Relates to mandating insurance coverage for medical devices and products to treat withdrawal symptoms which are approved by the food and drug administration.
STATE OF NEW YORK
________________________________________________________________________
7141
IN SENATE(Prefiled)
January 3, 2018
___________
Introduced by Sen. BROOKS -- 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 mandating insurance
coverage for medical devices to treat withdrawal symptoms
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraph (A) of paragraph 30 of subsection (i) of
2 section 3216 of the insurance law, as amended by section 1 of part B of
3 chapter 71 of the laws of 2016, is amended to read as follows:
4 (A) Every policy that provides hospital, major medical or similar
5 comprehensive coverage must provide inpatient coverage for the diagnosis
6 and treatment of substance use disorder, including detoxification and
7 rehabilitation services, including the use of medications, medical
8 devices and products approved by the food and drug administration for
9 the treatment of withdrawal symptoms. Such inpatient coverage shall
10 include unlimited medically necessary treatment for substance use disor-
11 der treatment services provided in residential settings as required by
12 the Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. §
13 1185a). Further, such inpatient coverage shall not apply financial
14 requirements or treatment limitations, including utilization review
15 requirements, to inpatient substance use disorder benefits that are more
16 restrictive than the predominant financial requirements and treatment
17 limitations applied to substantially all medical and surgical benefits
18 covered by the policy. Further, such coverage shall be provided consist-
19 ent with the federal Paul Wellstone and Pete Domenici Mental Health
20 Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
21 § 2. Subparagraph (A) of paragraph 31 of subsection (i) of section
22 3216 of the insurance law, as added by chapter 41 of the laws of 2014,
23 is amended to read as follows:
24 (A) Every policy that provides medical, major medical or similar
25 comprehensive-type coverage must provide outpatient coverage for the
26 diagnosis and treatment of substance use disorder, including detoxifica-
27 tion and rehabilitation services, including the use of medications,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13812-01-7
S. 7141 2
1 medical devices and products approved by the food and drug adminis-
2 tration for the treatment of withdrawal symptoms. Such coverage shall
3 not apply financial requirements or treatment limitations to outpatient
4 substance use disorder benefits that are more restrictive than the
5 predominant financial requirements and treatment limitations applied to
6 substantially all medical and surgical benefits covered by the policy.
7 Further, such coverage shall be provided consistent with the federal
8 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction
9 Equity Act of 2008 (29 U.S.C. § 1185a).
10 § 3. Paragraph 7-a of subsection (l) of section 3221 of the insurance
11 law, as added by section 2 of part B of chapter 69 of the laws of 2016,
12 is amended to read as follows:
13 (7-a) Every policy that provides medical, major medical or similar
14 comprehensive-type large group coverage shall provide coverage for medi-
15 cation for the detoxification or maintenance treatment, including
16 medical devices or products for the treatment of withdrawal symptoms, of
17 a substance use disorder approved by the food and drug administration
18 for the detoxification or maintenance treatment of substance use disor-
19 der.
20 § 4. Subsection (l-1) of section 4303 of the insurance law, as added
21 by section 3 of part B of chapter 69 of the laws of 2016, is amended to
22 read as follows:
23 (l-1) Every contract that provides medical, major medical, or similar
24 comprehensive-type large group coverage shall provide coverage for medi-
25 cation for the detoxification or maintenance treatment, including
26 medical devices or products for the treatment of withdrawal symptoms, of
27 a substance use disorder approved by the food and drug administration
28 for the detoxification or maintenance treatment of substance use disor-
29 der.
30 § 5. This act shall take effect on the first of January next succeed-
31 ing the date on which it shall have become a law and shall apply to
32 policies and contracts issued, renewed, modified, altered or amended on
33 and after such date.