New York S 499: Enacts the "ensuring access to behavioral health act"

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S00499 Summary:

BILL NOS00499 

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SAME ASSAME AS A01792

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SPONSORFERNANDEZ

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COSPNSR

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MLTSPNSR

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Amd §§4401 & 4403, Pub Health L

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Enacts the "ensuring access to behavioral health act"; includes mental health services, substance use disorder treatment services and recovery support services to network adequacy requirements for insurance coverage.

Go to top S00499 Actions:

BILL NOS00499 

&nbsp

01/08/2025REFERRED TO HEALTH

01/07/2026REFERRED TO HEALTH

Go to topS00499 Committee&nbspVotes:

Go to topS00499 Floor&nbspVotes:

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

Go to topS00499 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 499

 2025-2026 Regular Sessions

 IN SENATE

 (Prefiled)

 January 8, 2025
 ___________

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

 AN ACT to amend the public health law, in relation to including mental
 health services, substance use disorder treatment services and recov-
 ery support services to network adequacy requirements; and directs the
 superintendent of financial services and the commissioner of health to
 review data and update regulations regarding health maintenance organ-
 izations and network adequacy requirements

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

 1 Section 1. Short title. This act shall be known and may be cited as
 2 the "ensuring access to behavioral health act".
 3 § 2. Subdivision 3 of section 4401 of the public health law, as added
 4 by chapter 938 of the laws of 1976, is amended to read as follows:
 5 3. "Comprehensive health services" means all those health services
 6 which an enrolled population might require in order to be maintained in
 7 good health, and shall include, but shall not be limited to, physician
 8 services (including consultant and referral services), in-patient and
 9 out-patient hospital services, mental health services, substance use
 10 disorder treatment services, recovery support services, diagnostic labo-
 11 ratory and therapeutic and diagnostic radiologic services, and emergency
 12 and preventive health services. Such term may be further defined by
 13 agreement with enrolled populations providing additional benefits neces-
 14 sary, desirable or appropriate to meet their health care needs.
 15 § 3. Paragraph (a) of subdivision 5 of section 4403 of the public
 16 health law, as amended by chapter 586 of the laws of 1998, is amended to
 17 read as follows:
 18 (a) The commissioner, at the time of initial licensure, at least every
 19 three years thereafter, and upon application for expansion of service
 20 area, shall ensure that the health maintenance organization maintains a

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD01855-01-5

 S. 499 2

 1 network of health care providers adequate to meet the comprehensive
 2 health needs, including mental health services, substance use disorder
 3 treatment services, including but not limited to opioid treatment
 4 programs and medication assisted treatment options, and recovery support
 5 services, of its enrollees and to provide an appropriate choice of
 6 providers sufficient to provide the services covered under its
 7 enrollee's contracts by determining that (i) there are a sufficient
 8 number of geographically accessible participating providers, including
 9 all opioid treatment programs in all counties of the state and in the
 10 city of New York and all authorized buprenorphine prescribers in all
 11 counties of the state and in the city of New York; (ii) there are oppor-
 12 tunities to select from at least three primary care providers pursuant
 13 to travel and distance time standards, providing that such standards
 14 account for the conditions of accessing providers in rural areas; (iii)
 15 there are sufficient providers in each area of specialty practice to
 16 meet the needs of the enrollment population; (iv) there is no exclusion
 17 of any appropriately licensed type of provider as a class; and (v)
 18 contracts entered into with health care providers neither transfer
 19 financial risk to provid