Bill > S03185

This bill amends the New York insurance law to require health insurance policies to provide outpatient coverage for non-opioid treatment of chronic pain, including complementary and integrative treatments. Specifically, the bill mandates that insurance policies covering pain management services must offer access to non-opioid treatments that is comparable to other covered services, with coverage equally available for treatments provided by licensed professionals. The bill defines chronic pain as pain that persists or recurs for more than three months and stipulates that financial requirements and treatment limitations for non-opioid pain treatments cannot be more restrictive than those applied to other medical benefits or opioid-based pain treatments. Financial requirements include deductibles, co-payments, co-insurance, and out-of-pocket expenses, while treatment limitations encompass limits on visit frequency, number of visits, days of coverage, and other restrictions such as medical necessity standards, provider network participation, and geographic or specialty-based limitations. The bill applies to individual medical policies, group insurance policies, and contracts issued by hospital and health service corporations, ensuring consistent coverage across different types of health insurance in New York. The provisions will take effect on the first day of January following the bill's passage and will apply to all policies and contracts issued, renewed, or modified after that date.

Budget and Finance, Business and Industry

https://www.nysenate.gov/legislation/bills/2025/S3185