Bill > A07038

This bill requires insurance companies, health service corporations, and medical corporations to set reimbursement rates for certain addiction and mental health treatment services based on fee schedules published by specific state offices. Specifically, the bill mandates that rates for outpatient treatment at facilities licensed by the Office of Addiction Services and Supports or the Office of Mental Health must be at least as high as rates in the medical assistance program, and these rates must be detailed in fee schedules published by November 1st of the preceding year, with an effective date of April 1st. The fee schedules must specify the exact fee for each individual service covered, providing transparency and consistency in reimbursement. The bill also allows insurers and corporations to adjust future premium rate filings to account for differences between estimated and actual rates. This legislation applies to various types of insurance policies, including individual, group, and commercial plans, and aims to ensure fair and predictable compensation for addiction and mental health treatment providers while maintaining a standardized approach to reimbursement across different insurance providers.

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https://www.nysenate.gov/legislation/bills/2025/A7038