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N.Y. Dept. of Financial Services issues guidance on health insurance parity

July 28, 2016
by Tom Valentino, Senior Editor
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Health insurers in New York have been put on notice by the state’s Department of Financial Services: Do not discriminate against individuals facing mental health and/or substance use disorders.

The Department of Financial Services (DFS) issued a letter of guidance on parity on Wednesday, informing insurers of their responsibility to provide the same level of coverage for mental health and substance use disorders as for medical or surgical care.

“This administration will have zero tolerance for insurance companies that seek to shirk their obligations to provide coverage for substance abuse and mental health treatment,” Gov. Andrew M. Cuomo said in a statement.

Cuomo recently signed legislation that limits insurance barriers to access for treatment and medication to treat substance use disorders. Insurers cannot impose prior authorization for inpatient treatment or for greater access to drug treatment, and insurers are required to use state-designated criteria to determine the level of care for individuals suffering from substance use disorders.

The New York attorney general’s office has been active in enforcing parity laws in recent years. The attorney general’s Health Care Bureau has reached settlements with five major insurers that were determined to be not in compliance with federal and state laws because they improperly denied patients seeking mental health and substance abuse treatment.

The DFS, meanwhile, is currently conducting a broad Mental Health Parity and Addiction Equity Act (MHPAEA) compliance review. As part of the process, the department seeks input from stakeholders, which could help guide future directives that ensure consistency in the application of mental health and substance use disorder benefits for health insurers.

Interested parties can submit comments to the DFS at: mentalhealthparity@dfs.ny.gov.

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