Jones, Cook, Colton, Simon, Barrett, De Los Santos, Raga, Burdick, Eachus
MLTSPNSR
Amd §§3216, 3221 & 4303, Ins L
Requires insurance policies to provide coverage for services related to the diagnosis and treatment of mental, nervous or emotional disorders or ailments; makes related provisions.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A21
SPONSOR: Magnarelli TITLE OF BILL:
An act to amend the insurance law, in relation to coverage for children
for services related to the diagnosis and treatment of mental, nervous
or emotional disorders or ailments
PURPOSE:
This legislation requires that health insurers in the State of New York
provide coverage for treatment Of children at facilities owned and oper-
ated by the State Office of Mental Health (0MH). Children are defined
as being up to 18 years old.
SUMMARY OF PROVISIONS:
Section 1: Amends § 3216(i) of the Insurance Law adding new paragraph 35
to require every individual health insurance policy sold in the State to
include coverage for mental health treatment of children at State run
facilities.
Section 2: Amends § 3221(1) of the Insurance Law adding new paragraph
5-a to require every group or blanket health insurance policy solid in
the State to include coverage for mental health treatment of children at
State run facilities.
Section 3: Amends § 4303 of the Insurance Law adding new subsection g-1
to require health insurance policies issued by a non-profit hospital
service corporation or a health service corporation to include coverage
for mental health treatment of children at State run facilities.
Section 4: Establishes the effective date.
JUSTIFICATION:
The United States and New York State are facing a crisis in the treat-
ment of mental illness, particularly for youth. The problem is partic-
ularly acute in Central New York (CNY). In 2015, the Youth Mental Health
Taskforce was formed in CNY. to try and address the issues facing mental
health treatment for children in the region. A top priority of the Task-
force was addressing the lack of in-patient beds for children in CNY.
Hutchings Psychiatric Center in Syracuse, owned and operated by the
State of New York, is the only facility in the region offering in-pa-
tient treatment for youth with mental health issues. Unfortunately,
that facility is not open to families with private health insurance.
This forces families already in crisis to send their children to facili-
ties hours away and sometimes out-of-state. The last private hospital
in CNY closed in 2004.
Despite the efforts of the Taskforce and local mental health advocates,
Hutchings still does not have contracts with major insurance providers
in the area. This legislation would provide immediate relief to these
families by requiring all private health insurers in New York to cover
treatment for children at OMH run facilities.
Youth mental illness is a critical issue that needs to be address
comprehensively. However, no family should be forced to send their child
hours away for treatment because an insurance company will not cover
treatment at a local facility, simply because it is State run. This
bill is a first step in helping families dealing with mental illness get
the support they need.
LEGISLATIVE HISTORY:
2021-2022: A.1266; 2019-2020: A.2046; 2017-2018: A.6465-A
FISCAL IMPLICATIONS:
None to the State.
EFFECTIVE DATE:
This act shall take effect immediately and shall apply to any policy
issued, delivered, renewed, and/or modified on or after the effective
date of this act.
STATE OF NEW YORK
________________________________________________________________________
21
2023-2024 Regular Sessions
IN ASSEMBLY(Prefiled)
January 4, 2023
___________
Introduced by M. of A. MAGNARELLI, JONES, COOK, COLTON, SIMON, BARRETT,
DE LOS SANTOS -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to coverage for children
for services related to the diagnosis and treatment of mental, nervous
or emotional disorders or ailments
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subsection (i) of section 3216 of the insurance law is
2 amended by adding a new paragraph 37 to read as follows:
3 (37) (A) Every policy that provides medical, major medical or similar
4 comprehensive-type coverage, shall provide coverage for children for
5 services related to the diagnosis and treatment of mental, nervous or
6 emotional disorders or ailments, including but not limited to biologi-
7 cally based mental illnesses as defined by subparagraph (B) of paragraph
8 five of subsection (l) of section three thousand two hundred twenty-one
9 of this article and children with serious emotional disturbances as
10 defined by subparagraph (C) of paragraph five of subsection (l) of
11 section three thousand two hundred twenty-one of this article, in a
12 psychiatric center under the jurisdiction of the office of mental health
13 or other psychiatric in-patient facility in the department, and a
14 psychiatric in-patient facility maintained by a political subdivision of
15 the state for the care or treatment of the mentally ill. Coverage
16 required under this paragraph must be at least equal to coverage
17 provided in such policy for the diagnosis and treatment of mental, nerv-
18 ous or emotional disorders or ailments with no additional cost sharing.
19 (B) For the purposes of this paragraph, the term "children" shall mean
20 any person under the age of eighteen years.
21 § 2. Subsection (l) of section 3221 of the insurance law is amended by
22 adding a new paragraph 5-a to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00248-01-3
A. 21 2
1 (5-a) (A) Every policy that provides medical, major medical or similar
2 comprehensive-type coverage, shall provide coverage for children for
3 services related to the diagnosis and treatment of mental, nervous or
4 emotional disorders or ailments, including but not limited to biologi-
5 cally based mental illnesses as defined by subparagraph (B) of paragraph
6 five of this subsection and children with serious emotional disturbances
7 as defined by subparagraph (C) of paragraph five of this subsection, in
8 a psychiatric center under the jurisdiction of the office of mental
9 health or other psychiatric in-patient facility in the department, and a
10 psychiatric in-patient facility maintained by a political subdivision of
11 the state for the care or treatment of the mentally ill. Coverage
12 required under this paragraph must be at least equal to coverage
13 provided in such policy for the diagnosis and treatment of mental, nerv-
14 ous or emotional disorders or ailments with no additional cost sharing.
15 (B) For the purposes of this paragraph, the term "children" shall mean
16 any person under the age of eighteen years.
17 § 3. Section 4303 of the insurance law is amended by adding a new
18 subsection (g-1) to read as follows:
19 (g-1) (1) Every contract that provides medical, major medical or simi-
20 lar comprehensive-type coverage, shall provide coverage for children for
21 services related to the diagnosis and treatment of mental, nervous or
22 emotional disorders or ailments, including but not limited to biologi-
23 cally based mental illnesses as defined by subparagraph (B) of paragraph
24 two of subsection (g) of this section and children with serious
25 emotional disturbances as defined by paragraph three of subsection (g)
26 of this section, in a psychiatric center under the jurisdiction of the
27 office of mental health or other psychiatric in-patient facility in the
28 department, and a psychiatric in-patient facility maintained by a poli-
29 tical subdivision of the state for the care or treatment of the mentally
30 ill. Coverage required under this paragraph must be at least equal to
31 coverage provided in such policy for the diagnosis and treatment of
32 mental, nervous or emotional disorders or ailments with no additional
33 cost sharing.
34 (2) For the purposes of this subsection, the term "children" shall
35 mean any person under the age of eighteen years.
36 § 4. This act shall take effect immediately and shall apply to any
37 policy issued, delivered, renewed, and/or modified on or after the
38 effective date of this act.
