Bill > S06897

This bill amends the New York insurance law to require that rates paid for rehabilitation and opioid treatment services be set according to specific fee schedules published by the Office of Addiction Services and Supports (OASAS) and the Office of Mental Health. The bill applies to various types of health insurance plans, including individual, group, and commercial policies, and focuses on outpatient treatment facilities licensed or certified by these state agencies. Under the new provisions, insurers must negotiate reimbursement rates with participating facilities that are at least as high as rates in the medical assistance program, and these rates must be based on fee schedules that detail specific fees for individual services. These fee schedules must be published by November 1st of the preceding calendar year, with rates effective April 1st, and established before October 1st of the preceding year. The bill also requires that insurers receive guidance from the superintendent on how to calculate rate changes and allows for adjustments in future premium rate filings to account for differences between estimated and actual rates. The changes aim to provide more transparency and consistency in reimbursement rates for addiction and mental health treatment services across different types of health insurance plans in New York.

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https://www.nysenate.gov/legislation/bills/2025/S6897