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- Referred to insurance
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Sponsor's memo
BILL NUMBER:S7103
Title of bill
An act to amend the insurance law, in relation to requiring health insurance coverage for drug and alcohol abuse and dependency treatment services
Purpose or general idea of bill
To expand the time frame in which insurance companies will provide coverage for rehabilitation of opioid users.
Summary of specific provisions
Section 1 amends subdivision B of para- graph 30 of subsection (i) of section 3216 of the insurance law to require every policy delivered or issued for delivery in New York State increase the length of coverage for addiction rehabilitation to no less than 60 days of treatment. It specifies that coverage can only be termi- nated when the admitting or attending physician certifies that there is no further treatment necessary and the patient should be discharged. This allows for up to an additional 30 days of treatment, for a total of 90 days, if the admitting or attending physician deems it necessary.
It further provides that if the admitting or attending physician certi- fies that treatment beyond 90 days is necessary, his or her certif- ication shall be sufficient for eligibility for coverage through Medi- caid as administered through county social services departments. Costs associated with continued Medicaid coverage shall be borne by the state.
Section 2 amends subdivision B of paragraph 19 of subsection 1 of section 3221 of the insurance law. This section's language mirrors that of section 1, requiring that every group or blanket policy delivered or issued for delivery in New York State be subject to the same provisions.
Section 3 amends subdivision 2 of subsection (oo) of Section 4303 of insurance law. This section's language again mirrors that of section 1, to require that every contract issued by a hospital service company or health service corporation meet the same provisions.
Section 4 is the effective date.
Justification
As addiction to opioids, and particularly to heroin, continues to rise in New York State, it is imperative that this public health issue be addressed in a comprehensive way. Most of the treatment programs provided by private sector insurance in New York only allow for up to 30 days of treatment coverage - a duration that is grossly inade- quate for effective treatment. The result is a tragic scenario that plays out far too often in New York: parents who have health insurance coverage for their children that will not meet the needs of treating heroin addiction are forced to "emancipate" their loved ones so they qualify for Medicaid.
While requiring private sector policies to cover of up to 90 days will not bring comply with these federal Medicaid standards, it significantly improves on existing coverage. In addition, the bill provides for a
smooth transition from private coverage to Medicaid after 90 days, and ensures that any additional cost will be borne by the State, rather than counties.
Prior legislative history
New Bill - 2014
Fiscal implications
To be determined.
Effective date
This act shall take effect on the first of January next succeeding 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 date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.