A 8864: Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization.

  
  STATE OF NEW YORK ________________________________________________________________________ 8864 2025-2026 Regular Sessions  IN ASSEMBLY June 9, 2025 ___________ Introduced by M. of A. BORES -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to providing that cover- age for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subparagraph (A) 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 to read as 4 follows: 5 (A) Every policy that provides medical, major medical or similar 6 comprehensive-type coverage shall provide outpatient coverage for the 7 diagnosis and treatment of substance use disorder, including detoxifica- 8 tion and rehabilitation services. Such coverage shall not be subject to 9 preauthorization and shall not apply financial requirements or treatment 10 limitations to outpatient substance use disorder benefits that are more 11 restrictive than the predominant financial requirements and treatment 12 limitations applied to substantially all medical and surgical benefits 13 covered by the policy. 14 § 2. Subparagraph (A) of paragraph 7 of subsection (l) of section 3221 15 of the insurance law, as amended by section 16 of subpart A of part BB 16 of chapter 57 of the laws of 2019, is amended to read as follows: 17 (A) Every policy that provides medical, major medical or similar 18 comprehensive-type coverage shall provide outpatient coverage for the 19 diagnosis and treatment of substance use disorder, including detoxifica- 20 tion and rehabilitation services. Such coverage shall not be subject to 21 preauthorization and shall not apply financial requirements or treatment 22 limitations to outpatient substance use disorder benefits that are more 23 restrictive than the predominant financial requirements and treatment EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08834-02-5 
 A. 8864 2 1 limitations applied to substantially all medical and surgical benefits 2 covered by the policy. 3 § 3. Paragraph 1 of subsection (l) of section 4303 of the insurance 4 law, as amended by section 27 of subpart A of part BB of chapter 57 of 5 the laws of 2019, is amended to read as follows: 6 (1) Every contract that provides medical, major medical or similar 7 comprehensive-type coverage shall provide outpatient coverage for the 8 diagnosis and treatment of substance use disorder, including detoxifica- 9 tion and rehabilitation services. Such coverage shall not be subject to 10 preauthorization and shall not apply financial requirements or treatment 11 limitations to outpatient substance use disorder benefits that are more 12 restrictive than the predominant financial requirements and treatment 13 limitations applied to substantially all medical and surgical benefits 14 covered by the contract. 15 § 4. This act shall take effect immediately, and shall apply to poli- 16 cies and contracts issued, renewed, modified, altered or amended on or 17 after such date.