NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A4693
SPONSOR: Sempolinski TITLE OF BILL:
An act to amend the insurance law, in relation to requiring health
insurance coverage for substance use disorder treatment services
PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to guarantee coverage of detoxification
services for a minimum of seven days and rehabilitation services for a
minimum of thirty days for substance use disorders.
SUMMARY OF PROVISIONS:
Section one and two of paragraph 30 and 31 of subsection (i) of section
3126 of insurance law is amended. Such amendments provide that detox
services must be at least seven days and rehabilitation services must be
at least thirty.
Section three and four of paragraph 6 of subsection (1) of section 3221
of insurance law is amended to specify detox services must be at least
seven days and rehabilitation services must be at least thirty.
Section five and six of paragraph 3 of subsection (k) of section 4303 of
insurance law is amended to specify detox services must be at least
seven days and rehabilitation services must be at least thirty.
Section seven states that this act shall take effect on the thirtieth
day after it shall have become a law.
JUSTIFICATION:
The first step in treatment for heroin addiction Is detoxification. By
itself, detox is not the sole solution because for many using heroin,
their addiction will eventually lead them back to using unless they
receive further treatment. Withdrawal, while not necessarily life
threatening, is extremely painful and a process that is often difficult
to go through. Many heroin users in New York are frequently revived from
overdoses and released back to their community to continue to struggle.
Many firsthand accounts by parents, families and recovering addicts alt
stressed the importance of having detox available for addicts when they
decide to seek treatment. Families. recovering addicts and professionals
all expressed concerns regarding insurance reimbursements. the "fail
first" process for rehabilitation and the short time frame in which an
individual is covered for treatment by insurance. Several individuals
expressed how, in order for an addict to be given an inpatient rehab
bed, the individual needed to fall at outpatient rehab first and after
being admitted into a rehabilitation facility the individual only
received at maximum of thirty days in treatment. For many addicts, this
time frame is not long enough and when they are discharged individuals
often find themselves falling back into old habits.
PRIOR LEGISLATIVE HISTORY:•
2023-24: A.2401
2021-22: A.8387
2019-20: A.5834
2017-18: A.4721
2015-16: A.9604
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
To be determined.
EFFECTIVE DATE:
This act shall take effect on the thirtieth day.
STATE OF NEW YORK
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4693
2025-2026 Regular Sessions
IN ASSEMBLY
February 4, 2025
___________
Introduced by M. of A. SEMPOLINSKI -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health
insurance coverage for substance use disorder treatment services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph 30 of subsection (i) of section 3216 of the
2 insurance law, as amended by section 5 of subpart A of part BB of chap-
3 ter 57 of the laws of 2019, is amended by adding a new subparagraph (H)
4 to read as follows:
5 (H) Coverage provided under this paragraph for detoxification, shall
6 be at a minimum, seven days. Rehabilitation services shall be, at a
7 minimum, thirty days.
8 § 2. Paragraph 31 of subsection (i) of section 3216 of the insurance
9 law is amended by adding a new subparagraph (K) to read as follows:
10 (K) Coverage provided under this paragraph for detoxification, shall
11 be at a minimum, seven days. Rehabilitation services shall be, at a
12 minimum, thirty days.
13 § 3. Paragraph 6 of subsection (l) of section 3221 of the insurance
14 law is amended by adding a new subparagraph (H) to read as follows:
15 (H) Coverage provided under this paragraph for detoxification, shall
16 be at a minimum, seven days. Rehabilitation services shall be, at a
17 minimum, thirty days.
18 § 4. Paragraph 7 of subsection (l) of section 3221 of the insurance
19 law is amended by adding a new subparagraph (K) to read as follows:
20 (K) Coverage provided under this paragraph for detoxification, shall
21 be at a minimum, seven days. Rehabilitation services shall be, at a
22 minimum, thirty days.
23 § 5. Subsection (k) of section 4303 of the insurance law is amended by
24 adding a new paragraph 8 to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07530-01-5
A. 4693 2
1 (8) Coverage provided under this subsection for detoxification, shall
2 be at a minimum, seven days. Rehabilitation services shall be, at a
3 minimum, thirty days.
4 § 6. Subsection (l) of section 4303 of the insurance law is amended by
5 adding a new paragraph 11 to read as follows:
6 (11) Coverage provided under this subsection for detoxification, shall
7 be at a minimum, seven days. Rehabilitation services shall be, at a
8 minimum, thirty days.
9 § 7. This act shall take effect on the thirtieth day after it shall
10 have become a law.
