As budget negotiations settle, there is a clear uncertainty surrounding the future of Gov. Kathy Hochul’s proposal to ensure timely access and coverage for life-saving mental health care and substance use disorders. These reforms are a central component of the governor’s plan to address the decades-long crisis in New York’s mental health care system, and repealing these reforms will help New Yorkers who benefit most from them. It will hurt you.
Simply put, the governor’s proposal would make it more difficult for commercial insurance plans to deny access to medically necessary care for both adults and children. State and federal behavioral health insurance equality laws have helped improve access, but significant barriers remain. Hochul’s mental health plan addresses a longstanding gap in coverage.
Under the proposal, New Yorkers could not refuse medically necessary inpatient services or be discharged from a health care facility if their condition could not be reasonably controlled by outpatient treatment. of insurance plans to cover critical care coordination services.
Importantly, the governor’s proposal will allow New Yorkers access to care when they need it. Commercial plans should adopt behavioral health service appointment availability and geographic accessibility standards. This will also improve access to behavioral health services delivered via telemedicine. Continued high demand After the COVID-19 pandemic.
Additionally, Hochul’s plan requires commercial insurers to cover all services provided at school-based mental health clinics and pay providers at least Medicaid reimbursement rates. These clinics are an essential lifeline for families.
With overdoses prevalent, the proposal also closes a significant gap in coverage. It makes clear that a commercial insurance plan will be required to cover life-saving addiction treatment and over-the-counter overdose recovery medications.
The legislature did not include these proposed parity changes in the House bill. However, we hope that continued education and advocacy efforts will see them re-added to the final budget.
Commercial insurance plans have played a key role in Governor Hochul’s series of mental health care reviews. Removing this proposal from the budget would leave a formidable hole in her groundbreaking plan. You will face unnecessary risks. Can’t wait any longer.
Glenn Liebman is CEO of the New York State Mental Health Association. Kayleigh Zaloga is president and CEO of the New York State Coalition for Child Behavioral Health. Paul Samuels is Director and President of the Legal Action Center. Also contributing to this essay was her Sharon Horton, executive director of the National Psychiatric Alliance in New York State.
