STATE OF NEW YORK ________________________________________________________________________

9693

IN ASSEMBLY

April 3, 2024 ___________

Introduced by M. of A. WEPRIN -- read once and referred 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. LBD14954-01-4