NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A5436A
SPONSOR: Stirpe (MS) TITLE OF BILL:
An act to amend the insurance law, in relation to insurance coverage for
substance abuse disorder services
PURPOSE OF BILL:
To require insurance companies to provide at least 90 days of inpatient
rehabilitation services to an insured upon a doctor's prescription.
SUMMARY OF PROVISIONS:
Section l: Amends the Insurance Law to provide an individual accident
policy offering 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 referred by a doctor.
Section 2. Amends 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 facili-
ty when referred by a doctor.
Section 3. Amends 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 and
shall include coverage for at least ninety days at a rehabilitation
facility when referred by a doctor.
Section 4. Sets the effective date.
JUSTIFICATION:
Throughout New York State, opioid addiction runs rampant. Every communi-
ty, urban and rural alike, throughout the State is susceptible to opioid
addiction. The expansion of access to effective treatments for those who
are addicted to opioids is paramount in addressing this issue. One meth-
od of expanding access to treatments is to require insurance coverage
for at least 90 days of inpatient rehabilitation services for substance
abuse disorders upon a doctor's referral. This method ensures that a
connection is established between victims, users, and treatment facili-
ties thereby increasing the probability of effectively addressing
addiction. Therefore, it is imperative that this legislation be
enacted.
LEGISLATIVE HISTORY:
2016: A.9211/S.6478-A - Reported to Rules/ Referred to Insurance
2017-18: A.492/S.2099 - Referred to Ways and Means/Referred to Insurance
2019-20: A.1163 - Referred to Insurance 2021-22: A.3654 - Referred to
Insurance
FISCAL IMPLICATIONS:
To be determined.
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law and shall apply to any policy issued, amended, or renewed
on and after such effective date.
STATE OF NEW YORK
________________________________________________________________________
5436--A
2023-2024 Regular Sessions
IN ASSEMBLY
March 10, 2023
___________
Introduced by M. of A. STIRPE, JONES, DARLING, COOK, SAYEGH, JACOBSON,
REYES, AUBRY, DICKENS, SIMON, BUTTENSCHON, CRUZ, L. ROSENTHAL, MAGNAR-
ELLI, LUPARDO, HUNTER, DeSTEFANO, REILLY, RA, GOODELL, DiPIETRO,
BLANKENBUSH, STECK -- Multi-Sponsored by -- M. of A. EPSTEIN,
J. M. GIGLIO, HEVESI -- read once and referred 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 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 5 of subpart A of part BB of chap-
3 ter 57 of the laws of 2019, is amended by adding a new subparagraph (H)
4 to read as follows:
5 (H) 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 referral of a
9 doctor.
10 § 2. Paragraph 6 of subsection (l) of section 3221 of the insurance
11 law is amended by adding a new subparagraph (H) to read as follows:
12 (H) 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 referral of a
16 doctor.
17 § 3. Subsection (k) of section 4303 of the insurance law is amended by
18 adding a new paragraph 8 to read as follows:
19 (8) A policy providing coverage under this subsection shall include
20 coverage for at least ninety days at a rehabilitation facility;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00424-03-3
A. 5436--A 2
1 provided, however, that any stay in a rehabilitation facility required
2 to be covered pursuant to this subsection shall require the referral of
3 a doctor.
4 § 4. This act shall take effect on the ninetieth day after it shall
5 have become a law and shall apply to any policy issued, amended, or
6 renewed on and after such effective date.
