S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3463
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 26, 2021
                                ___________
 
 Introduced  by  M.  of  A. L. ROSENTHAL -- read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to  providing  reimburse-
   ment for transportation to and from inpatient and outpatient diagnosis
   and treatment of substance disorder

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (A) of  paragraph  30  of  subsection  (i)  of
 section  3216 of the insurance law, as amended by section 5 of subpart A
 of part BB of chapter 57 of the laws of 2019,  is  amended  to  read  as
 follows:
   (A)  Every  policy  that  provides  hospital, major medical or similar
 comprehensive coverage shall provide inpatient coverage for the  diagno-
 sis  and  treatment  of substance use disorder, including detoxification
 and rehabilitation services, AND SHALL PROVIDE REIMBURSEMENT FOR  TRANS-
 PORTATION  TO  AND  FROM  SUCH  INPATIENT  DIAGNOSIS  AND  TREATMENT  OF
 SUBSTANCE USE DISORDER. Such inpatient coverage shall include  unlimited
 medically  necessary  treatment  for  substance  use  disorder treatment
 services provided  in  residential  settings.  Further,  such  inpatient
 coverage  shall  not  apply  financial requirements or treatment limita-
 tions, including utilization review requirements, to inpatient substance
 use disorder benefits that are more  restrictive  than  the  predominant
 financial requirements and treatment limitations applied to substantial-
 ly all medical and surgical benefits covered by the policy.
   §  2.  Subparagraph  (A)  of paragraph 31 of subsection (i) of section
 3216 of the insurance law, as amended by section 6 of subpart A of  part
 BB of chapter 57 of the laws of 2019, is amended to read as follows:
   (A)  Every  policy  that  provides  medical,  major medical or similar
 comprehensive-type coverage shall provide outpatient  coverage  for  the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and  rehabilitation  services, AND SHALL PROVIDE REIMBURSEMENT FOR
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00959-01-1

 A. 3463                             2
 
 TRANSPORTATION TO AND FROM SUCH OUTPATIENT DIAGNOSIS  AND  TREATMENT  OF
 SUBSTANCE USE DISORDER. Such coverage shall not apply financial require-
 ments  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.
   § 3. Subparagraph (A) of paragraph 6 of subsection (l) of section 3221
 of  the  insurance law, as amended by section 15 of subpart A of part BB
 of chapter 57 of the laws of 2019, is amended to read as follows:
   (A) Every policy that provides  hospital,  major  medical  or  similar
 comprehensive  coverage shall provide inpatient coverage for the diagno-
 sis and treatment of substance use  disorder,  including  detoxification
 and  rehabilitation services, AND SHALL PROVIDE REIMBURSEMENT FOR TRANS-
 PORTATION  TO  AND  FROM  SUCH  INPATIENT  DIAGNOSIS  AND  TREATMENT  OF
 SUBSTANCE  USE DISORDER. Such inpatient coverage shall include unlimited
 medically necessary  treatment  for  substance  use  disorder  treatment
 services  provided  in  residential  settings.  Further,  such inpatient
 coverage shall not apply financial  requirements  or  treatment  limita-
 tions, including utilization review requirements, to inpatient substance
 use  disorder  benefits  that  are more restrictive than the predominant
 financial requirements and treatment limitations applied to substantial-
 ly all medical and surgical benefits covered by the policy.
   § 4. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221
 of the insurance law, as amended by section 16 of subpart A of  part  BB
 of chapter 57 of the laws of 2019, is amended to read as follows:
   (A)  Every  policy  that  provides  medical,  major medical or similar
 comprehensive-type coverage shall provide outpatient  coverage  for  the
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and  rehabilitation  services, AND SHALL PROVIDE REIMBURSEMENT FOR
 TRANSPORTATION TO AND FROM SUCH OUTPATIENT DIAGNOSIS  AND  TREATMENT  OF
 SUBSTANCE  USE  DISORDER.    Such  coverage  shall  not  apply financial
 requirements or treatment limitations to outpatient substance use disor-
 der 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.
   § 5. Paragraph 1 of subsection (k) of section 4303  of  the  insurance
 law,  as  amended by section 26 of subpart A of part BB of chapter 57 of
 the laws of 2019, is amended to read as follows:
   (1) Every contract that provides hospital, major  medical  or  similar
 comprehensive  coverage shall provide inpatient coverage for the diagno-
 sis and treatment of substance use  disorder,  including  detoxification
 and  rehabilitation services, AND SHALL PROVIDE REIMBURSEMENT FOR TRANS-
 PORTATION  TO  AND  FROM  SUCH  INPATIENT  DIAGNOSIS  AND  TREATMENT  OF
 SUBSTANCE USE DISORDER.  Such inpatient coverage shall include unlimited
 medically  necessary  treatment  for  substance  use  disorder treatment
 services provided  in  residential  settings.  Further,  such  inpatient
 coverage  shall  not  apply  financial requirements or treatment limita-
 tions, including utilization review requirements, to inpatient substance
 use disorder benefits that are more  restrictive  than  the  predominant
 financial requirements and treatment limitations applied to substantial-
 ly all medical and surgical benefits covered by the contract.
   §  6.  Paragraph  1 of subsection (l) of section 4303 of the insurance
 law, as amended by section 27 of subpart A of part BB of chapter  57  of
 the laws of 2019, is amended to read as follows:
   (1)  Every  contract  that  provides medical, major medical or similar
 comprehensive-type coverage shall provide outpatient  coverage  for  the

 A. 3463                             3
 
 diagnosis and treatment of substance use disorder, including detoxifica-
 tion  and  rehabilitation  services, AND SHALL PROVIDE REIMBURSEMENT FOR
 TRANSPORTATION TO AND FROM SUCH OUTPATIENT DIAGNOSIS  AND  TREATMENT  OF
 SUBSTANCE  USE  DISORDER.    Such  coverage  shall  not  apply financial
 requirements or treatment limitations to outpatient substance use disor-
 der 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.
   § 7. This act shall take effect on the ninetieth day  after  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.