A3767 • 2025

Prohibits the retrospective denial of payment for substance use disorder treatment services

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: David Weprin
Last action: 2026-05-20
Official status: In Assembly Committee
Effective date: Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Prohibits the retrospective denial of payment for substance use disorder treatment services

Prohibits the retrospective denial of payment for substance use disorder treatment services Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.

What This Bill Does

Prohibits the retrospective denial of payment for substance use disorder treatment services Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.

Limits and Unknowns

This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

2026-05-20 Assembly
REPORTED REFERRED TO CODES
2026-01-07 Assembly
REFERRED TO INSURANCE
2025-01-30 Assembly
REFERRED TO INSURANCE

Official Summary Text

Prohibits the retrospective denial of payment for substance use disorder treatment services
Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.

Current Bill Text

Read the full stored bill text

S T A T E   O F   N E W   Y O R K
        ________________________________________________________________________

                                          3767

                               2025-2026 Regular Sessions

                                  I N  A S S E M B L Y

                                    January 30, 2025
                                       ___________

        Introduced by M. of A. WEPRIN -- read once and referred to the Committee
          on Insurance

        AN ACT to amend the insurance law, in relation to prohibiting the retro-
          spective  denial  of  payment  for  substance  use  disorder treatment
          services

          THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
        BLY, DO ENACT AS FOLLOWS:

     1    Section  1.  The insurance law is amended by adding a new section 3246
     2  to read as follows:
     3    § 3246. RETROSPECTIVE DENIAL OF  PAYMENT  OF  SUBSTANCE  USE  DISORDER
     4  TREATMENT  SERVICES.  NOTWITHSTANDING  ANY  OTHER  PROVISION OF LAW, ANY
     5  RETROSPECTIVE DENIAL OF PAYMENT  OF  SUBSTANCE  USE  DISORDER  TREATMENT
     6  SERVICES PROVIDED THAT ARE BASED ON THE INSURED INDIVIDUAL'S ELIGIBILITY
     7  SHALL  BE  PROHIBITED  AFTER  THE PROVIDER HAS VERIFIED WITH THE INSURER
     8  THAT THE INSURED HAS COVERAGE FOR SUCH TREATMENT AT THE TIME SUCH TREAT-
     9  MENT WAS INITIATED. THE INSURER SHALL IMMEDIATELY NOTIFY  THE  TREATMENT
    10  PROVIDER  WHEN  AN INSURED HAS LOST COVERAGE BASED ON TERMINATION OF THE
    11  INSURED'S EMPLOYMENT AND PROVIDED,  FURTHER,  THAT  DENIAL  OF  COVERAGE
    12  SHALL  BE  BASED  ON TERMINATION OF EMPLOYMENT AND SHALL NOT BE BASED ON
    13  SUSPENSION OF EMPLOYMENT. FAILURE OF THE INSURER TO  IMMEDIATELY  NOTIFY
    14  THE  TREATMENT PROVIDER OF SUCH TERMINATION OF EMPLOYMENT SHALL PRECLUDE
    15  ANY RETROSPECTIVE REVIEW BASED  ON  THE  INSURED'S  ELIGIBILITY.    THIS
    16  SECTION  SHALL  BE  APPLICABLE  TO  THE  NEW YORK STATE HEALTH INSURANCE
    17  PROGRAM.
    18    § 2. This act shall take effect immediately.



         EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07028-01-5