New York S 6897: Requires rates paid for rehabilitation and opioid treatment be pursuant to certain fee schedules published by the office of addiction services and supports

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S06897 Summary:

BILL NOS06897A

&nbsp

SAME ASSAME AS A07038-A

&nbsp

SPONSORBAILEY

&nbsp

COSPNSRRHOADS

&nbsp

MLTSPNSR

&nbsp

Amd §§3216, 3221 & 4303, Ins L

&nbsp

Requires rates paid for rehabilitation and opioid treatment be pursuant to certain fee schedules published by the office of addiction services and supports.

Go to top S06897 Actions:

BILL NOS06897A

&nbsp

03/26/2025REFERRED TO INSURANCE

05/01/2025AMEND AND RECOMMIT TO INSURANCE

05/01/2025PRINT NUMBER 6897A

05/05/20251ST REPORT CAL.926

05/06/20252ND REPORT CAL.

05/07/2025ADVANCED TO THIRD READING 

06/12/2025SUBSTITUTED BY A7038A

&nbspA07038 AMEND=A Weprin

&nbsp03/18/2025referred to insurance

&nbsp04/02/2025reported 

&nbsp04/03/2025advanced to third reading cal.96

&nbsp04/29/2025amended on third reading 7038a

&nbsp05/20/2025passed assembly

&nbsp05/20/2025delivered to senate

&nbsp05/20/2025REFERRED TO INSURANCE

&nbsp06/12/2025SUBSTITUTED FOR S6897A

&nbsp06/12/20253RD READING CAL.926

&nbsp06/12/2025PASSED SENATE

&nbsp06/12/2025RETURNED TO ASSEMBLY

&nbsp12/08/2025delivered to governor

&nbsp12/19/2025signed chap.660

&nbsp12/19/2025approval memo.41

Go to topS06897 Committee&nbspVotes:

Go to topS06897 Floor&nbspVotes:

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

Go to topS06897 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6897--A

 2025-2026 Regular Sessions

 IN SENATE

 March 26, 2025
 ___________

 Introduced by Sen. BAILEY -- read twice and ordered printed, and when
 printed to be committed 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 requiring rates paid
 for rehabilitation and opioid treatment be pursuant to certain fee
 schedules published by the office of addiction services and supports

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

 1 Section 1. Subparagraph (J) of paragraph 31 of subsection (i) of
 2 section 3216 of the insurance law, as added by section 1 of part AA of
 3 chapter 57 of the laws of 2024, is amended to read as follows:
 4 (J) This subparagraph shall apply to facilities in this state that are
 5 licensed, certified, or otherwise authorized by the office of addiction
 6 services and supports for the provision of outpatient, intensive outpa-
 7 tient, outpatient rehabilitation and opioid treatment that are partic-
 8 ipating in the insurer's provider network. Reimbursement for covered
 9 outpatient treatment provided by such facilities shall be at rates nego-
 10 tiated between the insurer and the participating facility, provided that
 11 such rates are not less than the rates that would be paid for such
 12 treatment pursuant to the medical assistance program under title eleven
 13 of article five of the social services law. For the purposes of this
 14 subparagraph, the rates that would be paid for such treatment pursuant
 15 to the medical assistance program under title eleven of article five of
 16 the social services law shall be set forth in a fee schedule setting
 17 forth the specific fee for each individual service covered by this
 18 subparagraph published by the office of addiction services and supports
 19 by November first of the preceding calendar year and shall be the rates
 20 with an effective date of April first of the preceding year, which shall
 21 be established prior to October first of the preceding calendar year.
 22 Prior to the submission of premium rate filings and applications, the

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD11143-03-5

 S. 6897--A 2

 1 superintendent shall provide insurers with guidance on factors to
 2 consider in calculating the impact of rate changes for the purposes of
 3 submitting premium rate filings and applications to the superintendent
 4 for the subsequent policy year. To the extent that the rates with an
 5 effective date of April first differ from the estimated rates incorpo-
 6 rated in premium rate filings and applications, insurers may account for
 7 such differences in future premium rate filings and applic