What's happening
This bill expands insurance coverage for eating disorders to include all disorders listed in the current DSM, not just anorexia and bulimia.
Why it matters
Broadens access to treatment for less-recognized eating disorders. By including all disorders listed in the DSM, the bill ensures coverage for conditions like binge eating disorder, avoidant/restrictive food intake disorder, pica, and rumination disorder, not just the traditionally recognized anorexia and bulimia. This reflects current medical understanding and addresses gaps in care for people with less common but serious eating disorders.
Aligns insurance law with updated clinical standards. The bill ties the definition of "eating disorder" to the latest Diagnostic and Statistical Manual of Mental Disorders (DSM), allowing insurance coverage to automatically reflect advances and changes in psychiatric diagnosis, rather than being limited by outdated legal definitions.
Reduces financial barriers for early and accurate intervention. By requiring insurance coverage for a broader range of eating disorders, individuals may be able to receive treatment earlier in the course of their illness, which can improve health outcomes and potentially reduce long-term healthcare costs associated with delayed or inadequate care.
Promotes parity in mental health coverage. The legislation supports the principle that mental health conditions, including the full spectrum of eating disorders, should be treated with the same seriousness and insurance benefits as other biologically based mental illnesses, supporting equity in healthcare access.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Cover Eating Disorders
Plain English, a few words. Used as the page title.
Sponsors
Assembly Member · Assembly District 25
23 Co-sponsors
- Carmen De La Rosa
- William Colton
- Steven Englebright
- Felix Ortiz
- Jo Anne Simon
- Patricia Fahy
- Michael Blake
- Ellen C. Jaffee
- Anthony D'Urso
- Shelley Mayer
- Aileen Gunther
- Marcos Crespo
- Jose Rivera
- Thomas Abinanti
- Didi Barrett
- Luis R. Sepúlveda
- Harry B. Bronson
- Linda Rosenthal
- Andrew Raia
- Mark C. Johns
- Daniel Rosenthal
- Michaelle C. Solages
- Nathalia Fernandez
History
- Referred to insurance
- Delivered to senate
- Passed assembly
- Amended on third reading 6396c
- Ordered to third reading cal.458
- Returned to assembly
- Died in senate
- Referred to rules
- Delivered to senate
- Passed assembly
- Amended on third reading 6396b
- Advanced to third reading cal.537
Show 5 earlier actions
- Reported
- Reported referred to codes
- Print number 6396a
- Amend and recommit to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Expand Eating Disorder Coverage
In Senate Committee · Insurance · Sponsor Kathleen A. Marchione
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
6396--C Cal. No. 458
2017-2018 Regular Sessions
IN ASSEMBLY
March 6, 2017
Introduced by M. of A. ROZIC, DE LA ROSA, COLTON, ENGLEBRIGHT, ORTIZ, SIMON, FAHY, HARRIS, BLAKE, JAFFEE, D'URSO, MAYER, GUNTHER, CRESPO, RIVERA, ABINANTI, BARRETT, SEPULVEDA, BRONSON, L. ROSENTHAL, RAIA, JOHNS -- Multi-Sponsored by -- M. of A. COOK, CROUCH,… Show allHide
Introduced by M. of A. ROZIC, DE LA ROSA, COLTON, ENGLEBRIGHT, ORTIZ, SIMON, FAHY, HARRIS, BLAKE, JAFFEE, D'URSO, MAYER, GUNTHER, CRESPO, RIVERA, ABINANTI, BARRETT, SEPULVEDA, BRONSON, L. ROSENTHAL, RAIA, JOHNS -- Multi-Sponsored by -- M. of A. COOK, CROUCH, GALEF, GIGLIO, HIKIND, M. L. MILLER, NOLAN, RA -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- reported and referred to the Committee on Codes -- reported from committee, advanced to a third reading, amended and ordered reprinted, retaining its place on the order of third reading -- ordered to a third reading, amended and ordered reprinted, retaining its place on the order of third reading
AN ACT to amend the insurance law, in relation to coverage for eating disorders
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subparagraph (B) of paragraph 5 of subsection (1) of section 3221 of the insurance law, as amended by chapter 502 of the laws of 2007, is amended to read as follows:
(B) (i) Every insurer delivering a group or school blanket policy or issuing a group or school blanket policy for delivery, in this state, which provides coverage for inpatient hospital care or coverage for physician services, shall provide comparable coverage for adults and children with biologically based mental illness. Such group policies issued or delivered in this state shall also provide such comparable coverage for children with serious emotional disturbances. Such coverage shall be provided under the terms and conditions otherwise applicable under the policy, including network limitations or variations, exclusions, co-pays, coinsurance, deductibles or other specific cost sharing mechanisms. Provided further, where a policy provides both in-network and out-of-network benefits, the out-of-network benefits may have
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06526-06-8
A. 6396--C 2
different coinsurance, co-pays, or deductibles, than the in-network benefits, regardless of whether the policy is written under one license or two licenses.
(ii) For purposes of this paragraph, the term "biologically based mental illness" means a mental, nervous, or emotional condition that is caused by a biological disorder of the brain and results in a clinically significant, psychological syndrome or pattern that substantially limits the functioning of the person with the illness. Such biologically based mental illnesses are defined as schizophrenia/psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorders[, bulimia, and anorexia] or an eating disorder.
(iii) For purposes of this paragraph, the term "eating disorder" means pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding or eating disorder, and any other eating disorder contained in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.
§ 2. Paragraph 2 of subsection (g) of section 4303 of the insurance law, as amended by chapter 502 of the laws of 2007, is amended to read as follows:
(2) (A) A hospital service corporation or a health service corporation, which provides group, group remittance or school blanket coverage for inpatient hospital care, shall provide comparable coverage for adults and children with biologically based mental illness. Such hospital service corporation or health service corporation shall also provide such comparable coverage for children with serious emotional disturbances. Such coverage shall be provided under the terms and conditions otherwise applicable under the contract, including network limitations or variations, exclusions, co-pays, coinsurance, deductibles or other specific cost sharing mechanisms. Provided further, where a contract provides both in-network and out-of-network benefits, the out-of-network benefits may have different coinsurance, co-pays, or deductibles, than the in-network benefits, regardless of whether the contract is written under one license or two licenses.
(B) For purposes of this subsection, the term "biologically based mental illness" means a mental, nervous, or emotional condition that is caused by a biological disorder of the brain and results in a clinically significant, psychological syndrome or pattern that substantially limits the functioning of the person with the illness. Such biologically based mental illnesses are defined as schizophrenia/psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorders[, anorexia, and bulimia] or an eating disorder.
(C) For purposes of this subsection, the term "eating disorder" means pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding or eating disorder, and any other eating disorder contained in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.
§ 3. Paragraph 2 of subsection (h) of section 4303 of the insurance law, as amended by chapter 502 of the laws of 2007, is amended to read as follows:
(2) (A) A medical expense indemnity corporation or a health service corporation, which provides group, group remittance or school blanket coverage for physician services, shall provide comparable coverage for
A. 6396--C 3
adults and children with biologically based mental illness. Such medical expense indemnity corporation or health service corporation shall also provide such comparable coverage for children with serious emotional disturbances. Such coverage shall be provided under the terms and conditions otherwise applicable under the contract, including network limitations or variations, exclusions, co-pays, coinsurance, deductibles or other specific cost sharing mechanisms. Provided further, where a contract provides both in-network and out-of-network benefits, the outof-network benefits may have different coinsurance, co-pays, or deductibles, than the in-network benefits, regardless of whether the contract is written under one license or two licenses.
(B) For purposes of this subsection, the term "biologically based mental illness" means a mental, nervous, or emotional condition that is caused by a biological disorder of the brain and results in a clinically significant, psychological syndrome or pattern that substantially limits the functioning of the person with the illness. Such biologically based mental illnesses are defined as schizophrenia/psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder[, anorexia, and bulimia] or an eating disorder.
(C) For purposes of this subsection, the term "eating disorder" means pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding or eating disorder, and any other eating disorder contained in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.
§ 4. This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that the provisions of this act shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such effective date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.