New York State
Mental Health Professionals Act
Changes to the New York State Mental Health Professionals Act
On October 3rd, 2009, some important changes will go into effect with the NYS Mental Health ProfessionalsAct. These changes are coming down from the federal level, and the New York Mental Health Professionals Act is the state's recognition and implementation of these important changes.
On October 3rd, 2008, President Bush signed the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). This New York State Mental Health Professionals Act put into effect the following laws concerning mental health coverage.
- If there is a group health plan which includes medical and surgical benefits as well as mental health benefits, the deductibles and co-payments and any treatment limitations on the mental health benefits cannot be any more restrictive than the predominant financial stipulations or treatment limitations that apply to substantially all of the plan's medical or surgical benefits. The same parity must also be included in any plans that include substance use disorder treatments.
- Neither mental health benefits nor substance use disorder benefits are permitted to be subject to any separate treatment limitations or cost sharing requirements which apply exclusively to them.
- If a group health plan includes medical or surgical benefits and mental health benefits and that same plan provides for out of network medical and/or surgical benefits, it is mandatory for that plan to also provide for out of network mental health benefits. The same parity must be observed in any plan that provides for substance use disorder treatments and has out of network provisions for medical and/or surgical benefits.
- Standards used for medical necessity determinations and any reasons for the denial of mental health or substance use disorder benefits have to be made available to plan participants upon their request.
- The parity requirements concerning annual and lifetime dollar payout limits under the existing law shall continue and they shall cover substance use disorder benefits.
The New York State Mental Health Professionals Act is intended to enable the better protection of the rights of those who are residents of New York and suffer from psychiatric disorders. Attempts to make New York a state that better covers and protects such patients extend back to 1957.
The New York State Mental Health Professionals Act will make it harder for those who suffer from psychological disorders to be treated by insurance companies as if they don't have a "real" medical problem.
There may be many bones of contention, however, as health care providers come up with plans that won't cover psychiatric illnesses without special provisions (that is, more money paid out in premiums). After the beginning of October of 2009, if you sign up for a plan and then suffer from a psychiatric illness and need treatment, make sure that you know your legal rights. Don't get denied your insurance payout.
After reading about the New York State Mental Health Professionals Act see our New York Map or go back to our Law Resources.
Thanks for viewing our info on the New York State Mental Health Professionals Act.
