Bill S1237-2011

Establishes mental health parity in public health insurance plans

Establishes mental health parity in public health insurance plans.

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  • Jan 4, 2012: REFERRED TO SOCIAL SERVICES
  • Jan 6, 2011: REFERRED TO SOCIAL SERVICES

Memo

BILL NUMBER:S1237

TITLE OF BILL:

An act to amend the social services law, in relation to establishing mental health parity in public health insurance plans

PURPOSE:

Provides that the benefits provided in Family Health Plus for the treatment of mental health and substance abuse disorders be comparable to medical services.

SUMMARY OF PROVISIONS:

Section 1. Provides that mental health and substance abuse benefits provided in Family Health Plus shall be comparable to medical benefits provided as part of the Family Health Plus program.

Section 2. Authorizes the Commissioner to seek any necessary waivers to implement this chapter.

Section 3. Provides for an effective date of April 1 of the year next succeeding enactment.

JUSTIFICATION:

Timothy's Law (Chapter 748 of the Laws of 2006), one of the 42 state mental health parity laws in the US, took effect January 1, 2007 and applies to most insurance policies in New York on the day they are issued, renewed, modified, altered, or amended. Before the law passed, health plans were permitted to discriminate against those with mental health needs by charging much higher co-payments and deductibles for inpatient and outpatient mental health care compared with the fees they charge consumers for regular medical office visits. Top health plans also recently began to restrict coverage for mental health conditions, exclude coverage for chronic mental illnesses, and impose life time limits on inpatient psychiatric care. Timothy's Law remedied many of these barriers to care.

Further, Federal law recently added mental health parity requirements to the Child Health Insurance plans (effective April 1, 2009) and Medicare (effective on a phased in schedule over the next few years) as well as self-insured plans and other large employers, including parity in coverage for the treatment of chemical dependency (effective with plan years beginning after October 3, 2009 except for certain collectively bargained plans that are subject to special rules regarding effective date).

These changes and equity and the comparability provisions of Timothy's Law do not presently apply to the Family Health Plus Program. This program already provides coverage for inpatient and outpatient mental health and alcohol and substance abuse services, but unlike other health insurance programs that may not limit such services, these benefits are limited in Family Health Plus.

This legislation simply assures that such coverage is comparable to that which is provided for other medical conditions under these programs, and does not place greater restrictions on coverage for mental health conditions or addictions than apply for other needs.

Recent studies confirm the efficacy and cast effectiveness of such coverage, and, furthermore demonstrate that the costs associated with the enactment of mental health parity legislation are minimal. Actuarial analyses and emerging data from states with parity laws demonstrate that equitable insurance coverage for mental illnesses is indeed affordable. Studies demonstrate that the cost of adopting mental health parity is negligible - often below one per cent. The NYS insurance department projected costs for Timothy's Law premium subsidies for small employers to be about one percent for the premium component attributable to the entire mental health benefit among private insurers and Health Maintenance Organizations in NYS.

The comparability required under this legislation would cost a mere fraction of that sum, since (unlike commercial health plans previously) the Family Health Plus Program already provide mental health and addiction treatment coverage. Further, the cost to the taxpayer will be reduced, since those who may would need benefits beyond the Family Health Plus limited benefit are at times forced onto Medicaid.

Finally, costs are incurred by individuals, employers, all levels of government, and society as a whole as a result of untreated mental illnesses that can also cause or contribute to accidents, job dissatisfaction, interpersonal conflict, turnover, disability, workers' compensation, involvement with the criminal justice system, disrupted lives and families, and increased dependency on public resources. By providing comparable coverage for mental health and substance abuse services for all using the Family Health Plus Program, mental illness and substance abuse can be diagnosed and treated quickly and thoroughly, thus placing less of a burden on public resources and businesses.

LEGISLATIVE HISTORY:

2010: S.7550 (Duane) Died in Finance

FISCAL IMPLICATIONS:

Minimal.

EFFECTIVE DATE:

April 1st of the year next succeeding enactment.


Text

STATE OF NEW YORK ________________________________________________________________________ 1237 2011-2012 Regular Sessions IN SENATE January 6, 2011 ___________
Introduced by Sen. DUANE -- read twice and ordered printed, and when printed to be committed to the Committee on Social Services AN ACT to amend the social services law, in relation to establishing mental health parity in public health insurance plans THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subparagraph (ix) of paragraph (e) of subdivision 1 of section 369-ee of the social services law, as added by chapter 1 of the laws of 1999, is amended to read as follows: (ix) inpatient and outpatient mental health and alcohol and substance abuse services, as defined by the commissioner, PROVIDED THAT COVERAGE FOR MENTAL HEALTH, ALCOHOL AND SUBSTANCE ABUSE SERVICES SHALL BE PROVIDED ON THE SAME TERMS AND CONDITIONS AS THE COVERAGE FOR OTHER COVERED HEALTH CARE SERVICES; S 2. The commissioner of health is authorized to submit amendments to the state plan for medical assistance and submit one or more applica- tions for waivers of the federal social security act as may be necessary to obtain the federal approvals necessary to implement this chapter. S 3. This act shall take effect on the first of April next succeeding the date on which it shall have become a law.

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