NYAPRS Alert: Action Needed!
Call Your Legislators and Senate & Assembly Leadership Today June 15, 2018
to Express Support & Urge Vote on Legislation (A3694C/S1156C) Requiring Insurers and Health Plans To Submit Key Compliance Data with Federal and State MH/SUD Parity Laws:
With only a handful of days left in the Legislative Session, it is imperative you call or email your legislators and Senate and Assembly leadership TODAY [INSERT DATE] to express strong support for legislation (S.1156-C/A.3694-C), which directs the Superintendent of the Department of Financial Services to collect certain key data and matrixes from insurers and health plans in order to scrutinize and analyze if they are in compliance with the federal and state mental health and substance use (MH/SUD) disorder parity laws. The information collected would be analyzed and used for the preparation of a parity compliance report in the annual “Consumer Guide to Health Insurers” issued by Department of Financial Services.
Why is this legislation so important and needed NOW?
- The current enforcement & compliance system is complaint driven -- putting the onus on consumers!
- This legislation is extremely important as we know non-compliance persists, which unnecessarily delays and/or denies access to care for MH/SUD.
- The eight settlements/agreements the New York Attorney General reached with several major insurers, health plans and managers of behavioral health benefits found major acts of non-compliance, including among others:
- applying more stringent and frequent utilization review for MH/SUD as compared to medical/surgical benefits;
- denying care and treatment for mental health and substance use disorders at higher rates;
- imposing a higher/specialist copayment rate for outpatient mental health and substance use disorder care than for outpatient/medical surgical care;
- and, using medical necessary criteria and models inconsistent with the laws and regulations of the State.
- Hence, New York needs this legislation to allow for annual review of compliance with MH/SUD parity laws.
- Now more than ever, this legislation is needed as New York faces an increasing number of suicides and opioids deaths.
- Recent CDC data shows a 28.8% increase in suicide in New York State between 1999 to 2016. Suicide is now the 10th leading cause of death with the number of suicides (nationally) surpassing the number of deaths by automobile accidents, homicides and most recently breast cancer. According to a recent OMH report and plan on suicide prevention, “1,700 New Yorkers died by suicide in 2014. Only four states in the country had a higher number.”
- Nearly 3,600 opioid deaths in 2016 (a 135% increase between 2013-2016).
- Compliance with the parity laws is critical to assuring access to care and treatment.
- Under this legislation, insurers and health plans would have to submit data on: network adequacy; rates of utilization review; rates of adverse determinations; percentage of claims paid for in-network and out-of-network MH/SUD care and treatment; percentage of providers who remained in network; network adequacy; and any other data or metric the Superintendent deems necessary to evaluate compliance with the MH/SUD parity laws.
Please see the below message/script below. It is critical that you make your voice heard today!
Please call or write:
- Your Senator AND Assemblymember – Call the main Senate and Assembly switchboards and asked to be connected to your local legislator:
NYS Senate: (518) 455-2800
NYS Assembly: (518) 455-4100
To find out who your Assemblymember is, enter your address at: http://assembly.state.ny.us/mem/search/.
To find out who your Senator is, enter your address at: https://www.nysenate.gov/find-my-senator.
- Senate Majority Leader John Flanagan – Albany Office Number: (518) 455-2071
- Senate Minority Leader Andrea Stewarts-Cousins – Albany Office: (518) 455-2585
- Assembly Speaker Carl Heastie – Albany Office Number: (518) 455-4800
- Assembly Minority Leader Brian Kolb – Albany Office: (518) 455-3751
To send an email, visit the Senator or Assemblymember’s official Senate or Assembly web page.
Hi, my name is ___________________. I am a constituent and/or treat constituents of Senator or Assemblymember _____________ 's district. I am calling today to: (1) identify myself as a constituent and/or [psychiatrist; psychologist; social worker; family advocate; peer] who strongly supports legislation (S.1156-C/A.3694-C) requiring insurers and health plans to annually to disclose information and data necessary to evaluate their compliance with Federal and State mental health and substance use disorder (MH/SUD) parity laws. Although MH/SUD parity laws have been on the books for a decade on the federal level and more than twelve years in New York State, there still exists within the health insurance and health plan industry patterns of disparity between coverage criteria imposed on MH/SUD care and treatment as compared to other covered services. Hence, this legislation is an important mechanism for moving forward with full implementation with the parity laws, a critical component to assuring continued access to care. Please support this bill and urge it be brought the floor for a vote before the end of the session