What's happening
This bill requires commercial insurance policies to cover peer support services by certified recovery peer advocates for substance use disorder treatment.
Why it matters
Expanding Treatment Options. By mandating coverage of peer support services provided by certified recovery peer advocates, the bill recognizes the value of lived experience in substance use disorder (SUD) recovery, integrating non-clinical, peer-led support into mainstream care.
Reducing Barriers to Access. Insurance coverage for peer support may lower out-of-pocket costs for individuals seeking SUD treatment, making these services more accessible—especially for those who might not engage with traditional clinical programs.
Aligning with Parity Laws. The bill explicitly requires that coverage for peer support services cannot be subject to more restrictive financial requirements or treatment limitations than other medical or surgical benefits, reinforcing federal mental health parity protections.
Recognizing Peer Advocates as Essential Providers. By defining and including certified recovery peer advocates in insurance law, the bill elevates their role within the treatment system, potentially leading to broader workforce development and professionalization in the field.
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Who cares
Commercial health insurers
The bill would require comprehensive medical policies and contracts to cover certified peer support services as part of outpatient substance use disorder treatment.
People with substance use disorder covered by commercial insurance
They would gain coverage for peer support services under the existing limits on financial requirements and treatment restrictions for outpatient substance use disorder benefits.
Certified recovery peer advocates
Their services would become a required covered benefit when provided as part of outpatient substance use disorder treatment, using the certification definition set by the Office of Alcoholism and Substance Abuse Services.
Headline styles
Insurers Cover Peer Addiction Support
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred 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.
Require Insurance for Peer Support
In Senate Committee · Insurance · Sponsor Pete Harckham
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
7566
2019-2020 Regular Sessions
IN ASSEMBLY
May 9, 2019
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 mandating commercial insurance coverage of peer support services as part of treatment for substance use disorder
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subparagraph (A) of paragraph 31 of subsection (i) of section 3216 of the insurance law, as added by chapter 41 of the laws of 2014, is amended to read as follows:
(A) Every policy that provides medical, major medical or similar comprehensive-type coverage must provide outpatient coverage for the diagnosis and treatment of substance use disorder, including detoxification and rehabilitation services and also including peer support services provided by a certified recovery peer advocate as defined by the office of alcoholism and substance abuse services. Such coverage 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. Further, such coverage shall be provided consistent with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
§ 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 detoxification and rehabilitation services and also including peer support services provided by a certified recovery peer advocate as defined by
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11397-01-9
A. 7566 2
the office of alcoholism and substance abuse services. Such coverage 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.
§ 3. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221 of the insurance law, as amended by chapter 41 of the laws of 2014, is amended to read as follows:
(A) Every policy that provides medical, major medical or similar comprehensive-type coverage must provide outpatient coverage for the diagnosis and treatment of substance use disorder, including detoxification and rehabilitation services and also including peer support services provided by a certified recovery peer advocate as defined by the office of alcoholism and substance abuse services. Such coverage 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. Further, such coverage shall be provided consistent with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
§ 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 detoxification and rehabilitation services and also including peer support services provided by a certified recovery peer advocate as defined by the office of alcoholism and substance abuse services. Such coverage 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.
§ 5. Paragraph 1 of subsection (l) of section 4303 of the insurance law, as amended by chapter 41 of the laws of 2014, is amended to read as follows:
(1) Every contract that provides medical, major medical or similar comprehensive-type coverage must provide outpatient coverage for the diagnosis and treatment of substance use disorder, including detoxification and rehabilitation services and also including peer support services provided by a certified recovery peer advocate as defined by the office of alcoholism and substance abuse services. Such coverage 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. Further, such coverage shall be provided consistent with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
§ 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:
A. 7566 3
(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 detoxification and rehabilitation services and also including peer support services provided by a certified recovery peer advocate as defined by the office of alcoholism and substance abuse services. Such coverage 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.
§ 7. This act shall take effect on the thirtieth day after it shall have become a law; provided that the amendments to subparagraph (A) of paragraph (31) of subsection (i) of section 3216 of the insurance law made by section two of this act, the amendments to subparagraph (A) of paragraph (7) of subsection (l) of section 3221 of the insurance law made by section four of this act and the amendments to paragraph (1) of subsection (l) of section 4303 of the insurance law made by section six of this act shall take effect on the same date and in the same manner as subpart A of part BB of chapter 57 of the laws of 2019, takes effect.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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