(New York, NY – Insurance News 360) – Governor Andrew M. Cuomo announced the initiatives to help New York residents with substance abuse issues in Long Island and New York City’s underserved communities. New regulations limit barriers to insurance coverage for addiction treatment and patient brokering.
Cuomo made these announcements on Sept. 6, at the opening of a new substance use disorder treatment center for women with children, female young adults and those over 55 years of age. The center is located on Wards Island.
“New York is committed to the fight against addiction, and with these latest investments, we are taking necessary steps to ensure individuals and families in underserved communities are connected with the resources and support services they need,” Governor Cuomo said. “These new regulations and expanded services are part of our continued efforts to support New Yorkers dealing with substance use disorders, as we work harder than ever to create a stronger, healthier New York for all.”
New Regulation and Guidance
A new DFS regulation requires insurers who offer large group coverage to allow consumers to appeal coverage denials for medically necessary addiction medications when they are not on the list of covered drugs. Insurers will be issued a checklist to ensure their compliance with new rules for reviewing the medical necessity of substance use disorder medications.
Additionally, OASAS will also take further action to restrict “patient brokering,” where brokers collect payments from treatment providers, in exchange for referring patients to those programs. A new directive will require this service be delivered by OASAS-certified and -credentialed professionals, who are prohibited from receiving referral fees.
Source: New York Department of Financial Services.