Behavioral Health Parity

Over the last eighteen months the Governor and the Legislature have put together a comprehensive response to behavioral health parity.

MHANYS as well as our colleagues at NYAPRS has enthusiastically embraced these reforms that notably include:

No preauthorization of psychiatric inpatient days for individuals under the age of 18 for first fourteen days of hospitalization

No preauthorization review of substance use disorder services during the first 28 days of outpatient or inpatient treatment

Review by NYS OMH of existing medical necessity criteria from insurers to create medical necessity policy that is evidenced based, peer reviewed and age appropriate

Funding to insure that the Department of Financial Services has the ability to review existing insurance claims to insure that the provisions of parity are being followed appropriately

Funding for an ombuds program dedicated to providing health insurance coverage through access to mental health and substance use coverage for those in need of care.

Budget Negotiations:

We are concerned that during negotiations, all of the stakeholders continue to understand the importance of behavioral health parity especially during a time of crisis when anxiety, addiction issues and issues of self-harm are greatly heightened.

The specific concern relates to a proposal in the Executive Budget that includes an October 1, 2020 deadline to issue more detailed regulations that will ensure compliance with DFS and DOH regarding parity enforcement. Despite strong support from every statewide behavioral health advocacy group, this still remains an issue. The more the process is delayed, the more people are denied the coverage they desperately need. The Governor and Senate have been very supportive of this regulation.  We need the continued support of the Assembly who has been our champion on so many other issues of importance to our community.

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