Bill > A07522

This bill amends insurance law to prohibit the application of fail-first or step therapy protocols and prior authorization requirements for drugs prescribed to treat serious mental health conditions. The bill specifically defines "serious mental health condition" as nine categories of mental health disorders from the Diagnostic and Statistical Manual of Mental Disorders, including neurodevelopmental disorders, schizophrenia spectrum disorders, bipolar disorders, depressive disorders, anxiety disorders, obsessive-compulsive disorders, trauma-related disorders, neurodegenerative disorders, and substance-related disorders. It applies to health insurance policies and contracts, ensuring that mental health benefits, including outpatient drug coverage, cannot have more restrictive financial requirements or treatment limitations compared to medical and surgical benefits. The bill also updates language to use gender-neutral terms and expands coverage to include outpatient drug coverage for mental health treatments. The changes will take effect on the first day of January following the bill's passage and will apply to all policies and contracts issued, renewed, modified, altered, or amended after that date.

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https://www.nysenate.gov/legislation/bills/2025/A7522