What's happening
This bill requires insurance policies to cover FDA-approved medical devices and products for treating withdrawal symptoms from substance use disorders.
Why it matters
Expands access to newer treatment options. By requiring insurance coverage for FDA-approved medical devices and products for withdrawal, the bill enables patients and doctors to consider non-traditional or innovative therapies—potentially improving outcomes when standard medications are not suitable or effective.
Reduces financial barriers for patients. Mandating coverage means patients are less likely to face out-of-pocket costs for these devices and products, making it easier for individuals with substance use disorders to access comprehensive withdrawal management and stick with treatment.
Promotes parity in treatment of substance use disorders. The bill ensures that restrictions on coverage for withdrawal treatments (including devices and products) are not more stringent than those for other medical or surgical benefits, supporting equal treatment for addiction care.
Encourages insurance market consistency. By applying the requirement across a range of insurance plans (individual, group, and contracts), the legislation prevents gaps in coverage, making the availability of these withdrawal treatments more predictable and uniform statewide.
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Who cares
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Cover Devices for Withdrawal
Plain English, a few words. Used as the page title.
Sponsors
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History
- Referred to insurance
- Referred to insurance
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8268
2019-2020 Regular Sessions
IN ASSEMBLY
June 11, 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 insurance coverage for medical devices to treat withdrawal symptoms
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subparagraph (A) of paragraph 30 of subsection (i) of section 3216 of the insurance law, as amended by section 5 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 hospital, major medical or similar comprehensive coverage shall provide inpatient coverage for the diagnosis and treatment of substance use disorder, including detoxification and rehabilitation services, including the use of medications, medical devices and products approved and/or cleared by the food and drug administration for the treatment of withdrawal symptoms. Such inpatient coverage shall include unlimited medically necessary treatment for substance use disorder treatment services provided in residential settings. Further, such inpatient coverage shall not apply financial requirements or treatment limitations, including utilization review requirements, to inpatient 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. Paragraph 30 of subsection (i) of section 3216 of the insurance law, as amended by section 7 of subpart B of part J of chapter 57 of the laws of 2019, is renumbered paragraph 30-a.
§ 3. Paragraph 7-a of subsection (l) of section 3221 of the insurance law, as added by section 2 of part B of chapter 69 of the laws of 2016, is amended to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06895-06-9
A. 8268 2
(7-a) Every policy that provides medical, major medical or similar comprehensive-type large group coverage shall provide coverage for medication for the detoxification or maintenance treatment, including medical devices or products for the treatment of withdrawal symptoms, of a substance use disorder approved by the food and drug administration for the detoxification or maintenance treatment of substance use disorder.
§ 4. Subsection (l-1) of section 4303 of the insurance law, as added by section 3 of part B of chapter 69 of the laws of 2016, is amended to read as follows:
(l-1) Every contract that provides medical, major medical, or similar comprehensive-type large group coverage shall provide coverage for medication for the detoxification or maintenance treatment, including medical devices or products for the treatment of withdrawal symptoms, of a substance use disorder approved by the food and drug administration for the detoxification or maintenance treatment of substance use disorder.
§ 5. 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, including the use of medications, medical devices and products approved and/or cleared by the food and drug administration for the treatment of withdrawal symptoms. 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.
§ 6. 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 and shall apply to policies and contracts issued, renewed, modified, altered or amended on and after such date; provided, however, that section two of this act shall take effect on the same date and in the same manner as section 7 of subpart B of part J of chapter 57 of the laws of 2019, takes effect.
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