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NY S04867
Bill
Status
Introduced
2/13/2025
Primary Sponsor
Patricia Fahy
Click for details
AI Summary
- Prohibits insurance policies from applying fail-first or step therapy protocols to prescription drugs for serious mental health conditions
- Eliminates prior authorization requirements for medications prescribed to treat serious mental health conditions
- Defines "serious mental health condition" to include nine DSM-listed categories: neurodevelopmental disorders, schizophrenia spectrum and psychotic disorders, bipolar disorders, depressive disorders, anxiety disorders, obsessive-compulsive disorders, trauma-and-stressor-related disorders, neurodegenerative disorders, and substance-related and addictive disorders
- Requires mental health outpatient benefits to include outpatient drug coverage without more restrictive financial requirements or treatment limitations than those applied to medical and surgical benefits
- Takes effect January 1 following enactment and applies to all policies issued, renewed, or modified after that date
Legislative Description
Prohibits the application of fail-first or step therapy protocols to coverage for the diagnosis and treatment of serious mental health conditions; defines serious mental health condition.
Last Action
REFERRED TO INSURANCE
1/7/2026
Committee Referrals
Insurance1/7/2026
Rules6/13/2025
Insurance2/13/2025
Full Bill Text
No bill text available