STATE OF NEW YORK
________________________________________________________________________
8064
IN SENATE
March 23, 2018
___________
Introduced by Sens. AKSHAR, AMEDORE, HANNON, JACOBS -- 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 providing that cover-
age for outpatient diagnosis and treatment of substance use disorder
shall not be subject to preauthorization
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 31 of subsection (i) of
2 section 3216 of the insurance law, as added by chapter 41 of the laws of
3 2014, is amended to read as follows:
4 (A) Every policy that provides medical, major medical or similar
5 comprehensive-type coverage must provide outpatient coverage for the
6 diagnosis and treatment of substance use disorder, including detoxifica-
7 tion and rehabilitation services. Such coverage shall not be subject to
8 preauthorization and shall not apply financial requirements or treatment
9 limitations to outpatient substance use disorder benefits that are more
10 restrictive than the predominant financial requirements and treatment
11 limitations applied to substantially all medical and surgical benefits
12 covered by the policy. Further, such coverage shall be provided
13 consistent with the federal Paul Wellstone and Pete Domenici Mental
14 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
15 § 2. Subparagraph (A) of paragraph 7 of subsection (1) of section 3221
16 of the insurance law, as amended by chapter 41 of the laws of 2014, is
17 amended to read as follows:
18 (A) Every policy that provides medical, major medical or similar
19 comprehensive-type coverage must provide outpatient coverage for the
20 diagnosis and treatment of substance use disorder, including detoxifica-
21 tion and rehabilitation services. Such coverage shall not be subject to
22 preauthorization and shall not apply financial requirements or treatment
23 limitations to outpatient substance use disorder benefits that are more
24 restrictive than the predominant financial requirements and treatment
25 limitations applied to substantially all medical and surgical benefits
26 covered by the policy. Further, such coverage shall be provided
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD14728-01-8
S. 8064 2
1 consistent with the federal Paul Wellstone and Pete Domenici Mental
2 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
3 § 3. Paragraph 1 of subsection (l) of section 4303 of the insurance
4 law, as amended by chapter 41 of the laws of 2014, is amended to read as
5 follows:
6 (1) Every contract that provides medical, major medical or similar
7 comprehensive-type coverage must provide outpatient coverage for the
8 diagnosis and treatment of substance use disorder, including detoxifica-
9 tion and rehabilitation services. Such coverage shall not be subject to
10 preauthorization and shall not apply financial requirements or treatment
11 limitations to outpatient substance use disorder benefits that are more
12 restrictive than the predominant financial requirements and treatment
13 limitations applied to substantially all medical and surgical benefits
14 covered by the contract. Further, such coverage shall be provided
15 consistent with the federal Paul Wellstone and Pete Domenici Mental
16 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
17 § 4. This act shall take effect immediately, and shall apply to
18 polices and contracts issued, renewed, modified, altered or amended on
19 or after such date.
