NY A07704

Part A establishes behavioral health parity requirements effective January 1, 2023, by renaming "Office of Alcoholism and Substance Abuse Services" to "Office of Addiction Services and Supports" throughout insurance law sections 3216, 3221, and 4303.

Part A eliminates preauthorization and concurrent utilization review for the first 28 days of inpatient substance use disorder treatment and first 4 weeks (28 visits) of outpatient substance use disorder treatment at licensed facilities, provided facilities notify insurers within two business days using a standardized form.

Part A requires treatment facilities to perform daily clinical review and consult periodically with insurers by day 14 regarding patient progress, treatment course, and discharge plans; insurers must actively participate in these consultations and process claims within statutory timeframes.

Part A grants private right of action to individuals injured by violations, allowing them to recover actual damages or $1,000 (whichever is greater) plus up to $5,000 additional damages if willful violation is found, with potential recovery of attorney's fees.

Part B, effective immediately, eliminates prior authorization requirements for initial and renewal prescriptions for buprenorphine, methadone, long-acting injectable naltrexone, and opioid overdose reversal medications across all insurance plans.