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A04721 Summary:

BILL NOA04721
 
SAME ASNo Same As
 
SPONSORGiglio
 
COSPNSRGraf
 
MLTSPNSR
 
Amd 3216, 3221 & 4303, Ins L
 
Requires health insurance coverage for substance use disorder treatment services.
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A04721 Actions:

BILL NOA04721
 
02/03/2017referred to insurance
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A04721 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A4721
 
SPONSOR: Giglio
  TITLE OF BILL: An act to amend the insurance law, in relation to requiring health insurance coverage for substance use disorder treatment services   PURPOSE: 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 all 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 fail 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: 2016: A.9604 (Giglio) Referred to Insurance   FISCAL IMPLICATIONS: To be determined.   EFFECTIVE DATE: This act shall take effect on the thirtieth day.
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A04721 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          4721
 
                               2017-2018 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 3, 2017
                                       ___________
 
        Introduced by M. of A. GIGLIO -- 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 1 of part B of chapter  71  of  the
     3  laws  of  2016,  is  amended by adding a new subparagraph (E) to read as
     4  follows:
     5    (E) 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. Subparagraph (D) of paragraph 31 of  subsection  (i)  of  section
     9  3216  of  the  insurance  law  is  relettered subparagraph (E) and a new
    10  subparagraph (D) is added to read as follows:
    11    (D) Coverage provided under this paragraph for  detoxification,  shall
    12  be  at  a  minimum,  seven  days. Rehabilitation services shall be, at a
    13  minimum, thirty days.
    14    § 3. Paragraph 6 of subsection (l) of section 3221  of  the  insurance
    15  law is amended by adding a new subparagraph (E) to read as follows:
    16    (E)  Coverage  provided under this paragraph for detoxification, shall
    17  be at a minimum, seven days. Rehabilitation  services  shall  be,  at  a
    18  minimum, thirty days.
    19    § 4. Subparagraph (D) of paragraph 7 of subsection (l) of section 3221
    20  of  the  insurance law is relettered subparagraph (E) and a new subpara-
    21  graph (D) is added to read as follows:
    22    (D) Coverage provided under this paragraph for  detoxification,  shall
    23  be  at  a  minimum,  seven  days. Rehabilitation services shall be, at a
    24  minimum, thirty days.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD08004-01-7

        A. 4721                             2
 
     1    § 5. Paragraph 3 of subsection (k) of section 4303  of  the  insurance
     2  law  is renumbered paragraph 5 and a new paragraph 3 is added to read as
     3  follows:
     4    (3)  Coverage  provided under this paragraph for detoxification, shall
     5  be at a minimum, seven days. Rehabilitation  services  shall  be,  at  a
     6  minimum, thirty days.
     7    §  6.  Paragraphs  3  and  4  of subsection (l) of section 4303 of the
     8  insurance law, as amended by chapter 41 of the laws of 2014, are amended
     9  to read as follows:
    10    (3) 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    (4) Coverage provided under this subsection may be subject  to  annual
    14  deductibles and co-insurance as deemed appropriate by the superintendent
    15  and  that  are  consistent with those imposed on other benefits within a
    16  given contract.
    17    [(4)] (5) A contract providing coverage  for  substance  use  disorder
    18  services  pursuant  to this subsection shall provide up to twenty outpa-
    19  tient visits per contract or calendar year to an individual who  identi-
    20  fies  him  or  herself  as  a  family  member of a person suffering from
    21  substance use disorder and who seeks treatment as a family member who is
    22  otherwise  covered  by  the  applicable  contract   pursuant   to   this
    23  subsection.  The  coverage  required  by  this  subsection shall include
    24  treatment as a family  member  pursuant  to  such  family  member's  own
    25  contract provided such family member:
    26    (A)  does not exceed the allowable number of family visits provided by
    27  the applicable contract pursuant to this subsection; and
    28    (B) is otherwise entitled to coverage pursuant to this subsection  and
    29  such family member's applicable contract.
    30    §  7.  This  act shall take effect on the thirtieth day after it shall
    31  have become a law.
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