What's happening
This bill prohibits health insurers from requiring behavioral health providers to participate in all of their insurance products, allowing providers to choose specific plans.
Why it matters
Empowers behavioral health providers. by allowing them to selectively join insurance networks for only the plans they choose, rather than being forced to participate in all of an insurer’s products—potentially increasing provider bargaining power and autonomy.
Could improve provider participation. in insurance networks, especially for those who may have opted out entirely due to all-or-nothing contracting, which might expand mental health service access for patients.
Aims to address network adequacy. and patient choice by potentially encouraging more behavioral health providers to accept at least some insurance plans, rather than dropping out of networks completely due to restrictive contracting practices.
Standardizes protections. across Medicaid, Child Health Plus, commercial insurance, and HMOs, ensuring consistent provider choice regardless of the insurance market segment, and clarifies the definition of “behavioral health services” for regulatory purposes.
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Who cares
Headline styles
Let Therapists Choose Insurance Plans
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Referred to health
- Delivered to senate
- Passed assembly
- Ordered to third reading cal.3
- Returned to assembly
- Died in senate
- Referred to rules
- Delivered to senate
- Passed assembly
- Ordered to third reading rules cal.79
- Rules report cal.79
- Reported
Show 3 earlier actions
- Reported referred to rules
- Reported referred to ways and means
- Referred to health
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
23
2017-2018 Regular Sessions
IN ASSEMBLY (Prefiled)
January 4, 2017
Introduced by M. of A. CAHILL -- read once and referred to the Committee on Health
AN ACT to amend the social services law, the public health law and the insurance law, in relation to prohibiting a provider of health care coverage from requiring providers of behavioral health services to offer all products offered by the provider of health care coverage
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 365-m of the social services law is amended by adding a new subdivision 6 to read as follows:
6. (a) No managed care provider under section three hundred sixtyfour-j of this title shall by contract or written policy or procedure, require a behavioral health services provider to participate in the in-network portion of any product offered by such managed care provider, other than products under such section. Behavioral health services providers shall have the right to select by execution of a separate agreement the products of such managed care provider in which the provider agrees to participate in the in-network portion.
(b) As used in this subdivision, "behavioral health services" means inpatient and outpatient behavioral health services provided by those licensed or certified pursuant to article thirty-one or thirty-two of the mental hygiene law, or programs that are licensed pursuant to both article thirty-one of the mental hygiene law and article twenty-eight of the public health law, or certified under both article thirty-two of the mental hygiene law and article twenty-eight of the public health law.
§ 2. Section 2511 of the public health law is amended by adding a new subdivision 22 to read as follows:
22. (a) No approved organization shall by contract or written policy or procedure, require a behavioral health services provider to participate in the in-network portion of any product offered by such organiza-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01657-01-7
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tion, other than products under this title. Behavioral health services providers shall have the right to select by execution of a separate agreement the products of such approved organization in which the provider agrees to participate in the in-network portion.
(b) As used in this subdivision, "behavioral health services" means inpatient and outpatient behavioral health services provided by those licensed or certified pursuant to article thirty-one or thirty-two of the mental hygiene law, or programs that are licensed pursuant to both article thirty-one of the mental hygiene law and article twenty-eight of this chapter, or certified under both article thirty-two of the mental hygiene law and article twenty-eight of this chapter.
§ 3. Section 4406-c of the public health law is amended by adding a new subdivision 9 to read as follows:
9. (a) No health care plan licensed pursuant to this article shall by contract or written policy or procedure, require a behavioral health services provider to participate in the in-network portion of any product offered by such plan. Behavioral health services providers shall have the right to select by execution of a separate agreement the products of such plan in which the provider agrees to participate in the in-network portion.
(b) As used in this subdivision, "behavioral health services" means inpatient and outpatient behavioral health services provided by those licensed or certified pursuant to article thirty-one or thirty-two of the mental hygiene law, or programs that are licensed pursuant to both article thirty-one of the mental hygiene law and article twenty-eight of this chapter, or certified under both article thirty-two of the mental hygiene law and article twenty-eight of this chapter.
§ 4. Section 3217-b of the insurance law is amended by adding a new subsection (k) to read as follows:
(k) (1) No insurer subject to the provisions of this article shall by contract, written policy or procedure, require a behavioral health services provider to participate in the in-network portion of any product offered by such insurer. Behavioral health services providers shall have the right to select by execution of a separate agreement the products of such insurers in which the provider agrees to participate in the in-network portion.
(2) As used in this subsection, "behavioral health services" means inpatient and outpatient behavioral health services provided by those licensed or certified pursuant to article thirty-one or thirty-two of the mental hygiene law, or programs that are licensed pursuant to both article thirty-one of the mental hygiene law and article twenty-eight of the public health law, or certified under both article thirty-two of the mental hygiene law and article twenty-eight of the public health law.
§ 5. Section 4325 of the insurance law is amended by adding a new subsection (l) to read as follows:
(l) (1) No corporation organized pursuant to this article shall by contract, written policy or procedure, require a behavioral health services provider to participate in the in-network portion of any product offered by such corporation. Behavioral health services providers shall have the right to select by execution of a separate agreement the products of such corporation in which the provider agrees to participate in the in-network portion.
(2) As used in this subsection, "behavioral health services" means inpatient and outpatient behavioral health services provided by those licensed or certified pursuant to article thirty-one or thirty-two of the mental hygiene law, or programs that are licensed pursuant to both
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article thirty-one of the mental hygiene law and article twenty-eight of the public health law, or certified under both article thirty-two of the mental hygiene law and article twenty-eight of the public health law.
§ 6. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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