GOVERNOR HOCHUL LAUNCHES PUBLIC AWARENESS CAMPAIGN TO EDUCATE NEW YORKERS ON ACCESS TO BEHAVIORAL HEALTH TREATMENT

The following information was released by the office of the Governor of New York:

Campaign Runs Through June; Highlights Governor's Initiative to Improve Access to Mental Health and Substance Use Disorder Care

'Real Care, Real Access to Behavioral Health Services' Campaign Educates Consumers About Their Rights Under New York's Network Adequacy Rules

Governor Kathy Hochul today announced the launch of a public awareness campaign to educate New Yorkers on regulations that improve access to mental health and substance use disorder care. The 'Real Care, Real Access to Behavioral Health Services' campaign highlights regulations that give New Yorkers with qualifying health plans access to initial outpatient appointments for behavioral health care within ten business days of the request and require insurers to help insured individuals access the care they are entitled to receive. The campaign also includes a new website with information about patient rights and how to file a complaint if those rights are violated.

"Every New Yorker deserves to have access to the care they need, and it is crucial now more than ever that the State continues to expand services," Governor Hochul said. "By launching this public awareness campaign, more people across the state will be able to know their rights when it comes to behavioral health treatments and find more affordable options for providers."

Led by the State's Department of Financial Services and Office of Mental Health, the statewide public education campaign is aimed at encouraging more New Yorkers to access in-network mental health and substance use disorder care and understand their rights under these rules. Through June, multi-lingual ads will be featured on multiple digital and out-of-home platforms, including social media; transportation signage and digital kiosks; traditional television and radio; and on other digital platforms, including search and streaming services.

The campaign highlights the pillars of New York's behavioral health regulations, including:

Timely Appointments

New Yorkers covered by individual and group health insurance policies that are subject to New York law, including policies purchased through the New York State of Health Marketplace, Medicaid Managed Care, Child Health Plus, and the Essential Plan, are entitled to see a mental health or substance use disorder provider within ten business days for initial outpatient visits, or seven calendar days for a follow-up after being discharged from a hospital or emergency room.

Help Finding Providers

Health plans must post on their websites an accurate and up-to-date directory of their health care provider network, including the provider's city/town and zip code, telehealth options, languages spoken if the provider is a health care professional, any restrictions concerning the conditions treated or ages served, and any affiliations the provider has with participating facilities, among other information.

The regulations also require health plans to have dedicated employees who can help their insureds find an in-network provider that treats the insured's specific behavioral health condition. Additionally, the health plans must provide a list of in-network providers available to treat the insured's specific behavioral health condition within three business days, following the request of an insured or the insured's designee.

Out-of-Network Care

If an insured is unable to schedule an appointment with an in-network behavioral health care provider within certain specified wait times because there is no such provider available, then the insured, or the insured's designee, may submit an access complaint to the health plan. The health plan has three business days from receipt of the access complaint to locate an in-network provider that can treat the insured's behavioral health condition and is able to meet the appointment wait times.

If no in-network behavioral health care provider is available after an insured or the insured's designee files an access complaint, the health plan must approve care from an out-of-network provider that can meet the appointment wait times. To ensure cost is never a barrier to getting care, if an out-of-network provider is approved because in-network care is not available, the insured only must pay the in-network copay, coinsurance, and deductible.

New York State Department of Financial Services Acting Superintendent Kaitlin Asrow said, "DFS is committed to ensuring New Yorkers have access to the essential care they are entitled to. A critical component to access is awareness and this campaign strives to ensure that every policyholder understands their rights to behavioral care in New York."

New York State Office of Mental Health Commissioner Dr. Ann Sullivan said, "These regulatory changes are helping to ensure New Yorkers have timely access to behavioral health care and that health plans, including commercial insurers, have adequate networks to serve them. This public awareness campaign will enable individuals and families to understand the changes now in effect and ensure they have access to high-quality mental health and substance use services whenever needed. Spreading word of the changes reflects Governor Hochul's continued efforts to expand access to behavioral health care for all New Yorkers."

New York State Health Commissioner Dr. James McDonald said, "Governor Hochul understands that often the first step for those in need of mental health or substance use health care is knowing what services are available and where to find them. This public awareness campaign will help New Yorkers navigate the options that are available to them so they can access timely appointments, find in-network providers and can access care at no extra cost when in-network care is not available. New York State will continue to be a leader in expanding access to lifesaving health and behavioral health services while removing barriers to care."

New York State Office of Addiction Services and Support Commissioner Dr. Chinazo Cunningham said, "New Yorkers shouldn't have to struggle to find the mental health and substance use disorder care they need, when they need it. Under Governor Hochul's leadership, New York State has made significant strides in strengthening access to behavioral health care, and this initiative further advances equitable access by ensuring timely appointments and stronger accountability across health plans."

State Senator Samra Brouk said, "As Chair of the Senate Mental Health Committee, I recognize that access is key to helping our residents receive the critical care they need. I applaud Governor Hochul's efforts to increase public awareness for behavioral health services in New York State and uphold patient rights. Insurers must be held accountable for ensuring adequate provider networks exist in every community for the wellbeing of all New Yorkers."

State Senator Nathalia Fernandez said, "Access to mental health and substance use disorder care is not optional. It is a fundamental part of our health system. These regulations reinforce that patients have rights and insurers have responsibilities. Clear standards for timely appointments, transparent provider networks, and real accountability from insurers help ensure New Yorkers can get care when they need it."

Assemblymember Jo Anne Simon said, "Mental health and substance use disorder care must be timely, transparent, and treated with the same urgency as any other medical issue. This new statewide public service campaign will help New Yorkers understand their rights, navigate coverage, and connect to care without delays. I commend Governor Hochul for her commitment to strengthening mental health access and treatment."

These rules do not apply to self-funded Employee Retirement Income Security Act (ERISA) plans. New Yorkers who are unsure of their coverage should contact their insurer or employer. Those needing mental health or substance use disorder services should also check their health insurance policies for a list of what is covered.

New Yorkers can file a complaint against health plans not in compliance. New Yorkers covered by Medicaid, Essential Plan, or Child Health Plus may file a complaint with the State Department of Health, while New Yorkers with state-regulated commercial insurance coverage may file a complaint with DFS.