Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.
STATE OF NEW YORK
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2644
2025-2026 Regular Sessions
IN SENATE
January 22, 2025
___________
Introduced by Sen. ADDABBO -- 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 prohibiting the retro-
spective denial of payment 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. The insurance law is amended by adding a new section 3246
2 to read as follows:
3 § 3246. Retrospective denial of payment of substance use disorder
4 treatment services. Notwithstanding any other provision of law, any
5 retrospective denial of payment of substance use disorder treatment
6 services provided that are based on the insured individual's eligibility
7 shall be prohibited after the provider has verified with the insurer
8 that the insured has coverage for such treatment at the time such treat-
9 ment was initiated. The insurer shall immediately notify the treatment
10 provider when an insured has lost coverage based on termination of the
11 insured's employment and provided, further, that denial of coverage
12 shall be based on termination of employment and shall not be based on
13 suspension of employment. Failure of the insurer to immediately notify
14 the treatment provider of such termination of employment shall preclude
15 any retrospective review based on the insured's eligibility. This
16 section shall be applicable to the New York state health insurance
17 program.
18 § 2. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07028-01-5
