NU Online News Service, May 5, 4:08 p.m. EDT

New York Gov. David A. Paterson said today he will seek legislation making permanent the law setting requirements for the mental health care that must be provided by group or school health insurers.

The measure would make permanent "Timothy's Law," which took effect January 1, 2007 and was named after a youth who was unable to obtain mental treatment and committed suicide.

Under the statute insurers issuing group or school blanket health insurance policies or contracts in New York must provide a minimum of 30 inpatient days and 20 outpatient visits (30/20 benefit) for the treatment of mental health conditions.

Timothy's Law also requires large group health insurance policies (with more than 50 employees or members) to provide coverage for adults and children diagnosed with biologically based mental illnesses and children diagnosed with serious emotional disturbances at the same level of coverage as is provided for other health conditions.

Timothy's Law is currently set to expire on Dec. 31.

The law will provide "New Yorkers with the mental health coverage they need to remain healthy and be productive residents of our state," said Gov. Paterson.

The Superintendent of Insurance, in consultation with the Office of Mental Health (OMH), as required by the law did an impact study that was given to Gov. Paterson today.

Among the report's findings was that access to 30/20 benefit mental health coverage increased from 42 percent to 100 percent in the combined large and small group markets. Access to coverage for biologically based mental illnesses and serious emotional disturbances in children beyond the 30/20 benefit increased from 9.6 percent to 43.7 percent in the small group market, and from 11 percent to 100 percent in the large group market.

The 30/20 benefit was found to have increased monthly costs by approximately $1.04 per member per month in the small group market, amounting to 1/2 of 1 percent of total monthly cost.

Timothy's Law is strengthened by a recently enacted federal mental health parity law. Enacted in October 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act does not mandate that employers provide coverage for mental health benefits, but requires that those large employer groups (more than 50 employees) that do provide mental health benefits must do so in full parity with other medical benefits covered under the policy.

After the federal act takes effect in October, Timothy's Law will require that large group policies provide mental health benefits, and the federal act will require that any such mental health benefits provided by large group policies be in full parity with other medical benefits.

New York State Insurance Superintendent Eric Dinallo said, "This report shows that Timothy's Law has been a success. More New Yorkers are getting better coverage for mental health care with no added cost to small businesses."

Want to continue reading?
Become a Free PropertyCasualty360 Digital Reader

Your access to unlimited PropertyCasualty360 content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Breaking insurance news and analysis, on-site and via our newsletters and custom alerts
  • Weekly Insurance Speak podcast featuring exclusive interviews with industry leaders
  • Educational webcasts, white papers, and ebooks from industry thought leaders
  • Critical converage of the employee benefits and financial advisory markets on our other ALM sites, BenefitsPRO and ThinkAdvisor
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.