NY State Senate Bill 2011-S4756

Senate Bill S4756

2011-2012 Legislative Session

Requires blanket health insurance policies to provide coverage for outpatient treatment by mental health practitioners

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 04, 2012	referred to insurance
Apr 18, 2011	referred to insurance

2011-S4756 (ACTIVE) - Details

See Assembly Version of this Bill:: A9186
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2013-2014: S2708, A978
2015-2016: S2065, A6376
2017-2018: S3952, A2163
2019-2020: S886, A670
2021-2022: A1171

2011-S4756 (ACTIVE) - Summary

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.

2011-S4756 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S4756

TITLE OF BILL:

An act
to amend the insurance law, in relation to health insurance coverage of
outpatient care provided by a mental health practitioner

PURPOSE:

The purpose of this bill is to require blanket health insurance
policies to provide coverage for outpatient treatment by mental
health practitioners.

SUMMARY OF PROVISIONS:

Section (1) would amend item (ii) of subparagraph (A) of paragraph 5
of subsection 1 of section 3221 of the insurance law to provide that
a group or accident and health insurance policy which provides
coverage for physician services must also provide coverage for
outpatient care by a mental health counselor, marriage and family
therapist, creative arts therapist or psychoanalyst licensed under
article one hundred sixty three of the education law.

Section 2 would amend paragraph 1 of subsection (h) of section 4303 of
the insurance law to require that a medical expense indemnity

corporation or health service corporation must provide coverage for
outpatient care by a mental health counselor, marriage and family
therapist, creative arts therapist or psychoanalyst licensed under
article one hundred sixty-three of the education law.

Section 3 states the enactment date.

EXISTING LAW:

Timothy's law currently requires an insurer to provide benefits for
the diagnosis and treatment of mental, nervous or emotional disorders
provided by a psychiatrist, psychologist or a licensed clinical
social worker.

JUSTIFICATION:

Current law does not explicitly include mental health practitioners as
allowable providers of outpatient mental health services, thereby
allowing insurers to deny coverage for the valuable services these
practitioners can provide.

Mental health practitioners licensed by the New York State Department
of Education face strict requirements for licensure, including the
requirement that they obtain a Master's degree or higher in a mental
health course of study. These requirements ensure that such
practitioner is fully capable of providing mental health therapy.

This bill would require insurers to reimburse mental health
practitioners, in addition to psychiatrists, psychologists or
licensed clinical social workers. This change will continue to serve


the intent of Timothy's Law by making needed mental health services
available to more patients. It will benefit rural areas especially,
where a patient may have limited access to a psychiatrist,
psychologist or a licensed clinical social worker. This amendment
will ensure that a patient is not denied mental health services
because the currently enumerated providers are located too far from
the patients home, or the patient is unable to afford the out of
pocket expense of a mental health practitioner. In addition, this
bill would amplify patient choice by increasing the variety and
number of reimbursable providers available to treat mental health
disorders.

LEGISLATIVE HISTORY:

This is a new bill.

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

This act shall take effect on the first of January next succeeding the
date on which it shall have become law and shall apply to policies
and contracts issued, renewed, modified, altered or amended on or
after such effective date.

2011-S4756 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4756

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             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:

  Section 1. Item (ii) of subparagraph (A) of paragraph 5 of  subsection
(1)  of  section 3221 of the insurance law, as amended by chapter 502 of
the laws of 2007, is amended to read as follows:
  (ii) where the policy provides coverage  for  physician  services,  it
shall include benefits for outpatient care provided by a psychiatrist or
psychologist  licensed  to  practice  in this state,  OR A MENTAL HEALTH
COUNSELOR, MARRIAGE AND FAMILY THERAPIST,  CREATIVE  ARTS  THERAPIST  OR
PSYCHOANALYST  LICENSED  PURSUANT  TO ARTICLE ONE HUNDRED SIXTY-THREE OF
THE EDUCATION LAW, OR a licensed clinical social worker  who  meets  the
requirements  of  subparagraph (D) of paragraph four of this subsection,
or a professional corporation or university faculty practice corporation
thereof. Such benefits may be limited to not less than twenty visits  in
any contract year, plan year, or calendar year.
  S  2.  Paragraph  1 of subsection (h) of section 4303 of the insurance
law, as amended by chapter 502 of the laws of 2007, is amended  to  read
as follows:
  (1) A medical expense indemnity corporation or a health service corpo-
ration,  which provides group, group remittance or school blanket cover-
age for physician services, shall provide as part of its contract broad-
based coverage for the diagnosis and treatment  of  mental,  nervous  or
emotional  disorders  or  ailments, however defined in such contract, at
least equal to the coverage provided for  other  health  conditions  and
shall  include:  benefits for outpatient care provided by a psychiatrist
or psychologist licensed to practice in this state, OR A  MENTAL  HEALTH
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

PSYCHOANALYST LICENSED PURSUANT TO ARTICLE ONE  HUNDRED  SIXTY-THREE  OF
THE  EDUCATION  LAW,  OR a licensed clinical social worker who meets the
requirements of subsection (n) of this section, or a professional corpo-
ration  or  university faculty practice corporation thereof, which bene-
fits may be limited to not less than twenty visits in any contract year,
plan year or calendar year. Such coverage may be provided on a  contract
year,  plan year or calendar year basis and shall be consistent with the
provision of other benefits under the contract.  Such  coverage  may  be
subject  to annual deductibles, co-pays and coinsurance as may be deemed
appropriate by the superintendent and shall  be  consistent  with  those
imposed  on  other  benefits  under the contract. In the event the group
remittance group or contract holder is provided coverage provided  under
this paragraph and under subparagraph (B) of paragraph one of subsection
(g) of this section from the same health service corporation, or under a
contract  which  is  jointly  underwritten  by two health service corpo-
rations or by a health service corporation and a medical expense  indem-
nity  corporation,  the  aggregate  of the benefits for out-patient care
obtained under subparagraph (B) of paragraph one of  subsection  (g)  of
this  section  and this paragraph may be limited to not less than twenty
visits in any contract year, plan year or calendar year.
  S 3. This act shall take effect on the first of January next  succeed-
ing  the  date  on  which  it shall have become a law and shall apply to
policies and contracts issued, renewed, modified, altered or amended  on
or after such effective date.

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