NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1921B
SPONSOR: Paulin TITLE OF BILL:
An act to amend the insurance law, in relation to providing insurance
coverage for non-pharmacological treatments and non-opioid drugs for
chronic pain
PURPOSE OF BILL:
Provides outpatient insurance coverage for non-opioid treatment of
chronic pain including complementary and integrative treatments.
SUMMARY OF PROVISIONS:
Section 1 amends subsection (i) of section 3216 of the Insurance Law, by
adding a new paragraph 42 to require policies offering medical, major
medical, or similar comprehensive coverage to include outpatient cover-
age for non-opioid treatment of chronic pain, encompassing complementary
and integrative treatments and this coverage would be on par with other
covered services and provided by licensed professionals. Notably, the
provision prohibits imposing financial requirements or treatment limita-
tions on non-opioid chronic pain treatment that are more restrictive
than those for medical benefits in general or for opioid-based chronic
pain treatment. Key definitions are provided such as "financial require-
ment," "predominant," "treatment limitation," and "chronic pain," to
ensure clarity and consistency in implementation.
Section 2 amends subsection (1) of section 3221 of the Insurance Law, by
adding a new paragraph 23, extending coverage for pain management
services in group or blanket insurance policies, substantially similar
to those outlined in section 1.
Section 3 amends section 4303 of the Insurance law, by adding a new
subsection (xx) to extend coverage for pain management services in
contracts issued by hospital service corporations, health service corpo-
rations, or medical expense indemnity corporations, substantially simi-
lar to those outlined in section 1.
Section 4 provides the effective date.
JUSTIFICATION:
Chronic pain affects millions of individuals across the United States,
spanning a spectrum of conditions such as arthritis, migraines, cancer,
neuropathic pain, and more. Unfortunately, conventional approaches to
managing chronic pain often rely heavily on opioid medications, despite
their well-documented risks of addiction, overdose, and other adverse
effects. This reliance on opioids not only poses significant health
risks to patients but also contributes to the ongoing opioid epidemic,
which has ravaged communities nationwide.
Fortunately, there exists a diverse array of non-opioid treatments for
chronic pain, which have demonstrated efficacy in managing certain types
of chronic pain according to the Federal Centers for Disease Control and
Prevention and the National Institutes of Health. Additionally, non-
pharmacological interventions such as acupuncture and chiropractic care,
physical therapy, and cognitive-behavioral therapy offer alternative
approaches to pain management that can be both effective and safer than
opioids.
However, access to these non-opioid treatments has been limited for many
individuals, often due to barriers such as lack of insurance coverage
and financial constraints. The proposed bill seeks to address this
disparity by mandating insurance coverage for non-opioid treatments for
chronic pain, encompassing both pharmacological and non-pharmacological
interventions. By ensuring that these treatments are readily accessible
and on par with conventional medical benefits, the bill aims to remove
financial barriers and treatment limitations that may prevent individ-
uals from seeking alternative pain management options.
In doing so, the bill not only empowers patients to explore safer and
more effective alternatives to opioids but also promotes a holistic
approach to pain management that considers the individual needs and
preferences of each patient. Moreover, by expanding access to non-opioid
treatments, including medication, the bill has the potential to mitigate
the risks associated with opioid use and contribute to border efforts to
combat the opioid epidemic.
This bill represents a significant step towards addressing a critical
public health issue and advancing the well-being of individuals with
chronic pain across the nation. By promoting evidence-based, patient-
centered care and reducing reliance on opioids, the bill underscores a
commitment to fostering safer, more sustainable approaches to pain
management in The State of New York.
LEGISLATIVE HISTORY:
2024: S9192 Rivera / A9716 Paulin
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
Undetermined.
EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law and shall apply to all policies
and contracts issued, renewed, modified, altered, or amended on or after
such date.
