NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A5219
SPONSOR: Cusick (MS)
 
TITLE OF BILL:
An act to amend the insurance law, in relation to post traumatic stress
disorder
 
PURPOSE OR GENERAL IDEA OF BILL:
This legislation would include post traumatic stress disorder (PTSD)
among the list of biologically based mental illnesses that would be
covered under Timothy's Mental Health Parity Law.
 
SUMMARY OF SPECIFIC PROVISIONS:
Sections one, two and three of the bill amends sections 3221 and 4303 of
the insurance law to include post traumatic stress disorder among the
list of biologically based mental illnesses to be covered.
Section four of the bill provides for an effective date.
 
JUSTIFICATION:
A number of important physiological differences have been found in indi-
viduals diagnosed with PTSD compared with individuals without the disor-
der which support the inclusion of PTSD within the list of biologically
based mental illnesses that are covered under NYS's Mental Health Parity
Law. For example, brain imaging studies demonstrate increased cerebral
blood flow in regions associated with memory and emotional regulation.
Hormonal abnormalities have been found in domestic violence victims
suffering from PTSD and are thought to explain why individuals with PTSD
are kept in a constant heightened state of readiness for threat despite
not encountering actual danger. PTSD is also linked to metabolic changes
and cellular damage in the cingulate gyrus, the limbic region responsi-
ble for autonomic nervous system functioning, such as cognitive process-
ing, blood pressure and heart rate regulation.
While the prevalence of PTSD in the general population is small, it is
relatively high when you look at certain subgroups of the population
that are affected by it. Veterans who have been in combat, victims of
violent crimes such as rape, survivors of childhood abuse, and persons
exposed to catastrophic events such as natural disasters or terrorism
all suffer from much higher rates of PTSD. Additionally the symptoms are
very real and debilitating. Left untreated, PTSD is highly associated
with serious medical ailments leading to significant physical debili-
tation and even premature death. Further, suicide risk for PTSD patients
is considerably higher than among unaffected populations.
New York State adopted Mental Health Parity under Timothy's Law in 2006
and made it permanent in 2009. New York State should work to include
PTSD among the disorders covered under the Parity Law. By doing so we
will be making sure that our returning veterans, victims of abuse or and
other violent crimes and others suffering from PTSD are afforded the
care they need through their insurance coverage to address their
disease.
 
PRIOR LEGISLATIVE HISTORY:
2013-2014: S.1778 - Died in Insurance/ A.5413 - Died in Insurance
2009-2010: S.185 - Passed Senate. A.4572 - Died in Insurance.
2008-2009: S.6818 - Held on Senate Calendar. A.10078 - Died in Ways and
Means.
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
90 days after enactment provided that this bill shall apply to policies
and contracts issued, renewed, modified, altered or amended on or after
such effective date.
STATE OF NEW YORK
________________________________________________________________________
5219
2015-2016 Regular Sessions
IN ASSEMBLY
February 13, 2015
___________
Introduced by M. of A. CUSICK, TITONE, ABINANTI -- read once and
referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to post traumatic stress
disorder
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Clause (ii) of subparagraph (B) of paragraph 5 of
2 subsection (1) of section 3221 of the insurance law, as amended by chap-
3 ter 502 of the laws of 2007, is amended to read as follows:
4 (ii) For purposes of this paragraph, the term "biologically based
5 mental illness" means a mental, nervous, or emotional condition that is
6 caused by a biological disorder of the brain and results in a clinically
7 significant, psychological syndrome or pattern that substantially limits
8 the functioning of the person with the illness. Such biologically based
9 mental illnesses are defined as schizophrenia/psychotic disorders, major
10 depression, bipolar disorder, delusional disorders, panic disorder,
11 obsessive compulsive disorders, bulimia, [and] anorexia, and post trau-
12 matic stress disorder.
13 § 2. Subparagraph (B) of paragraph 2 of subsection (g) of section 4303
14 of the insurance law, as amended by chapter 502 of the laws of 2007, is
15 amended to read as follows:
16 (B) For purposes of this subsection, the term "biologically based
17 mental illness" means a mental, nervous, or emotional condition that is
18 caused by a biological disorder of the brain and results in a clinically
19 significant, psychological syndrome or pattern that substantially limits
20 the functioning of the person with the illness. Such biologically based
21 mental illnesses are defined as schizophrenia/psychotic disorders, major
22 depression, bipolar disorder, delusional disorders, panic disorder,
23 obsessive compulsive disorders, anorexia, [and] bulimia, and post trau-
24 matic stress disorder.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08708-01-5
A. 5219 2
1 § 3. Subparagraph (B) of paragraph 2 of subsection (h) of section 4303
2 of the insurance law, as amended by chapter 502 of the laws of 2007, is
3 amended to read as follows:
4 (B) For purposes of this subsection, the term "biologically based
5 mental illness" means a mental, nervous, or emotional condition that is
6 caused by a biological disorder of the brain and results in a clinically
7 significant, psychological syndrome or pattern that substantially limits
8 the functioning of the person with the illness. Such biologically based
9 mental illnesses are defined as schizophrenia/psychotic disorders, major
10 depression, bipolar disorder, delusional disorders, panic disorder,
11 obsessive compulsive disorder, anorexia, [and] bulimia, and post trau-
12 matic stress disorder.
13 § 4. This act shall take effect on the ninetieth day after it shall
14 have become a law; provided, however, that the provisions of this act
15 shall apply to policies and contracts issued, renewed, modified, altered
16 or amended on or after such effective date.