What's happening
This bill requires insurance policies to cover and reimburse transportation to and from substance use disorder treatment and diagnosis.
Why it matters
Addresses a Major Barrier to Treatment Access. By requiring insurance to cover transportation for both inpatient and outpatient substance use disorder services, this bill helps remove a key obstacle—getting to treatment—that often prevents people from seeking or continuing care, particularly in rural or underserved areas.
Could Improve Treatment Outcomes. Reliable transportation increases the likelihood that individuals will attend and complete treatment programs, which can lead to better health outcomes and reduce rates of relapse, overdose, and hospitalizations.
Promotes Equity in Healthcare. Transportation challenges disproportionately affect low-income, disabled, and marginalized populations. Mandating coverage for these costs can help level the playing field and ensure more equitable access to substance use disorder care.
May Impact Insurance Premiums and Healthcare Costs. While the bill could generate upfront costs for insurers (and potentially policyholders), it might also lower overall healthcare spending by reducing emergency room visits, hospital readmissions, and untreated addiction-related complications in the long run.
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Cover Rides for Addiction Treatment
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History
- Referred to insurance
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
9111
IN ASSEMBLY
January 21, 2020
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 providing reimbursement for transportation to and from inpatient and outpatient diagnosis and treatment of substance disorder
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, and shall provide reimbursement for transportation to and from such inpatient diagnosis and treatment of substance use disorder. 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. 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 shall provide reimbursement for transportation to and from such outpatient diagnosis and treatment of substance use disorder. Such coverage shall not apply financial requirements or treatment limitations to outpatient substance use disorder
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD14557-01-9
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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 6 of subsection (l) of section 3221 of the insurance law, as amended by section 15 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, and shall provide reimbursement for transportation to and from such inpatient diagnosis and treatment of substance use disorder. 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.
§ 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 shall provide reimbursement for transportation to and from such outpatient diagnosis and treatment of substance use disorder. 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 (k) of section 4303 of the insurance law, as amended by section 26 of subpart A of part BB of chapter 57 of the laws of 2019, is amended to read as follows:
(1) Every contract 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, and shall provide reimbursement for transportation to and from such inpatient diagnosis and treatment of substance use disorder. 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 contract.
§ 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:
(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 shall provide reimbursement for transportation to and from such outpatient diagnosis and treatment of
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substance use disorder. 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 ninetieth day after it shall have become a law; provided, however, that if part BB of chapter 57 of the laws of 2019 has not taken effect on or before such date then this act shall take effect on the same date and in the same manner as such part takes effect; and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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