New York A 3148: Relates to requiring renewal notices for applications under the SCRIE program

Bill Text

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A03148 Summary:

BILL NOA03148A

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SAME ASSAME AS S01763-A

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SPONSORGonzalez-Rojas

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COSPNSRHevesi, Shimsky, Burdick, Davila, Gallagher, Levenberg, Steck, Brown K, Reyes, Forrest, Lunsford,
 Griffin, Schiavoni, Kelles, Valdez

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MLTSPNSR

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Amd §§3216, 3221 & 4303, Ins L

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Provides that for a substance use disorder outpatient treatment episode of care by a provider licensed, certified or otherwise authorized by the office of addiction services and supports, an insured shall only be responsible for a cost sharing fee not to exceed two hundred fifty dollars.

Go to top A03148 Actions:

BILL NOA03148A

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01/23/2025referred to insurance

03/31/2025amend and recommit to insurance

03/31/2025print number 3148a

01/07/2026referred to insurance

Go to topA03148 Committee&nbspVotes:

Go to topA03148 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA03148 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 3148--A

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 23, 2025
 ___________

 Introduced by M. of A. GONZALEZ-ROJAS, HEVESI, SHIMSKY, BURDICK, DAVILA,
 GALLAGHER, LEVENBERG, STECK, K. BROWN, REYES -- 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 certain cost sharing
 fees for outpatient treatment at a substance use treatment program

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Subparagraph (E) of paragraph 31 of subsection (i) of
 2 section 3216 of the insurance law, as amended by section 6 of subpart A
 3 of part BB of chapter 57 of the laws of 2019, is amended and a new
 4 subparagraph (K) is added to read as follows:
 5 (E) This subparagraph shall apply to facilities in this state that are
 6 licensed, certified or otherwise authorized by the office of [alcoholism
 7 and substance abuse] addiction services and supports for the provision
 8 of outpatient, intensive outpatient, outpatient rehabilitation and
 9 opioid treatment that are participating in the insurer's provider
 10 network. Coverage provided under this paragraph shall not be subject to
 11 preauthorization. Coverage provided under this paragraph shall not be
 12 subject to concurrent review for the first four weeks of continuous
 13 treatment, not to exceed twenty-eight visits, provided the facility
 14 notifies the insurer of both the start of treatment and the initial
 15 treatment plan within two business days. The facility shall perform
 16 clinical assessment of the patient at each visit, including periodic
 17 consultation with the insurer at or just prior to the fourteenth day of
 18 treatment to ensure that the facility is using the evidence-based and
 19 peer reviewed clinical review tool utilized by the insurer which is
 20 designated by the office of [alcoholism and substance abuse] addiction
 21 services and supports and appropriate to the age of the patient, to
 22 ensure that the outpatient treatment is medically necessary for the
 23 patient. Any utilization review of the treatment provided under this

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD03320-03-5

 A. 3148--A 2

 1 subparagraph may include a review of all services provided during such
 2 outpatient treatment, including all services provided during the first
 3 four weeks of continuous treatment, not to exceed twenty-eight visits,
 4 of such outpatient treatment. Provided, however, the insurer shall only
 5 deny coverage for any portion of the initial four weeks of continuous
 6 treatment, not to exceed twenty-eight visits, for outpatient treatment
 7 on the basis that such treatment was not medically necessary if such
 8 outpatient treatment was contrary to the evidence-based and peer
 9 reviewed clinical review tool utilized by the insurer which is desig-
 10 nated by the office of [alcoholism and substance abuse] addiction
 11 services and supports. An insured shall only have financial responsibil-
 12 ities as set out in subparagraph (K) of this paragraph and shall not
 13 have any financial o