— ALBANY, NY – Senator Terry Gipson (D-Dutchess, Putnam) today joined fellow Senators from across New York State to unveil a legislative package to combat the growing heroin epidemic impacting communities throughout New York State. Senator Gipson’s legislation, S.7103, would ensure that private sector insurance carriers in New York act responsibly in their obligation to provide adequate coverage for addiction treatment by expanding the coverage time frame for the inpatient rehabilitation of the opioid users.
“Providing adequate substance abuse treatment is vital to combating the serious problem of heroin and opioid abuse in our communities,” said Senator Gipson. “Insurance companies have an obligation to cover the essential services opioid abusers require to succeed and avoid relapsing into addiction.”
Under Senator Gipson’s legislation, private carriers must cover no less than 60 days of treatment, after which, coverage can only be terminated when the admitting or attending physician certifies that there is no further treatment necessary and the patient should be discharged. Up to an additional 30 days of treatment must be covered – for a total of 90 days – if the admitting or attending physician deems it necessary.
The bill also provides for a smooth transition from private coverage to Medicaid after 90 days, and ensures that any additional cost will be borne by the State, rather than counties. Many private insurers require evidence that an addict has tried one or more outpatient treatments before they will even consider paying for inpatient. Further, many treatment programs provided by private sector insurance in New York only allow for up to 30 days of treatment coverage – a duration that is grossly inadequate for effective treatment.
Senator Gipson concluded, “Those seeking help deserve the best and most effective treatment possible, not what is most economical for insurance companies. I am proud to sponsor this legislation that will help families across New York State fight the effects of this debilitating addiction by reforming and streamlining the process of treatment and streamlining the process of treatment and rehabilitation funding.”