New York Senate Bill S10149

New York 2025-2026 Regular Session

• Introduced: 4/30/26
• Refer: 4/30/26

Caption

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

Summary

S10149 would amend New York insurance law to require that certain health insurance policies and contracts covering medical, major medical, or similar comprehensive care include outpatient coverage for the diagnosis and treatment of substance use disorder, including detoxification and rehabilitation services, without requiring preauthorization. The bill applies this rule to individual, group, and nonprofit health insurance provisions in the Insurance Law. The measure also bars insurers from imposing financial requirements or treatment limitations on outpatient substance use disorder benefits that are more restrictive than those applied to substantially all medical and surgical benefits covered by the policy or contract. In practical terms, the bill is intended to reduce administrative barriers and align substance use disorder outpatient coverage more closely with other covered medical services. It would take effect immediately and apply to policies and contracts issued, renewed, modified, altered, or amended on or after that date.

Impact

The bill would amend sections 3216, 3221, and 4303 of the Insurance Law, expanding and clarifying existing coverage requirements for outpatient substance use disorder treatment. It would prohibit preauthorization for those outpatient services and limit insurers’ ability to apply more restrictive cost-sharing or utilization controls than those used for comparable medical and surgical benefits. The affected parties are health insurers, nonprofit health plans, policyholders, and individuals seeking outpatient substance use disorder treatment.

Sentiment

Based on the bill text and available context, the bill appears to reflect a generally supportive approach toward improving access to substance use disorder treatment and reducing insurance barriers. There is no recorded committee transcript or vote history in the provided material, so no formal opposition or amendment debate is available. The sponsors’ selection suggests bipartisan or cross-party interest in the issue, but the public record here does not show a documented floor or committee sentiment.

Contention

The main policy issue is the elimination of preauthorization for outpatient substance use disorder care, which insurers may view as reducing utilization management tools and potentially increasing costs or limiting oversight. Supporters would likely argue that preauthorization delays needed treatment and creates barriers to care, especially for addiction services where timely access is important. No specific objections, amendments, or named opponents are included in the provided record.