NY A08839

Requires insurance policies and group/blanket policies providing medical or major medical coverage to reimburse in-network behavioral health providers at a minimum rate equivalent to the Ambulatory Patient Group (APG) rate-setting methodology used for Medicaid services.

Applies to providers licensed under Public Health Law Article 28 or Mental Hygiene Law Articles 31-32 delivering ambulatory behavioral health services.

Allows insurers and providers to negotiate different rates and payment methods, but insurers cannot pay less than the equivalent Medicaid APG rates for these services.

Applies the same minimum reimbursement requirements to health maintenance organizations and all types of insurance entities (medical expense indemnity corporations, hospital service corporations, and health service corporations).

Takes effect September 1, 2024 for all policies and contracts issued, renewed, modified, altered, or amended on or after that date.