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A00343 Summary:

BILL NOA00343
 
SAME ASSAME AS S02538
 
SPONSORGottfried
 
COSPNSRGonzalez-Rojas, Paulin
 
MLTSPNSR
 
Amd 2510, Pub Health L
 
Provides for coverage of mental health and alcohol and substance use services under the child health insurance plan.
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A00343 Actions:

BILL NOA00343
 
01/06/2021referred to health
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A00343 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A343
 
SPONSOR: Gottfried
  TITLE OF BILL: An act to amend the public health law, in relation to coverage of mental health and alcohol and substance use services under the child health insurance plan   PURPOSE OR GENERAL IDEA OF BILL: To ensure that children who receive health insurance under the Child Health Plus (CHP) program have access to necessary "early and periodic screening, diagnosis, and treatment" (EPSDT) services, especially relat- ing to children with physical or mental disabilities and to a full range of mental health and alcohol and substance use services..   SUMMARY OF PROVISIONS: Section 1 amends Public Health Law section 2510 subdivision 7 to add "early and periodic screening, diagnosis and treatment for eligible children under the age of six and for other eligible children to ascer- tain physical and mental disabilities" to the definition of "covered health care services" in the CHP program. It also removes the phrase limiting mental health and substance use coverage to only services "as defined by the commissioner in consultation with the superintendent." Section 2. Takes effect April 1 after it becomes a law. Effective imme- diately, the Commissioner of Health shall make regulations and take other actions reasonably necessary to implement this act on that date.   JUSTIFICATION: Since 1967, the Federal government has required state Medicaid programs to include coverage of services under the umbrella of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, a category that captures a slate of preventive services for all enrollees under age 21. The broad scope of this benefit entitles Medicaid-eligible children to comprehensive health care and age-appropriate screenings and services throughout their early life. However, the CHP law does not require the full range of EPSDT services. A variety of behavioral health individual and family treatment and support services that are available through Medicaid are not covered by CHP because current law gives the Commissioner of Health and the Super- intendent of the Department of Financial Services the authority to limit mental health and substance use services. This outdated limitation violates the , principle of parity for coverage of these services.   PRIOR LEGISLATIVE HISTORY: 2019-2020: A.11117 referred to Health committee   FISCAL IMPLICATIONS FOR STATE AND LOCA GOVERNMENTS: To be determined. Since the Federal government pays for 76.5% of New York's CHP expenditures, adding these services to CHP will cost even less state share than including them in Medicaid costs.   EFFECTIVE DATE: April 1 after it becomes a law. Effective immediately, the Commissioner of Health shall make regulations and take other actions reasonably necessary to implement this act on that date.
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A00343 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                           343
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                       (Prefiled)
 
                                     January 6, 2021
                                       ___________
 
        Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
          Committee on Health
 
        AN ACT to amend the public health law, in relation to coverage of mental
          health and alcohol and substance use services under the  child  health
          insurance plan

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Subdivision 7 of section 2510 of the public health law,  as
     2  amended  by  chapter  428  of  the  laws  of 2013, is amended to read as
     3  follows:
     4    7. "Covered health care services" means: the services  of  physicians,
     5  optometrists,  nurses,  nurse  practitioners, midwives and other related
     6  professional personnel  which  are  provided  on  an  outpatient  basis,
     7  including  routine well-child visits; diagnosis and treatment of illness
     8  and injury; early and periodic screening, diagnosis  and  treatment  for
     9  eligible  children  under the age of six and for other eligible children
    10  to ascertain physical and mental  disabilities;  inpatient  health  care
    11  services;  laboratory  tests;  diagnostic  x-rays; prescription and non-
    12  prescription drugs and durable  medical  equipment;  radiation  therapy;
    13  chemotherapy;  hemodialysis;  outpatient  blood clotting factor products
    14  and other treatments and services furnished in connection with the  care
    15  of  hemophilia  and other blood clotting protein deficiencies; emergency
    16  room services;  hospice  services;  emergency,  preventive  and  routine
    17  dental  care,  including  medically  necessary orthodontia but excluding
    18  cosmetic surgery; emergency, preventive and routine vision care, includ-
    19  ing eyeglasses; speech and hearing services; and, inpatient  and  outpa-
    20  tient  mental  health,  alcohol  and  substance [abuse] use services [as
    21  defined by the commissioner in consultation  with  the  superintendent].
    22  "Covered  health  care services" shall not include drugs, procedures and
    23  supplies for the treatment of erectile dysfunction when provided to,  or
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02905-01-1

        A. 343                              2
 
     1  prescribed  for  use  by,  a person who is required to register as a sex
     2  offender pursuant to article six-C of the correction law, provided  that
     3  any  denial  of  coverage  of  such  drugs, procedures or supplies shall
     4  provide  the  patient with the means of obtaining additional information
     5  concerning both the denial and the means of challenging such denial.
     6    § 2. This act shall take effect on the first of April after it becomes
     7  a law.  Effective immediately, the commissioner  of  health  shall  make
     8  regulations  and  take  other  actions reasonably necessary to implement
     9  this act on that date.
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