S 2644: Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.
The bill aims to prohibit the retrospective denial of payment for substance use disorder treatment services. The insurer must verify with the provider that the insured has coverage for such treatment at the time it was initiated. If the insured loses coverage due to termination of employment, the insurer must immediately notify the treatment provider. Denial of coverage is based on termination of employment, not suspension. Failure to notify the treatment provider within a certain timeframe prevents retrospective review of the insured's eligibility. This law applies to the New York State Health Insurance Program. The law takes effect immediately.
| Jun. 05, 2026 | COMMITTED TO RULES |
| Feb. 05, 2026 | ADVANCED TO THIRD READING |
| Feb. 04, 2026 | 2ND REPORT CAL. |
| Feb. 03, 2026 | 1ST REPORT CAL.217 |
| Jan. 07, 2026 | REFERRED TO INSURANCE |
STATE OF NEW YORK ________________________________________________________________________ 2644 2025-2026 Regular Sessions IN SENATE January 22, 2025 ___________ Introduced by Sen. ADDABBO -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to prohibiting the retro- spective denial of payment for substance use disorder treatment services The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The insurance law is amended by adding a new section 3246 2 to read as follows: 3 § 3246. Retrospective denial of payment of substance use disorder 4 treatment services. Notwithstanding any other provision of law, any 5 retrospective denial of payment of substance use disorder treatment 6 services provided that are based on the insured individual's eligibility 7 shall be prohibited after the provider has verified with the insurer 8 that the insured has coverage for such treatment at the time such treat- 9 ment was initiated. The insurer shall immediately notify the treatment 10 provider when an insured has lost coverage based on termination of the 11 insured's employment and provided, further, that denial of coverage 12 shall be based on termination of employment and shall not be based on 13 suspension of employment. Failure of the insurer to immediately notify 14 the treatment provider of such termination of employment shall preclude 15 any retrospective review based on the insured's eligibility. This 16 section shall be applicable to the New York state health insurance 17 program. 18 § 2. This act shall take effect immediately. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD07028-01-5