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NY Enacts Mental Parity Law

NY Enacts Mental Parity Law

ALBANY—Timothy’s Law, which will require insurance companies to provide coverage for individuals with mental illnesses, was signed into law Friday by Gov. George E. Pataki.

The new law is named after Timothy O’Clair, a 12-year old boy from Schenectady County
who had an emotional disorder, but was unable to obtain mental health services
under his parent’s health insurance coverage. Timothy completed suicide in March 2001.

“It is vital that our society take care of those in need, especially our most vulnerable children,”
Governor Pataki said. “Timothy’s Law is an important step to ensure that mental health services
are accessible to all individuals and families, so that they can receive beneficial assistance
and treatment for mental illnesses. Insurance coverage serves as a safety net
and with this new law, we have extended this protection to children and families across the State.

“I commend the efforts of Tom and Donna O’Clair in helping to get this law enacted.
Sharing their experiences and sense of loss was no doubt a difficult task, but through
their tireless work and the support of numerous groups and individuals, individuals
with mental illnesses will benefit,” the Governor added.

Tom O’Clair, Timothy’s father, said, “On behalf of my family and myself I wish
to thank the Governor, the Leaders, the entire Legislature and staff for their
efforts that have made this day possible. I have maintained throughout this
effort that this is Timothy’s work. With the timeless efforts of the advocates and supporters,
and in Timothy’s name, New York can join some 39 other states in
ending the discrimination facing mental illness.
What a wonderful way for New Yorkers to celebrate the holidays.”

Under this new law, which takes effect Jan. 1, 2007, health insurance providers are
required to provide comparable insurance coverage for mental illnesses (“parity”)
as the policies provide for other medical care. This will allow adults and children with
biologically-based mental illnesses to receive the same health care coverage benefits
as those provided for other physical ailments.

In a calendar year, the coverage must include at least 30 days of active inpatient (hospital) care,
and at least 20 days of active treatment in a facility operated by the State Office of Mental Health (OMH),
a psychiatrist or psychologist licensed to practice in New York, or a university
faculty practice corporation.
The cost of any premiums and deductibles must be consistent with those imposed for
other benefits available under the insurance policy.

Insurance coverage for businesses with 50 or more employees
must include treatment for schizophrenia/psychotic disorders, major depression,
obsessive compulsive disorders, bulimia, anorexia, serious cases of attention
deficit disorders in children, disruptive disorders, or pervasive development disorders.
In addition, children under 18 years of age are eligible for coverage if they
have serious suicidal symptoms or other life-threatening self-destructive behaviors,
significant psychotic symptoms, behavior causes by emotional disturbances that place
the child at risk of causing personal injury or significant property damage,
or behavior caused by emotional disturbances that place the child at substantial
risk of removal from the household.

A group insurance purchaser with 50 or fewer employees,
such as a small business, will be required to make the parity benefits coverage
for mental health services available for purchase upon request. In addition, the law seeks to offset
the additional costs that may be placed on such groups by directing the Superintendent of the
State Insurance Department to develop and implement a plan to fully cover the costs
for these small group insurance purchasers, which will be financed through the State General Fund.

Timothy’s law would sunset on Jan. 31, 2009. 12-22-06

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