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N.Y. Parity Mandate To Sunset

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New York Gov. David Paterson wants to make a state mental health coverage law permanent.

“Timothy’s Law,” which was enacted in 2007 and is set to expire Dec. 31, requires insurers issuing group or school health policies to pay for a minimum level of mental health care.

New York group and school health care insurance plans now must cover at least 30 inpatient days and 20 outpatient visits for mental health conditions.

Timothy’s Law also requires state-regulated group health insurance policies with more than 50 members to provide children suffering from serious emotional disturbances and adults and children with biologically based mental illnesses with the same level of coverage provided for other health conditions.

The law was named after Timothy O’Clair, a 12-year-old boy who committed suicide in 2001. The boy’s parents said they could not get the boy treatment because they did not have enough health insurance, Paterson, D, says.

New York state children’s access to mental health benefits beyond the basic 30/20 formula has risen to 43%, from 10%, in the small group market since the law was enacted, according to New York Insurance Superintendent Eric Dinallo.

In the large group market, children’s access to improved mental health benefits has increased to 100%, from 11%, Dinallo reports.

The mental health mandate increased monthly health care costs for employers by an average of $1.04 per member per month in the small group market, or about 0.5% of the small employers’ total monthly coverage costs, Dinallo estimates.

A copy of the Dinallo parity mandate report is available here.


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