Help Ensure Insurance Coverage of Mental Health Issues by Telling the Legislature to Include Much Needed Reforms in the Final Budget Bill
NAMI-NYS's leading advocacy priority is increasing access to mental health supports and services for all New Yorkers. NAMI-NYS has long fought to strengthen insurance parity laws to ensure that psychiatric issues receive the same type of coverage as physical issues. We know that lack of coverage coupled with the high cost of psychiatric care presents a major barrier to recovery oriented services. We need your voice to help eliminate this barrier.
Governor Hochul has introduced sweeping reforms to strengthen parity laws, ensure network adequacy and coverage expansion. NAMI-NYS applauds the Senate for including these important measures in their one-house bills. However, we are extremely disappointed the Assembly has failed to adopt these much-needed reforms.
Governor Hochul has made insurance reforms a priority now we must tell the Assembly to make insurance reforms a priority, while telling the Senate it need remain a priority.
Governor Hochul is seeking to remedy some of the most critical barriers facing New Yorkers with behavioral health challenges, these crucial reforms include:
· Part II, subpart A would ensure that school-based mental health clinics are reimbursed at the Medicaid rate for services provided to children and youth covered by commercial insurance.
· Part II, subpart B prohibits insurers from performing preauthorization or concurrent reviews for the first 30 days of mental health treatment for adults in an in-network inpatient hospital or crisis residence licensed or operated by OMH, except where the insured meets designated clinical criteria or is receiving care in a facility designated by OMH in consultation with DFS and DOH. In addition, the proposal would require utilization review determinations for mental health conditions to be made using evidence-based, age-appropriate clinical review criteria approved by OMH in consultation with DFS and DOH
· Part II, subpart C would require state-regulated commercial insurance coverage for services provided via telehealth by Article 31, 32, 26 and 16 of mental hygiene law providers, reimbursed at the same rate as is reimbursed when delivered in person but not necessarily the Medicaid government rate
· Part II, subpart D authorizes insureds to bring legal actions against state-regulated commercial insurers to address state law parity violations.
· Part II, subpart E assures state-regulated commercial insurance coverage for detox or maintenance treatment of SUDs including all buprenorphine products, methadone, long-acting injectable naltrexone, or medications for opioid overdose.
· Part II, subpart F would require the state to update Network Adequacy standards that Medicaid and commercial plans must abide by.
Join Governor Hochul and NAMI-NYS
in fighting for access and insurance reforms!!!
