New York S 10315: Relates to supplemental therapeutic services reimbursement

Bill Text

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S10315 Summary:

BILL NOS10315 

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SAME ASNo Same As

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SPONSORWEBER

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COSPNSR

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MLTSPNSR

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Add §16.36, Ment Hyg L; amd §32, Pub Health L

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Establishes mandatory supplemental therapeutic services reimbursement for certain individuals receiving services through the office for people with developmental disabilities.

Go to top S10315 Actions:

BILL NOS10315 

&nbsp

05/12/2026REFERRED TO DISABILITIES

Go to topS10315 Committee&nbspVotes:

Go to topS10315 Floor&nbspVotes:

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

Go to topS10315 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 10315

 IN SENATE

 May 12, 2026
 ___________

 Introduced by Sen. WEBER -- read twice and ordered printed, and when
 printed to be committed to the Committee on Disabilities

 AN ACT to amend the mental hygiene law and the public health law, in
 relation to establishing a mandatory supplemental therapeutic services
 reimbursement for individuals receiving services through the office
 for people with developmental disabilities

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

 1 Section 1. The mental hygiene law is amended by adding a new section
 2 16.36 to read as follows:
 3 § 16.36 Supplemental therapeutic services reimbursement.
 4 1. Notwithstanding any inconsistent provision of law, rule or regu-
 5 lation, the commissioner shall, upon application and upon satisfaction
 6 of the criteria set forth in subdivision three of this section, author-
 7 ize supplemental reimbursement for therapeutic services for an eligible
 8 individual when such services: (a) have been determined to be medically
 9 necessary; (b) are included in an approved service plan, plan of care,
 10 or other authorized planning document; and (c) cannot be secured within
 11 twenty-one days despite documented reasonable efforts to obtain such
 12 services at state-established reimbursement rates.
 13 2. For purposes of this section, "therapeutic services" shall mean
 14 counseling, psychotherapy, behavioral therapy, or other clinically
 15 appropriate therapeutic intervention provided by a person who is
 16 licensed, certified, or otherwise legally authorized under the laws of
 17 this state to furnish such service.
 18 3. Supplemental reimbursement under this section shall be approved
 19 upon a determination by the commissioner, or the commissioner's desig-
 20 nee, that:
 21 (a) the service is medically necessary and included in an approved
 22 planning document;
 23 (b) the eligible individual or the individual's authorized represen-
 24 tative, in coordination with the relevant care manager, service coordi-
 25 nator, or other responsible planning entity, made documented reasonable
 26 efforts over a period of not less than twenty-one days to obtain the

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD15849-02-6

 S. 10315 2

 1 service from a provider willing to accept the applicable state-establ-
 2 ished reimbursement rate, and such efforts were unsuccessful;
 3 (c) delay or absence of such service would materially impair the indi-
 4 vidual's health, behavioral stability, community functioning, or mainte-
 5 nance in the least restrictive setting appropriate to such individual's
 6 needs; and
 7 (d) the provider selected to furnish the service is appropriately
 8 licensed, certified, or otherwise legally authorized under the laws of
 9 this state.
 10 4. Upon approval under subdivision three of this section, the commis-
 11 sioner shall authorize reimbursement in an amount equal to seventy-five
 12 percent of the provider's billed charges, subject to the following:
 13 (a) The minimum supplemental reimbursement floor shall be one hundred
 14 twenty dollars per hour for individual therapy sessions, ninety dollars
 15 per hour for group therapy sessions, and one hundred fifty dollars per
 16 hour for behavioral intervention or applied behavior analysis (ABA)
 17 services. Such reimbursement floors shall not be reduced by regulation
 18 or administrative action.
 19 (b) Beginning January first, two thousand twenty-eight, and annually
 20 thereafter, the minimum reimbursement floors set fo