S06212 Detail]

Download: New_York-2019-S06212-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         6212--A

                               2019-2020 Regular Sessions

                    IN SENATE

                                      May 23, 2019
                                       ___________

        Introduced  by Sens. KENNEDY, JACKSON -- read twice and ordered printed,
          and when printed to be committed 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  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
    17  clinical social worker [who meets the requirements of  subparagraph  (D)
    18  of  paragraph  four  of  subsection  (1)  of  section three thousand two
    19  hundred twenty-one of this article,] within the lawful scope of  his  or
    20  her practice, who is licensed pursuant to article one hundred fifty-four
    21  of  the  education  law,  a mental health counselor, marriage and family

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11946-02-9

        S. 6212--A                          2

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

        S. 6212--A                          3

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

        S. 6212--A                          4

     1  psychoanalyst licensed pursuant to article one  hundred  sixty-three  of
     2  the education law. The state board for social work shall maintain a list
     3  of  all  licensed  clinical  social  workers qualified for reimbursement
     4  under  this  subsection. The state board for mental health practitioners
     5  shall maintain a list of all licensed mental health counselors, marriage
     6  and family therapists, creative arts therapists or psychoanalysts quali-
     7  fied for reimbursement under this subsection.
     8    § 8. This act shall take effect on the first of January next  succeed-
     9  ing  the  date  upon which it shall have become a law and shall apply to
    10  policies and contracts issued, renewed, modified, altered or amended  on
    11  or after such effective date; provided, however, that:
    12    (a)  if section 8 of subpart A of part BB of chapter 57 of the laws of
    13  2019 shall not have taken effect on or before such date then section one
    14  of this act shall take effect on the same date and in the   same  manner
    15  as such chapter of the laws of 2019 takes effect;
    16    (b) if section 11 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 two
    18  of this act shall take effect on the same date and in the same manner as
    19  such chapter of the laws of 2019 takes effect;
    20    (c) if section 13 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
    22  four of this act shall take effect on the same  date  and  in  the  same
    23  manner as such chapter of the laws of 2019 takes effect;
    24    (d) if section 22 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  five 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; and
    28    (e) if section 30 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  seven 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.
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