Healthcare (Substance Abuse)

in committee · New York · Assembly Jan 7, 2026

A 3159: Mandates commercial insurance coverage of peer support services as part of treatment for substance use disorder

This bill (A 3159) requires commercial health insurance plans to cover peer support services as part of substance use disorder treatment. It directly affects insurance companies offering medical, major medical, or comprehensive coverage and people receiving substance use disorder care. The key provision mandates that insurers cover certified peer support services (provided by advocates certified under New York's addiction services program) with the same financial terms and treatment limitations as standard medical care - meaning no stricter copays, deductibles, or visit limits than for other medical services. This ensures individuals with substance use disorder have access to these specific support services without facing more restrictive insurance barriers than typical medical treatments. The bill applies to all commercial health insurance contracts covering outpatient substance use disorder treatment.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for peer support in substance use disorder treatment, expanding access to mental health services and requiring equal coverage terms.95% confidence

Sub-Topics Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 8839: Prevents discrimination by insurers based on an individual's mental health or substance use disorder

Prevents discrimination by insurers based on an individual's mental health or substance use disorder; incorporates into law federal enforcement rules set forth in the federal mental health parity and addiction equity act of 2008.

Topics ✓ HealthcareSupports HealthcarePrevents insurance discrimination for mental health/substance use disorders, aligning with federal parity laws to protect patient rights and expand coverage access.95% confidence

Sub-Topics Mental Health Substance Abuse

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passed · New York · Senate Mar 13, 2025

R 488: Senate budget resolution in response to the 2025-2026 Executive Budget submission

This Senate resolution (R 488) expresses the New York State Senate's position on the Governor's 2025-2026 Executive Budget proposal. It incorporates specific amendments to the Governor's budget bills (S.3000-B through S.3009-B) and details the Senate's recommended funding changes for state agencies. The resolution directly affects state programs by adding $20 million for Addiction Services grants, restoring $3.1 million for agricultural programs, increasing Aging Services funding by $33.8 million, and proposing Medicaid coverage expansions. It serves as the Senate's formal budget proposal to be considered during the legislative budget conference process.

Topics ✓ Budget & TaxesSupports Budget & TaxesAdds $20M for Addiction Services, restores $3.1M for agriculture, increases Aging Services funding - all direct funding expansions for public programs.90% confidence ✓ HealthcareSupports HealthcareAdds $20M for Addiction Services grants, a direct healthcare program funding increase per bill summary.90% confidence

Sub-Topics State Budget Medicaid Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 8864: Provides that coverage for outpatient diagnosis and treatment of substance use disorder shall not be subject to preauthorization

This bill removes preauthorization requirements for outpatient diagnosis and treatment of substance use disorder under most health insurance policies. It directly affects health insurers and patients seeking treatment for substance use disorders, ensuring such coverage cannot be blocked by prior approval. The law mandates that insurers provide this coverage without stricter financial limits or treatment restrictions than those applied to general medical and surgical care. The policy change applies immediately to all new, renewed, or modified insurance policies issued after the effective date.

Topics ✓ HealthcareSupports HealthcareRemoves preauthorization barriers for substance use disorder treatment, improving patient access to care without insurer delays or restrictions.95% confidence

Sub-Topics Insurance Substance Abuse

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in committee · New York · Senate Jan 7, 2026

S 5013: Requires health insurers to provide coverage for opioid antagonists and devices

This bill requires health insurers to cover at least one opioid antagonist (like naloxone) and related devices in all prescription drug plans. It directly affects insurers, patients at risk of opioid overdose, and healthcare providers who can prescribe these medications via standing orders. The law mandates coverage without eliminating deductibles or co-insurance, which may apply as they do for other covered treatments. Naloxone is specifically named as the primary opioid antagonist to be covered, as defined by the FDA and New York’s Department of Health.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for naloxone, expanding access to life-saving opioid overdose reversal treatment without eliminating cost-sharing.95% confidence

Sub-Topics Prescription Drugs Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 4262: Enacts the Health Care Nondiscrimination Act of 2025

Enacts the Health Care Nondiscrimination Act; requires insurance coverage and health plans to implement equality and non-discrimination between licensed health care providers; requires fee parity between different classes of licensed providers providing the similar or like-kind services; requires practitioners to discuss and refer or prescribe non-pharmacological treatment alternatives before prescribing an opioid treatment; allows any licensed health care provider to perform certain services, including certifying disability and employment by school districts; provides for enforcement and penalties.

Topics ✓ HealthcareSupports HealthcareRequires nondiscrimination in coverage, fee parity for similar services, and non-opioid referrals before opioids, advancing patient rights and access to equitable care.95% confidence

Sub-Topics Insurance Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 7920: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

This bill requires health insurance plans to cover at least one abuse-deterrent opioid pain medication per active ingredient, ensuring patients can access FDA-approved options designed to reduce misuse. It limits cost-sharing (like copays) for these drugs to the same level as non-abuse-deterrent opioids, preventing insurers from increasing patient costs to comply. The law also prohibits prior authorization rules from forcing prescribers to use non-abuse-deterrent opioids to access safer alternatives. It directly affects patients prescribed opioids, insurers, and healthcare providers by mandating equitable coverage for abuse-deterrent formulations. The policy applies to all opioid analgesics approved by the FDA with abuse-deterrent labeling.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage of abuse-deterrent opioids, prevents higher patient costs, and ensures access to safer FDA-approved options - improving patient access and safety in pain management.95% confidence

Sub-Topics Insurance Substance Abuse

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in committee · New York · Senate Jan 7, 2026

S 987: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

This bill (S 987) requires health insurance plans to cover at least one abuse-deterrent opioid pain medication per active ingredient, ensuring patients can access FDA-approved options designed to reduce misuse. It prohibits higher copays or deductibles for these medications compared to standard opioids and bans prior authorization rules that force patients to try non-abuse-deterrent opioids first. The law applies to all insurance plans covering opioid pain medications, directly affecting patients, insurers, and healthcare providers. Key provisions mandate equal cost-sharing for abuse-deterrent and non-abuse-deterrent versions and prevent insurers from adding financial barriers to access these medications. The bill takes effect 120 days after enactment for new or renewed insurance policies.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage of abuse-deterrent opioids without higher costs or prior authorization, improving patient access to safer pain medication options per bill summary.95% confidence

Sub-Topics Insurance Prescription Drugs Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 1792: Enacts the "ensuring access to behavioral health act"

Enacts the "ensuring access to behavioral health act"; includes mental health services, substance use disorder treatment services and recovery support services to network adequacy requirements for insurance coverage.

Topics ✓ HealthcareSupports HealthcareBill mandates inclusion of mental health/substance use services in insurance network adequacy, expanding coverage and access per healthcare topic description.95% confidence

Sub-Topics Insurance Mental Health Substance Abuse

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in committee · New York · Assembly Jan 7, 2026

A 2650: Limits the substitution of abuse-deterrent analgesic opioid drug products for analgesic opioids lacking such technology

This bill requires health insurance plans to cover at least one abuse-deterrent opioid painkiller for each active ingredient, ensuring patients can access these FDA-approved options without higher out-of-pocket costs. It prohibits insurers from forcing patients to try non-abuse-deterrent opioids first for prior authorization or coverage approval. The law mandates that cost-sharing (like copays) for abuse-deterrent opioids must match the lowest level applied to non-abuse-deterrent versions. It directly affects patients prescribed opioid painkillers and insurance plans, aiming to improve access to formulations designed to reduce misuse.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage for abuse-deterrent opioids without higher costs, improving patient access to safer pain management options.95% confidence

Sub-Topics Insurance Prescription Drugs Substance Abuse

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