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A01163 Summary:

BILL NOA01163
 
SAME ASNo Same As
 
SPONSORStirpe
 
COSPNSRBlankenbush, Buchwald, DiPietro, Goodell, Hunter, Lupardo, Magnarelli, Ra, Raia, Rosenthal L, Fernandez, Cruz, Buttenschon, Simon, Dickens, Aubry, Reyes, D'Urso, Jacobson, Sayegh, Reilly, Montesano, DeStefano, Cook, Raynor, Jaffee, Jones
 
MLTSPNSREnglebright, Epstein, Giglio, Hevesi, Wright
 
Amd 3216, 3221 & 4303, Ins L
 
Requires insurance companies to provide at least ninety days of rehabilitation services to an insured upon a doctor's prescription.
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A01163 Actions:

BILL NOA01163
 
01/14/2019referred to insurance
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A01163 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A1163
 
SPONSOR: Stirpe
  TITLE OF BILL: An act to amend the insurance law, in relation to insurance coverage for substance abuse disorder services   PURPOSE: To require insurance companies provide at least ninety days of inpatient rehabilitation services to an insured upon a doctor's prescription.   SUMMARY OF PROVISIONS: Section 1 amends § 3216(i)(30) of the Insurance Law to provide that an individual accident policy providing medical coverage for the diagnosis and treatment of substance use disorder shall include coverage for at least ninety days at an inpatient rehabilitation facility when prescribed by a doctor. Section 2 amends § 3221(1)(6) of the Insurance Law to provide that group or blanket accident and health insurance policies providing medical coverage for the diagnosis and treatment of substance use disorder shall include coverage for at least ninety days at an inpatient rehabilitation facility when prescribed by a doctor. Section 3 amends § 4303(k) of the Insurance Law to provide that every contract issued by a hospital service corporation or health service corporation which provides coverage for in-patient hospital care shall also provide coverage for the diagnosis and treatment of substance use disorder shall include coverage for at least ninety days at a rehabili- tation facility when prescribed by a doctor. Section 4 provides the effective date.   EXISTING LAW: Section 3216 of the Insurance Law relates to individual accident and health insurance policy provisions. Paragraph 30 of subsection (i) of this section provides, every policy that provides medical, major medical, or similar comprehensive-type coverage must provide inpatient coverage for the diagnosis and treatment of substance abuse disorder, including detoxification and rehabilitation services. Section 3221 of the Insurance Law relates to group or blanket accident and health insurance policies. Paragraph (6) of subsection (1) of this section provides, every policy that provides medical, major medical, or similar comprehensive-type coverage must provide inpatient coverage for the diagnosis and treatment of substance abuse disorder, including detoxification and rehabilitation services. Section 4303 of the Insurance Law relates to contracts issued by a hospital service corporation or health service corporation. Subsection (k) of this section provides, every policy that provides medical, major medical, or similar comprehensive-type coverage must provide inpatient coverage for the diagnosis and treatment of substance abuse disorder, including detoxification and rehabilitation services.   JUSTIFICATION: Heroin use has increased significantly across the United States and in New York among all demographics, including gender, age, and income level. All communities are susceptible to heroin or prescription opioid addiction and the use or misuse of these drugs is a problem in rural, suburban and urban communities across our state. Public awareness and community involvement are key factors in addressing this problem. But the expansion of access to effective treatments for those who are addicted is paramount in preventing the continued development of heroin and opioid addiction. By legislatively requiring insurance coverage for at least ninety days of inpatient rehabilitation services for substance abuse disorders upon a doctor's prescription, New York promotes public health in every community and makes a serious effort in reversing the national trend toward increased heroin and opioid use. The Centers for Disease Control reports that the greatest increases in heroin and opioid use have occurred in groups with historically lower rates of heroin use, including women and people with private insurance and higher incomes. In its most recent report the CDC found that nearly all individuals using heroin also use or misuse other substances, but the strongest risk factor for heroin use disorder is a prescription opioid use disorder. Increased use has also lead to increased deaths associated to heroin overdose. Heroin-related deaths increased a dramat- ic 39% between 2012 and 2013, while the rate of heroin-related overdose deaths nearly quadrupled over the past decade. Increased use of naloxone, or Narcan, the antidote used to reverse over- doses, has had an acute effect on saving lives from heroin overdose. But reversing overdoses is insufficient in combating and overcoming the heroin problem in New York State. Connecting overdose victims and those individuals struggling with prescription drug and heroin use disorders to treatment facilities is vital to the success of correcting heroin addiction in our state. Ensuring that insurance providers actually provide a minimum of 90 days of substance abuse inpatient rehabilitation services pursuant to a doctor's order is an integral component to making the connection between victims and users and treatment facilities effec- tive and successful. For all of the aforementioned reasons it is imper- ative that this legislation is enacted.   LEGISLATIVE HISTORY: A9211 of 2015-2016; 02/04/16 referred to insurance 05/25/16 reported referred to ways and means 06/01/16 reported referred to rules 2016-2017: referred to insurance 2017-2018: A.492/S.2099 referred to ways and means/referred to insurance   FISCAL IMPLICATIONS: To be determined.   EFFECTIVE DATE: This act shall take effect ninety days after is shall become law.
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A01163 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          1163
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 14, 2019
                                       ___________
 
        Introduced by M. of A. STIRPE, BLANKENBUSH, BUCHWALD, DiPIETRO, GOODELL,
          HUNTER,  LUPARDO,  MAGNARELLI, RA, RAIA, L. ROSENTHAL -- read once and
          referred to the Committee on Insurance
 
        AN ACT to amend the insurance law, in relation to insurance coverage for
          substance abuse disorder services

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Paragraph  30  of  subsection  (i) of section 3216 of the
     2  insurance law, as amended by section 1 of part B of chapter  71  of  the
     3  laws  of  2016,  is  amended by adding a new subparagraph (E) to read as
     4  follows:
     5    (E) A policy providing coverage under  this  paragraph  shall  include
     6  coverage  for  at  least  ninety  days  at  a  rehabilitation  facility;
     7  provided, however, that any stay in a rehabilitation  facility  required
     8  to  be covered pursuant to this paragraph shall require the prescription
     9  of a doctor.
    10    § 2. Paragraph 6 of subsection (l) of section 3221  of  the  insurance
    11  law is amended by adding a new subparagraph (E) to read as follows:
    12    (E)  A  policy  providing  coverage under this paragraph shall include
    13  coverage  for  at  least  ninety  days  at  a  rehabilitation  facility;
    14  provided,  however,  that any stay in a rehabilitation facility required
    15  to be covered pursuant to this paragraph shall require the  prescription
    16  of a doctor.
    17    § 3. Subsection (k) of section 4303 of the insurance law is amended by
    18  adding a new paragraph 5 to read as follows:
    19    (5)  A  policy  providing coverage under this subsection shall include
    20  coverage  for  at  least  ninety  days  at  a  rehabilitation  facility;
    21  provided,  however,  that any stay in a rehabilitation facility required
    22  to be covered pursuant to this subsection shall require the prescription
    23  of a doctor.
    24    § 4. This act shall take effect on the ninetieth day  after  it  shall
    25  have  become  a  law  and  shall apply to any policy issued, amended, or
    26  renewed on and after such effective date.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00545-01-9
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