NY State Senate Bill 2019-S333

Senate Bill S333

2019-2020 Legislative Session

Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization

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

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2020	referred to insurance
Jan 09, 2019	referred to insurance

2019-S333 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2017-2018: S8064
2021-2022: S1915
2023-2024: S4842

2019-S333 (ACTIVE) - Summary

Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization.

2019-S333 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S333

SPONSOR: AKSHAR
 
TITLE OF BILL:  An act to amend the insurance law, in relation to
providing that coverage for outpatient diagnosis and treatment of
substance use disorder shall not be subject to preauthorization

 
PURPOSE:

To amend the Insurance Law by prohibiting preauthorization for coverage
of outpatient diagnosis and treatment of substance use disorder.

 
SUMMARY OF PROVISIONS:

Sections one, two and three of this bill amends various sections of the
insurance law, as amended by chapter 41 of the laws of 2014, by stating
that coverage for outpatient diagnosis and treatment of substance use
disorder provided by policies providing medical coverage shall not be
subject to preauthorization.

Section four provides that the act shall take effect immediately after

its enactment, and shall apply to policies and contracts issued,
renewed, modified, altered or amended on or after such date.

 
JUSTIFICATION:

The aim of this bill is to work towards removing one of the many exist-
ent barriers to substance use treatment. In 2016, the Senate's Task
Force on Heroin and Opioid Addiction released a report with recommenda-
tions. Many of the recommendations were adopted that year, including
provisions which made it easier of people to access treatment, by among
other things, requiring health plan coverage, without preauthorization,
of in-network inpatient treatment by OASAS certified providers. The
state also adopted legislation to prohibit for the first 14 days of
treatment concurrent utilization review.

This legislation builds upon those reforms, by prohibiting preauthori-
zation for outpatient treatment of substance use disorder, making it
easier to access treatment and maintain sobriety.

 
LEGISLATIVE HISTORY:

2018 - S.8046: Referred to Insurance

 
FISCAL IMPLICATIONS:

To be determined, provided savings should accrue as those ready for
recovery can access outpatient care quickly and avoid the costly conse-
quences of returning to abusing substances.

 
EFFECTIVE DATE:
This act shall take effect immediately, and shall apply to policies and
contracts issued, renewed, modified, altered or amended on or after such
date.

2019-S333 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    333
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced  by  Sen.  AKSHAR -- 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:
 
   Section  1.  Subparagraph  (A)  of  paragraph  31 of subsection (i) of
 section 3216 of the insurance law, as added by chapter 41 of the laws of
 2014, is amended to read as follows:
   (A) Every policy that  provides  medical,  major  medical  or  similar
 comprehensive-type  coverage  must  provide  outpatient coverage for the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion and rehabilitation services. Such coverage shall not BE SUBJECT  TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations  to outpatient substance use disorder benefits that are more
 restrictive than the predominant financial  requirements  and  treatment
 limitations  applied  to substantially all medical and surgical benefits
 covered by the  policy.    Further,  such  coverage  shall  be  provided
 consistent  with  the  federal  Paul  Wellstone and Pete Domenici Mental
 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
   § 2. Subparagraph (A) of paragraph 7 of subsection (1) of section 3221
 of the insurance law, as amended by chapter 41 of the laws of  2014,  is
 amended to read as follows:
   (A)  Every  policy  that  provides  medical,  major medical or similar
 comprehensive-type coverage must provide  outpatient  coverage  for  the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and rehabilitation services. Such coverage shall not BE SUBJECT TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations to outpatient substance use disorder benefits that are  more
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD05578-01-9

 S. 333                              2
 
 restrictive  than  the  predominant financial requirements and treatment
 limitations applied to substantially all medical and  surgical  benefits
 covered  by  the  policy.    Further,  such  coverage  shall be provided
 consistent  with  the  federal  Paul  Wellstone and Pete Domenici Mental
 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
   § 3. Paragraph 1 of subsection (l) of section 4303  of  the  insurance
 law, as amended by chapter 41 of the laws of 2014, is amended to read as
 follows:
   (1)  Every  contract  that  provides medical, major medical or similar
 comprehensive-type coverage must provide  outpatient  coverage  for  the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and rehabilitation services. Such coverage shall not BE SUBJECT TO
 PREAUTHORIZATION AND SHALL NOT apply financial requirements or treatment
 limitations to outpatient substance use disorder benefits that are  more
 restrictive  than  the  predominant financial requirements and treatment
 limitations applied to substantially all medical and  surgical  benefits
 covered  by  the  contract.    Further,  such coverage shall be provided
 consistent with the federal Paul  Wellstone  and  Pete  Domenici  Mental
 Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
   §  4.  This  act  shall  take  effect  immediately, and shall apply to
 polices and contracts issued, renewed, modified, altered or  amended  on
 or after such date.

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