Amd §§3216, 3221 & 4303, rpld §3221 sub§ (l) ¶4 sub¶ (D), §4303 sub§ (i), Ins L
 
Requires blanket health insurance policies to provide coverage for outpatient treatment by mental health practitioners (mental health counsellors, marriage and family therapists, creative arts therapists and psychoanalysts) licensed pursuant to article 163 of the education law.
STATE OF NEW YORK
________________________________________________________________________
1171--A
2021-2022 Regular Sessions
IN ASSEMBLY
January 7, 2021
___________
Introduced by M. of A. BRONSON, CLARK, LUNSFORD, MEEKS, WALLACE,
BUTTENSCHON, ROZIC, SANTABARBARA, LUPARDO, HUNTER, GUNTHER, STECK,
STIRPE, JONES, MAGNARELLI, FAHY, McMAHON, BARRETT, WOERNER, WEPRIN,
GOTTFRIED, CRUZ, CARROLL -- read once and referred 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, item (i) as amended
3 by section 12 of part AA of chapter 57 of the laws of 2021 and item (ii)
4 as added by section 8 of subpart A of part BB of chapter 57 of the laws
5 of 2019, are amended to read as follows:
6 (i) where the policy provides coverage for inpatient hospital care,
7 such policy shall include benefits for inpatient care in a hospital as
8 defined by subdivision ten of section 1.03 of the mental hygiene law and
9 benefits for outpatient care provided in a facility issued an operating
10 certificate by the commissioner of mental health pursuant to the
11 provisions of article thirty-one of the mental hygiene law, or in a
12 facility operated by the office of mental health, or in a crisis
13 stabilization center licensed pursuant to section 36.01 of the mental
14 hygiene law, or, for care provided in other states, to similarly
15 licensed or certified hospitals or facilities; and
16 (ii) where the policy provides coverage for physician services, such
17 policy shall include benefits for outpatient care provided by a psychia-
18 trist or psychologist licensed to practice in this state, a licensed
19 clinical social worker [who meets the requirements of subparagraph (D)
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05221-02-1
A. 1171--A 2
1 of paragraph four of subsection (1) of section three thousand two
2 hundred twenty-one of this article,] within the lawful scope of his or
3 her practice, who is licensed pursuant to article one hundred fifty-four
4 of the education law, a mental health counselor, marriage and family
5 therapist, creative arts therapist or psychoanalyst licensed pursuant to
6 article one hundred sixty-three of the education law, a nurse practi-
7 tioner licensed to practice in this state, or a professional corporation
8 or university faculty practice corporation thereof. Nothing herein
9 shall be construed to modify or expand the scope of practice of a mental
10 health counselor, marriage and family therapist, creative arts therapist
11 or psychoanalyst licensed pursuant to article one hundred sixty-three of
12 the education law. Further, nothing herein shall be construed to create
13 a new mandated health benefit.
14 § 2. Subparagraph (A) of paragraph 4 of subsection (l) of section 3221
15 of the insurance law, as amended by section 11 of subpart A of part BB
16 of chapter 57 of the laws of 2019, is amended to read as follows:
17 (A) Every insurer delivering a group policy or issuing a group policy
18 for delivery, in this state, that provides reimbursement for psychiatric
19 or psychological services or for the diagnosis and treatment of mental
20 health conditions, however defined in such policy, by physicians,
21 psychiatrists or psychologists, shall [make available and if requested
22 by the policyholder] provide the same coverage to insureds for such
23 services when performed by a licensed clinical social worker, within the
24 lawful scope of his or her practice, who is licensed pursuant to article
25 one hundred fifty-four of the education law[. Written notice of the
26 availability of such coverage shall be delivered to the policyholder
27 prior to inception of such group policy and annually thereafter, except
28 that this notice shall not be required where a policy covers two hundred
29 or more employees or where the benefit structure was the subject of
30 collective bargaining affecting persons who are employed in more than
31 one state.] and mental health counselors, marriage and family thera-
32 pists, creative arts therapists and psychoanalysts licensed pursuant to
33 article one hundred sixty-three of the education law, within the lawful
34 scope of his or her practice. Nothing herein shall be construed to modi-
35 fy or expand the scope of practice of a mental health counselor,
36 marriage and family therapist, creative arts therapist or psychoanalyst
37 licensed pursuant to article one hundred sixty-three of the education
38 law. Further, nothing herein shall be construed to create a new mandated
39 health benefit.
40 § 3. Subparagraph (D) of paragraph 4 of subsection (l) of section 3221
41 of the insurance law is REPEALED.
42 § 4. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of
43 section 3221 of the insurance law, as amended by section 13 of subpart A
44 of part BB of chapter 57 of the laws of 2019, is amended to read as
45 follows:
46 (ii) where the policy provides coverage for physician services, it
47 shall include benefits for outpatient care provided by a psychiatrist or
48 psychologist licensed to practice in this state, or a mental health
49 counselor, marriage and family therapist, creative arts therapist or
50 psychoanalyst licensed pursuant to article one hundred sixty-three of
51 the education law, or a licensed clinical social worker [who meets the
52 requirements of subparagraph (D) of paragraph four of this subsection]
53 within the lawful scope of his or her practice, who is licensed pursuant
54 to article one hundred fifty-four of the education law, a nurse practi-
55 tioner licensed to practice in this state, or a professional corporation
56 or university faculty practice corporation thereof. Nothing herein shall
A. 1171--A 3
1 be construed to modify or expand the scope of practice of a mental
2 health counselor, marriage and family therapist, creative arts therapist
3 or psychoanalyst licensed pursuant to article one hundred sixty-three of
4 the education law. Further, nothing herein shall be construed to create
5 a new mandated health benefit.
6 § 5. Paragraph 2 of subsection (g) of section 4303 of the insurance
7 law, as added by section 22 of subpart A of part BB of chapter 57 of the
8 laws of 2019, is amended to read as follows:
9 (2) where the contract provides coverage for physician services such
10 contract shall provide benefits for outpatient care provided by a
11 psychiatrist or psychologist licensed to practice in this state, or a
12 mental health counselor, marriage and family therapist, creative arts
13 therapist or psychoanalyst licensed pursuant to article one hundred
14 sixty-three of the education law, or a licensed clinical social worker
15 [who meets the requirements of subsection (n) of this section] within
16 the lawful scope of his or her practice, who is licensed pursuant to
17 article one hundred fifty-four of the education law, a nurse practition-
18 er licensed to practice [on] in this state, or professional corporation
19 or university faculty practice corporation thereof. Nothing herein shall
20 be construed to modify or expand the scope of practice of a mental
21 health counselor, marriage and family therapist, creative arts therapist
22 or psychoanalyst licensed pursuant to article one hundred sixty-three of
23 the education law. Further, nothing herein shall be construed to create
24 a new mandated health benefit.
25 § 6. Subsection (i) of section 4303 of the insurance law is REPEALED.
26 § 7. Subsection (n) of section 4303 of the insurance law, as amended
27 by section 30 of subpart A of part BB of chapter 57 of the laws of 2019,
28 is amended to read as follows:
29 (n) [In addition to the requirements of subsection (i) of this
30 section, every] Every health service or medical expense indemnity corpo-
31 ration issuing a group contract pursuant to this section or a group
32 remittance contract for delivery in this state which contract provides
33 reimbursement to subscribers or physicians, psychiatrists or psychol-
34 ogists for psychiatric or psychological services or for the diagnosis
35 and treatment of mental health conditions, however defined in such
36 contract, must provide the same coverage to persons covered under the
37 group contract for such services when performed by a licensed clinical
38 social worker, within the lawful scope of his or her practice, who is
39 licensed pursuant to [subdivision two of section seven thousand seven
40 hundred four of the education law and in addition shall have either (i)
41 three or more additional years experience in psychotherapy, which for
42 the purposes of this subsection shall mean the use of verbal methods in
43 interpersonal relationships with the intent of assisting a person or
44 persons to modify attitudes and behavior which are intellectually,
45 socially or emotionally maladaptive, under supervision, satisfactory to
46 the state board for social work, in a facility, licensed or incorporated
47 by an appropriate governmental department, providing services for diag-
48 nosis or treatment of mental health conditions, or (ii) three or more
49 additional years experience in psychotherapy under the supervision,
50 satisfactory to the state board for social work, of a psychiatrist, a
51 licensed and registered psychologist or a licensed clinical social work-
52 er qualified for reimbursement pursuant to subsection (i) of this
53 section, or (iii) a combination of the experience specified in para-
54 graphs (i) and (ii) totaling three years, satisfactory to the state
55 board for social work.] article one hundred fifty-four of the education
56 law and a mental health counselor, marriage and family therapist, crea-
A. 1171--A 4
1 tive arts therapist or psychoanalyst licensed pursuant to article one
2 hundred sixty-three of the education law. Nothing herein shall be
3 construed to modify or expand the scope of practice of a mental health
4 counselor, marriage and family therapist, creative arts therapist or
5 psychoanalyst licensed pursuant to article one hundred sixty-three of
6 the education law. Further, nothing herein shall be construed to create
7 a new mandated health benefit. The state board for social work shall
8 maintain a list of all licensed clinical social workers qualified for
9 reimbursement under this subsection. The state board for mental health
10 practitioners shall maintain a list of all licensed mental health coun-
11 selors, marriage and family therapists, creative arts therapists or
12 psychoanalysts qualified for reimbursement under this subsection.
13 § 8. This act shall take effect on the first of January next succeed-
14 ing the date upon which it shall have become a law; provided, however,
15 that the amendments made to item (i) of subparagraph (A) of paragraph 35
16 of subsection (i) of section 3216 of the insurance law made by section
17 one of this act shall take effect on the same date and in the same
18 manner as part AA of chapter 57 of the laws of 2021 takes effect; and
19 provided further, shall apply to policies and contracts issued, renewed,
20 modified, altered or amended on or after such effective date.