NY State Senate Bill 2023-S4842

Senate Bill S4842

2023-2024 Legislative Session

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

download bill text pdf

Current 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 03, 2024	referred to insurance
Feb 15, 2023	referred to insurance

2023-S4842 (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
2019-2020: S333
2021-2022: S1915

2023-S4842 (ACTIVE) - Summary

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

2023-S4842 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S4842

SPONSOR: ASHBY
 
TITLE OF BILL:

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

 
PURPOSE:

To make it easier for people to access treatment for substance use by
removing the need for preauthorization of insurance.

 
SUMMARY OF PROVISIONS:

Sections 1,2 and 3 of this bill amend insurance law, by stating that
coverage for outpatient diagnosis and treatment of substance use disor-
der provided by policies providing medical coverage shall not be subject
to preauthorization.

Section 4 provides the effective date.

 
JUSTIFICATION:

The aim of this bill is to work towards removing one of the many exist-
ing barriers to substance use treatment: the need to seek prior authori-
zation from their insurance before starting treatment. This would allow
people to avoid any delays in the initiation of care.  Getting people
into treatment is a critical moment, and every minute saves patients
from continued substance use, medical complications, overdose and death.

In 2016, the Senate's Task Force on Heroin and Opioid Addiction released
a report with recommendations. 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, with-
out preauthorization, of in-network inpatient treatment by OASAS certi-
fied 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:

2021-22 - S.1915: Referred to Insurance

2019-20 - S.333: Referred to Insurance

2018 - S.8046: Referred to Insurance

 
FISCAL IMPLICATIONS:

To be determined, provided savings should accrue as those ready for
recovery can access outpatient care quicker 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.

2023-S4842 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4842
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 15, 2023
                                ___________
 
 Introduced  by  Sen.  ASHBY  -- 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 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. 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.
   § 2. Subparagraph (A) of paragraph 7 of subsection (1) 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. 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

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09227-01-3
 S. 4842                             2

 
 limitations applied to substantially all medical and  surgical  benefits
 covered by the policy.
   §  3.  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
 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.
   §  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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