What's happening
This bill requires health insurance policies in New York to cover outpatient mental health services provided by licensed counselors, therapists, and psychoanalysts, expanding beyond only social workers and psychologists.
Why it matters
Expands access to mental health care by allowing insurance reimbursement for services provided by a wider range of licensed professionals, such as mental health counselors, marriage and family therapists, creative arts therapists, and psychoanalysts. This could make it easier for individuals to find a provider and receive timely care, especially in areas with shortages of psychologists or social workers.
Removes restrictive requirements for clinical social workers to qualify for insurance reimbursement. By eliminating additional experience or supervision criteria, the bill simplifies the process for social workers to be reimbursed, potentially increasing the workforce available to deliver mental health care.
Specifies that expanding coverage to new provider types does not change their legal scope of practice. This maintains existing professional boundaries and ensures that insurance coverage does not inadvertently allow providers to perform services outside their training or licensure.
Requires state boards to maintain public lists of qualified mental health professionals eligible for reimbursement. This offers greater transparency and could help consumers and insurers verify which providers are covered under insurance plans.
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Who cares
Headline styles
Expand Mental Health Coverage
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Substituted by A670A
- Ordered to third reading cal.1786
- Print number 6212a
- Amend (t) 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 Mental Health Coverage
Vetoed · Sponsor Harry B. Bronson
Full text
4 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
6212--A
2019-2020 Regular Sessions
IN SENATE
May 23, 2019
Introduced by Sens. KENNEDY, JACKSON -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to health insurance coverage of outpatient care provided by a mental health practitioner and a clinical social worker; and to repeal certain provisions of such law relating thereto
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Items (i) and (ii) of subparagraph (A) of paragraph 35 of subsection (i) of section 3216 of the insurance law, as added by section 8 of subpart A of part BB of chapter 57 of the laws of 2019, are amended to read as follows:
(i) where the policy provides coverage for inpatient hospital care, such policy shall include benefits for inpatient care in a hospital as defined by subdivision ten of section 1.03 of the mental hygiene law and benefits for outpatient care provided in a facility issued an operating certificate by the commissioner of mental health pursuant to the provisions of article thirty-one of the mental hygiene law, or in a facility operated by the office of mental health, or, for care provided in other states, to similarly licensed or certified hospitals or facilities; and
(ii) where the policy provides coverage for physician services, such policy shall include benefits for outpatient care provided by a psychiatrist or psychologist licensed to practice in this state, a licensed clinical social worker [who meets the requirements of subparagraph (D) of paragraph four of subsection (1) of section three thousand two hundred twenty-one of this article,] within the lawful scope of his or her practice, who is licensed pursuant to article one hundred fifty-four of the education law, a mental health counselor, marriage and family
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11946-02-9
S. 6212--A 2
therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law, a nurse practitioner licensed to practice in this state, or a professional corporation or university faculty practice corporation thereof. Nothing herein shall be construed to modify or expand the scope of practice of a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law.
§ 2. Subparagraph (A) of paragraph 4 of subsection (l) of section 3221 of the insurance law, as amended by section 11 of subpart A of part BB of chapter 57 of the laws of 2019, is amended to read as follows:
(A) Every insurer delivering a group policy or issuing a group policy for delivery, in this state, that provides reimbursement for psychiatric or psychological services or for the diagnosis and treatment of mental health conditions, however defined in such policy, by physicians, psychiatrists or psychologists, shall [make available and if requested by the policyholder] provide the same coverage to insureds for such services when performed by a licensed clinical social worker, within the lawful scope of his or her practice, who is licensed pursuant to article one hundred fifty-four of the education law[. Written notice of the availability of such coverage shall be delivered to the policyholder prior to inception of such group policy and annually thereafter, except that this notice shall not be required where a policy covers two hundred or more employees or where the benefit structure was the subject of collective bargaining affecting persons who are employed in more than one state.] and mental health counselors, marriage and family therapists, creative arts therapists and psychoanalysts licensed pursuant to article one hundred sixty-three of the education law, within the lawful scope of his or her practice. Nothing herein shall be construed to modify or expand the scope of practice of a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law.
§ 3. Subparagraph (D) of paragraph 4 of subsection (l) of section 3221 of the insurance law, as amended by section 12 of subpart A of part BB of chapter 57 of the laws of 2019, is REPEALED.
§ 4. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of section 3221 of the insurance law, as amended by section 13 of subpart A of part BB of chapter 57 of the laws of 2019, is amended to read as follows:
(ii) where the policy provides coverage for physician services, it shall include benefits for outpatient care provided by a psychiatrist or psychologist licensed to practice in this state, or a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law, or a licensed clinical social worker [who meets the requirements of subparagraph (D) of paragraph four of this subsection] within the lawful scope of his or her practice, who is licensed pursuant to article one hundred fifty-four of the education law, a nurse practitioner licensed to practice in this state, or a professional corporation or university faculty practice corporation thereof. Nothing herein shall be construed to modify or expand the scope of practice of a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law.
S. 6212--A 3
§ 5. Paragraph 2 of subsection (g) of section 4303 of the insurance law, as added by section 22 of subpart A of part BB of chapter 57 of the laws of 2019, is amended to read as follows:
(2) where the contract provides coverage for physician services such contract shall provide benefits for outpatient care provided by a psychiatrist or psychologist licensed to practice in this state, or a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law, or a licensed clinical social worker [who meets the requirements of subsection (n) of this section] within the lawful scope of his or her practice, who is licensed pursuant to article one hundred fifty-four of the education law, a nurse practitioner licensed to practice [on] in this state, or professional corporation or university faculty practice corporation thereof. Nothing herein shall be construed to modify or expand the scope of practice of a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law.
§ 6. Subsection (i) of section 4303 of the insurance law, as amended by section 25 of subpart A of part BB of chapter 57 of the laws of 2019, is REPEALED.
§ 7. Subsection (n) of section 4303 of the insurance law, as amended by section 30 of subpart A of part BB of chapter 57 of the laws of 2019, is amended to read as follows:
(n) [In addition to the requirements of subsection (i) of this section, every] Every health service or medical expense indemnity corporation issuing a group contract pursuant to this section or a group remittance contract for delivery in this state which contract provides reimbursement to subscribers or physicians, psychiatrists or psychologists for psychiatric or psychological services or for the diagnosis and treatment of mental health conditions, however defined in such contract, must provide the same coverage to persons covered under the group contract for such services when performed by a licensed clinical social worker, within the lawful scope of his or her practice, who is licensed pursuant to [subdivision two of section seven thousand seven hundred four of the education law and in addition shall have either (i) three or more additional years experience in psychotherapy, which for the purposes of this subsection shall mean the use of verbal methods in interpersonal relationships with the intent of assisting a person or persons to modify attitudes and behavior which are intellectually, socially or emotionally maladaptive, under supervision, satisfactory to the state board for social work, in a facility, licensed or incorporated by an appropriate governmental department, providing services for diagnosis or treatment of mental health conditions, or (ii) three or more additional years experience in psychotherapy under the supervision, satisfactory to the state board for social work, of a psychiatrist, a licensed and registered psychologist or a licensed clinical social worker qualified for reimbursement pursuant to subsection (i) of this section, or (iii) a combination of the experience specified in paragraphs (i) and (ii) totaling three years, satisfactory to the state board for social work.] article one hundred fifty-four of the education law and a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed pursuant to article one hundred sixty-three of the education law. Nothing herein shall be construed to modify or expand the scope of practice of a mental health counselor, marriage and family therapist, creative arts therapist or
S. 6212--A 4
psychoanalyst licensed pursuant to article one hundred sixty-three of the education law. The state board for social work shall maintain a list of all licensed clinical social workers qualified for reimbursement under this subsection. The state board for mental health practitioners shall maintain a list of all licensed mental health counselors, marriage and family therapists, creative arts therapists or psychoanalysts qualified for reimbursement under this subsection.
§ 8. This act shall take effect on the first of January next succeeding the date upon which it shall have become a law and shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such effective date; provided, however, that:
(a) if section 8 of subpart A of part BB of chapter 57 of the laws of 2019 shall not have taken effect on or before such date then section one of this act shall take effect on the same date and in the same manner as such chapter of the laws of 2019 takes effect;
(b) if section 11 of subpart A of part BB of chapter 57 of the laws of 2019 shall not have taken effect on or before such date then section two of this act shall take effect on the same date and in the same manner as such chapter of the laws of 2019 takes effect;
(c) if section 13 of subpart A of part BB of chapter 57 of the laws of 2019 shall not have taken effect on or before such date then section four of this act shall take effect on the same date and in the same manner as such chapter of the laws of 2019 takes effect;
(d) if section 22 of subpart A of part BB of chapter 57 of the laws of 2019 shall not have taken effect on or before such date then section five of this act shall take effect on the same date and in the same manner as such chapter of the laws of 2019 takes effect; and
(e) if section 30 of subpart A of part BB of chapter 57 of the laws of 2019 shall not have taken effect on or before such date then section seven of this act shall take effect on the same date and in the same manner as such chapter of the laws of 2019 takes effect.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to health insurance coverage of outpatient care provided by a mental health practitioner and a clinical social worker; and to repeal certain provisions of such law relating thereto
Purpose
The purpose of this bill is to require blanket health insurance policies to provide coverage for outpatient treatment by licensed mental health providers.
Summary of provisions
Section 1 would amend item (ii) of subparagraph (A) of paragraph 5 of subsection 1 of section 3221 of the insurance law to provide that a group or accident and health insurance policy which provides coverage for physician services must also provide coverage for outpatient care by a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed under article one hundred sixty- three of the education law and a licensed clinical social worker licensed under article 154 of the education law.
Read the full memo (647 words)
Section 2 would amend paragraph 1 of subsection (h) of section 4303 of the insurance law to require that a medical expense indemnity corpo- ration or health service corporation must provide coverage for outpa- tient care by a mental health counselor, marriage and family therapist, creative arts therapist or psychoanalyst licensed under article one hundred sixty-three of the education law and a licensed clinical social worker licensed under article, 154 of the education law.
Section 3 states the enactment date.
Existing law
Timothy's law currently requires an insurer to provide benefits for the diagnosis and treatment of mental, nervous or emotional disorders provided by a psychiatrist, psychologist or a licensed clinical social worker with an additional three years of experience.
Justification
Current law does not explicitly include all licensed mental health providers as allowable providers of outpatient mental health services, thereby allowing insurers to deny coverage for the valuable services these practitioners can provide.
Mental health providers licensed by the New York State Department of Education face strict requirements for licensure, including the require- ment that they obtain a Master's degree or higher in a mental health course of study. These requirements ensure that such practitioner is fully capable of providing mental health counseling.
In addition to their Master's level coursework, Licensed Clinical Social Workers are required to pass two competency exams and complete three years of highly prescribed supervised experience in the provision of diagnosis, assessment based treatment planning and psychotherapy. As such, they have the statutory authority to diagnose and are often the first to diagnose and treat people with mental disorders and various emotional and, behavioral disturbances.Clinical Social Workers are essential to a variety of client- centered settings, including community mental health centers, hospitals, substance use treatment and recovery programs, schools, primary health care centers, child welfare agencies, aging services, employee assistance programs, and private practice settings.
This bill would require insurers to reimburse mental health providers licensed under article 163 of the education law and licensed clinical social workers licensed under 154 of the education law in addition to psychiatrists and psychologists. This change will continue to serve the intent of Timothy's Law by making needed mental health services avail- able to more patients. It will benefit rural areas especially, where a patient may have limited access to a psychiatrist or psychologist. This amendment will ensure that a patient is not denied mental health services because the currently enumerated providers are located too far from the patients home, or the patient is unable to afford the out of pocket expense of a mental health practitioner. In addition, this bill would amplify patient choice by increasing the variety and number of reimbursable providers available to treat mental health disorders.
Legislative history
2017,2018: S.3952/A.2163 Referred to Insurance 2015,2016: S.2065A/A.6376-A Referred to Insurance 2013,2014: S.2708/A.978 Referred to Insurance 2011,2012: 5.4756/A.9186 Referred to Insurance
Fiscal implications
Undetermined.
Effective date
This act shall take effect the first of January next succeeding
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.