S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9079
 
                           I N  A S S E M B L Y
 
                             January 18, 2018
                                ___________
 
 Introduced  by M. of A. GUNTHER -- read once and referred to the Commit-
   tee on Insurance
 
 AN ACT to amend the insurance law, in relation to substance use disorder
   coverage
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The opening paragraph of subparagraph (A) of paragraph 5 of
 subsection (1) of section 3221 of the insurance law, as amended by chap-
 ter 502 of the laws of 2007, is amended to read as follows:
   Every insurer delivering a group or school blanket policy or issuing a
 group  or  school  blanket  policy  for  delivery,  in this state, which
 provides coverage for inpatient hospital care or coverage for  physician
 services  shall  provide as part of such policy broad-based coverage for
 the diagnosis and treatment  of  mental,  nervous  [or],  emotional,  OR
 SUBSTANCE  USE disorders or ailments, however defined in such policy, at
 least equal to the coverage provided for other health conditions and:
   § 2. The opening paragraph of subsection (g) of section  4303  of  the
 insurance law, as amended by chapter 502 of the laws of 2007, is amended
 to read as follows:
   A  hospital service corporation or a health service corporation, which
 provides group, group remittance or school blanket  coverage  for  inpa-
 tient  hospital  care, shall provide as part of its contract broad-based
 coverage for the  diagnosis  and  treatment  of  mental,  nervous  [or],
 emotional,  OR  SUBSTANCE  USE disorders or ailments, however defined in
 such contract, at least equal to the coverage provided for other  health
 conditions and shall include:
   §  3.  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,  OR  SUBSTANCE  USE disorders or ailments, however defined in
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD13169-01-7

 A. 9079                             2
 
 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, a
 licensed clinical social worker who meets the requirements of subsection
 (n) of this section, or a professional corporation or university faculty
 practice  corporation thereof, which benefits 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  superinten-
 dent  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  subpara-
 graph  (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 corporations or by a health service
 corporation and a medical expense indemnity 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.
   § 4. Paragraph 4 of subsection (i) of section 3216  of  the  insurance
 law is amended to read as follows:
   (4)  If a policy provides for reimbursement for psychiatric or psycho-
 logical services or for diagnosis and treatment of mental, nervous, [or]
 emotional, OR SUBSTANCE USE disorders or ailments,  however  defined  in
 the  policy,  the  insured  shall  be entitled to reimbursement for such
 services, diagnosis or  treatment  whether  performed  by  a  physician,
 psychiatrist  or  a  certified  and  registered  psychologist,  when the
 services rendered are within the lawful scope of their practice.
   § 5. 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 all
 policies and contracts issued, renewed, modified, altered or amended  on
 or after such date.