What's happening
This bill requires health insurance plans to cover outpatient mental health care provided by licensed counselors, therapists, and psychoanalysts, in addition to psychiatrists and psychologists.
Why it matters
Expands access to mental health care. by allowing more types of licensed mental health professionals (including counselors, marriage and family therapists, creative arts therapists, and psychoanalysts) to be covered by insurance for outpatient services, potentially reducing wait times and increasing treatment options.
Addresses workforce shortages and provider choice. , especially in underserved or rural areas where psychiatrists and psychologists may be scarce, by letting patients use insurance for care from a broader pool of qualified practitioners.
Maintains professional boundaries. by explicitly stating the bill does not expand or change the legal scope of practice for the newly included provider types—ensuring each provider works within their existing legal limits, which may reassure critics concerned about quality or safety.
May help reduce overall healthcare costs. by enabling earlier, more accessible intervention from a wider array of mental health professionals, which can prevent more severe mental health crises and reduce reliance on higher-cost emergency or inpatient services.
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Who cares
Licensed mental health counselors, marriage and family therapists, creative arts therapists and psychoanalysts
The bill would require covered policies to include outpatient care they provide, without expanding their scope of practice.
Patients covered by affected health policies
They would gain required outpatient mental health benefits for care from four additional categories of licensed practitioners.
Insurers, medical expense indemnity corporations and health service corporations
They would have to include these practitioners in required outpatient benefits under affected policies and contracts issued, renewed or changed on or after the effective date.
Headline styles
Expand Mental Health Coverage
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Referred to insurance
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
886
2019-2020 Regular Sessions
IN SENATE
January 9, 2019
Introduced by Sens. YOUNG, ORTT -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to health insurance coverage of outpatient care provided by a mental health practitioner
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Item (ii) of subparagraph (A) of paragraph 5 of subsection (l) of section 3221 of the insurance law, as amended by chapter 502 of the laws of 2007, 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, or a professional corporation or university faculty practice corporation thereof. Such benefits may be limited to not less than twenty visits in any contract year, plan year, or calendar year. 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. Paragraph 1 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:
(1) A medical expense indemnity corporation or a health service corporation, which provides group, group remittance or school blanket coverage for physician services, shall provide as part of its contract broadbased coverage for the diagnosis and treatment of mental, nervous or emotional disorders or ailments, however defined in such contract, at
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04132-01-9
S. 886 2
least equal to the coverage provided for other health conditions and 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 subsection (n) of this section, or a professional corporation or university faculty practice corporation thereof, which benefits may be limited to not less than twenty visits in any contract year, plan year or calendar year. Such coverage may be provided on a contract year, plan year or calendar year basis and shall be consistent with the provision of other benefits under the contract. Such coverage may be subject to annual deductibles, co-pays and coinsurance as may be deemed appropriate by the superintendent and shall be consistent with those imposed on other benefits under the contract. In the event the group remittance group or contract holder is provided coverage provided under this paragraph and under subparagraph (B) of paragraph one of subsection (g) of this section from the same health service corporation, or under a contract which is jointly underwritten by two health service corporations or by a health service corporation and a medical expense indemnity corporation, the aggregate of the benefits for out-patient care obtained under subparagraph (B) of paragraph one of subsection (g) of this section and this paragraph may be limited to not less than twenty visits in any contract year, plan year or calendar year. 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. This act shall take effect on the first of January next succeeding the date on 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.
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
Purpose
The purpose of this bill is to require blanket health insurance policies to provide coverage for outpatient treatment by mental health practi- tioners.
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.
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.
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.
Justification
Current law does not explicitly include mental health practitioners as allowable providers of outpatient mental health services, thereby allow- ing insurers to deny coverage for the valuable services these practi- tioners can provide.
Mental health practitioners 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 therapy.
This bill would require insurers to reimburse mental health practition- ers, in addition to psychiatrists, psychologists or licensed clinical social workers. This change will continue to serve the intent of Timothy's Law by making needed mental health services available to more patients. It will benefit rural areas especially, where a patient may have limited access to a psychiatrist, psychologist or a licensed clin- ical social worker. 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 vari- ety 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: S.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.