S07423 Summary:

BILL NOS07423
 
SAME ASNo same as
 
SPONSORPARKER
 
COSPNSR
 
MLTSPNSR
 
Amd S4326, Ins L
 
Provides coverage for biologically-based mental illness, psychiatric or psychological services or diagnosis or treatment of mental, nervous or emotional disorders or ailments under the Healthy New York program.
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S07423 Actions:

BILL NOS07423
 
05/14/2012REFERRED TO INSURANCE
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S07423 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7423
 
                    IN SENATE
 
                                      May 14, 2012
                                       ___________
 
        Introduced  by  Sen.  PARKER -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
 
        AN ACT to amend the insurance law, in relation to providing coverage for
          biologically-based mental illness under the Healthy New York program
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 

     1    Section  1.  Paragraphs 14 and 15 of subsection (d) of section 4326 of
     2  the insurance law, paragraph 14 as amended and paragraph 15 as added  by
     3  chapter  219  of the laws of 2011, are amended and a new paragraph 16 is
     4  added to read as follows:
     5    (14) prescription drugs obtained at a participating pharmacy. In addi-
     6  tion to providing coverage at a participating pharmacy,  health  mainte-
     7  nance  organizations may utilize a mail order prescription drug program.
     8  Health maintenance organizations may provide prescription drugs pursuant
     9  to a drug formulary;  however,  health  maintenance  organizations  must
    10  implement   an   appeals  process  so  that  the  use  of  non-formulary
    11  prescription drugs may be requested by a physician; [and]
    12    (15) for a contract that is  not  a  grandfathered  health  plan,  the
    13  following additional preventive health services:

    14    (A)  evidence-based  items or services that have in effect a rating of
    15  'A' or 'B' in the current recommendations of the United  States  preven-
    16  tive services task force;
    17    (B)  immunizations that have in effect a recommendation from the advi-
    18  sory committee on immunization practices  of  the  centers  for  disease
    19  control and prevention with respect to the individual involved;
    20    (C)  with  respect  to  children,  including  infants and adolescents,
    21  evidence-informed preventive care and screenings  provided  for  in  the
    22  comprehensive  guidelines supported by the health resources and services
    23  administration; and
    24    (D) with respect to women, such additional preventive care and screen-
    25  ings not described in subparagraph (A) of this paragraph as provided for
    26  in comprehensive  guidelines  supported  by  the  health  resources  and
    27  services administration.
 

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11682-02-2

        S. 7423                             2
 
     1    (E)  For purposes of this paragraph, "grandfathered health plan" means
     2  coverage provided by a corporation in which an individual  was  enrolled
     3  on  March  twenty-third,  two  thousand  ten for as long as the coverage
     4  maintains grandfathered status in accordance with section 1251(e) of the
     5  Affordable Care Act, 42 U.S.C. § 18011(e)[.]; and
     6    (16)  psychiatric  or psychological services or diagnosis or treatment
     7  of mental, nervous or emotional disorders or ailments and  biologically-
     8  based mental illness.

     9    § 2. This act shall take effect immediately.
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