Requires all policies that provide coverage for inpatient hospital care to include benefits for child and family treatment and support services and children's home and community based services.
STATE OF NEW YORK
________________________________________________________________________
5389
2025-2026 Regular Sessions
IN ASSEMBLY
February 13, 2025
___________
Introduced by M. of A. WEPRIN -- read once and referred to the Committee
on Insurance
AN ACT to amend the insurance law, in relation to requiring insurance
coverage for child and family treatment and support services and chil-
dren's home and community based services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Item (i) of subparagraph (A) of paragraph 35 of subsection
2 (i) of section 3216 of the insurance law, as amended by section 1 of
3 subpart A of part II of chapter 57 of the laws of 2023, is amended to
4 read as follows:
5 (i) where the policy provides coverage for inpatient hospital care,
6 such policy shall include benefits for: inpatient care in a hospital as
7 defined by subdivision ten of section 1.03 of the mental hygiene law;
8 sub-acute care in a residential facility licensed or operated by the
9 office of mental health; outpatient care provided by a facility issued
10 an operating certificate by the commissioner of mental health pursuant
11 to the provisions of article thirty-one of the mental hygiene law or by
12 a facility operated by the office of mental health; outpatient care
13 provided by a crisis stabilization center licensed pursuant to section
14 36.01 of the mental hygiene law; outpatient care provided by a mobile
15 crisis intervention services provider licensed, certified, or designated
16 by the office of mental health or the office of addiction services and
17 supports; outpatient and inpatient care for critical time intervention
18 services and outpatient care for assertive community treatment services
19 provided by facilities issued an operating certificate by the commis-
20 sioner of mental health pursuant to the provisions of article thirty-one
21 of the mental hygiene law, beginning no later than thirty days following
22 discharge from a hospital as defined by subdivision ten of section 1.03
23 of the mental hygiene law or the emergency department of a hospital
24 licensed pursuant to article twenty-eight of the public health law;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07845-01-5
A. 5389 2
1 child and family treatment and support services; children's home and
2 community based services; or, for care provided in other states, to
3 similarly licensed or certified hospitals, facilities, or licensed,
4 certified or designated providers; and
5 § 2. Item (i) of subparagraph (A) of paragraph 5 of subsection (l) of
6 section 3221 of the insurance law, as amended by section 5 of subpart A
7 of part II of chapter 57 of the laws of 2023, is amended to read as
8 follows:
9 (i) where the policy provides coverage for inpatient hospital care,
10 benefits for: inpatient care in a hospital as defined by subdivision ten
11 of section 1.03 of the mental hygiene law; sub-acute care in a residen-
12 tial facility licensed or operated by the office of mental health;
13 outpatient care provided by a facility issued an operating certificate
14 by the commissioner of mental health pursuant to the provisions of arti-
15 cle thirty-one of the mental hygiene law, or by a facility operated by
16 the office of mental health; outpatient care provided by a crisis
17 stabilization center licensed pursuant to section 36.01 of the mental
18 hygiene law; outpatient care provided by a mobile crisis intervention
19 services provider licensed, certified, or designated by the office of
20 mental health or the office of addiction services and supports; outpa-
21 tient and inpatient care for critical time intervention services and
22 outpatient care for assertive community treatment services provided by
23 facilities issued an operating certificate by the commissioner of mental
24 health pursuant to the provisions of article thirty-one of the mental
25 hygiene law, beginning no later than thirty days following discharge
26 from a hospital as defined by subdivision ten of section 1.03 of the
27 mental hygiene law or the emergency department of a hospital licensed
28 pursuant to article twenty-eight of the public health law; child and
29 family treatment and support services; children's home and community
30 based services; or, for care provided in other states, to similarly
31 licensed or certified hospitals, facilities, or licensed, certified or
32 designated providers; and
33 § 3. Paragraph 1 of subsection (g) of section 4303 of the insurance
34 law, as amended by section 9 of subpart A of part II of chapter 57 of
35 the laws of 2023, is amended to read as follows:
36 (1) where the contract provides coverage for inpatient hospital care,
37 benefits for: in-patient care in a hospital as defined by subdivision
38 ten of section 1.03 of the mental hygiene law; sub-acute care in a resi-
39 dential facility licensed or operated by the office of mental health;
40 outpatient care provided by a facility issued an operating certificate
41 by the commissioner of mental health pursuant to the provisions of arti-
42 cle thirty-one of the mental hygiene law or by a facility operated by
43 the office of mental health; outpatient care provided by a crisis
44 stabilization center licensed pursuant to section 36.01 of the mental
45 hygiene law; outpatient care provided by a mobile crisis intervention
46 services provider licensed, certified, or designated by the office of
47 mental health or the office of addiction services and supports; outpa-
48 tient and inpatient care for critical time intervention services and
49 outpatient care for assertive community treatment services provided by
50 facilities issued an operating certificate by the commissioner of mental
51 health pursuant to the provisions of article thirty-one of the mental
52 hygiene law, beginning no later than thirty days following discharge
53 from a hospital as defined by subdivision ten of section 1.03 of the
54 mental hygiene law or the emergency department of a hospital licensed
55 pursuant to article twenty-eight of the public health law; child and
56 family treatment and support services; children's home and community
A. 5389 3
1 based services; or for care provided in other states, to similarly
2 licensed or certified hospitals, facilities, or licensed, certified or
3 designated providers; and
4 § 4. This act shall take effect January 1, 2026 and shall apply to
5 policies and contracts issued, renewed, amended, modified or altered on
6 or after such date; provided, however, that:
7 (a) if section 1 of subpart A of part II of chapter 57 of the laws of
8 2023 shall not have taken effect on or before such date, then section
9 one of this act shall take effect on the same date and in the same
10 manner as such section of such subpart of such part of such chapter of
11 the laws of 2023, takes effect;
12 (b) if section 5 of subpart A of part II of chapter 57 of the laws of
13 2023 shall not have taken effect on or before such date, then section
14 two of this act shall take effect on the same date and in the same
15 manner as such section of such subpart of such part of such chapter of
16 the laws of 2023, takes effect; and
17 (c) if section 9 of subpart A of part II of chapter 57 of the laws of
18 2023 shall not have taken effect on or before such date, then section
19 three of this act shall take effect on the same date and in the same
20 manner as such section of such subpart of such part of such chapter of
21 the laws of 2023, takes effect.
