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
________________________________________________________________________
4756
2011-2012 Regular Sessions
IN SENATE
April 18, 2011
___________
Introduced by Sen. YOUNG -- 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 health insurance
coverage of outpatient care provided by a mental health practitioner
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Item (ii) of subparagraph (A) of paragraph 5 of subsection
2 (1) of section 3221 of the insurance law, as amended by chapter 502 of
3 the laws of 2007, is amended to read as follows:
4 (ii) where the policy provides coverage for physician services, it
5 shall include benefits for outpatient care provided by a psychiatrist or
6 psychologist licensed to practice in this state, or a mental health
7 counselor, marriage and family therapist, creative arts therapist or
8 psychoanalyst licensed pursuant to article one hundred sixty-three of
9 the education law, or a licensed clinical social worker who meets the
10 requirements of subparagraph (D) of paragraph four of this subsection,
11 or a professional corporation or university faculty practice corporation
12 thereof. Such benefits may be limited to not less than twenty visits in
13 any contract year, plan year, or calendar year.
14 § 2. Paragraph 1 of subsection (h) of section 4303 of the insurance
15 law, as amended by chapter 502 of the laws of 2007, is amended to read
16 as follows:
17 (1) A medical expense indemnity corporation or a health service corpo-
18 ration, which provides group, group remittance or school blanket cover-
19 age for physician services, shall provide as part of its contract broad-
20 based coverage for the diagnosis and treatment of mental, nervous or
21 emotional disorders or ailments, however defined in such contract, at
22 least equal to the coverage provided for other health conditions and
23 shall include: benefits for outpatient care provided by a psychiatrist
24 or psychologist licensed to practice in this state, or a mental health
25 counselor, marriage and family therapist, creative arts therapist or
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD10925-01-1
S. 4756 2
1 psychoanalyst licensed pursuant to article one hundred sixty-three of
2 the education law, or a licensed clinical social worker who meets the
3 requirements of subsection (n) of this section, or a professional corpo-
4 ration or university faculty practice corporation thereof, which bene-
5 fits may be limited to not less than twenty visits in any contract year,
6 plan year or calendar year. Such coverage may be provided on a contract
7 year, plan year or calendar year basis and shall be consistent with the
8 provision of other benefits under the contract. Such coverage may be
9 subject to annual deductibles, co-pays and coinsurance as may be deemed
10 appropriate by the superintendent and shall be consistent with those
11 imposed on other benefits under the contract. In the event the group
12 remittance group or contract holder is provided coverage provided under
13 this paragraph and under subparagraph (B) of paragraph one of subsection
14 (g) of this section from the same health service corporation, or under a
15 contract which is jointly underwritten by two health service corpo-
16 rations or by a health service corporation and a medical expense indem-
17 nity corporation, the aggregate of the benefits for out-patient care
18 obtained under subparagraph (B) of paragraph one of subsection (g) of
19 this section and this paragraph may be limited to not less than twenty
20 visits in any contract year, plan year or calendar year.
21 § 3. This act shall take effect on the first of January next succeed-
22 ing the date on which it shall have become a law and shall apply to
23 policies and contracts issued, renewed, modified, altered or amended on
24 or after such effective date.
