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.