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HOFSTRA LABOR & EMPLOYMENT LAW JOURNAL
address the lack of parity between insurance coverage provided for mental illnesses and disabilities versus coverage provided for physical illnesses and disabilities.17 Discussed within are its practical effects on the insurance industry, employee benefits plans, and employees’ ability to recover damages under the law in the face of the expansive preemption clause of federally-enacted ERISA.
What is Timothy’s Law?
Timothy’s Law ensures that mental health and chemical dependency coverage is provided by insurers and health maintenance organizations (“HMOs”) on terms comparable to other healthcare and medical services.18 Prior to passing Timothy’s Law, health insurance contracts in New York could (a) deny coverage for the diagnosis and treatment of mental, nervous or emotional disorders; (b) place a limit on the number of days or visits permitted; and (c) require different deductibles, coinsurance or co-payments for treatment of mentally-based illnesses. 19
The intent of Timothy’s Law was to end the discriminatory policy
of providing benefits or coverage based upon whether a patient’s illness or condition is mental or physical.20 The changes that Timothy’s Law implemented in New York State’s insurance law included the following provisions: “[e]very insurer delivering a group or school blanket policy” is required to provide coverage for all “mental, nervous or emotional disorders or ailments”21 and is required to “provide coverage for the diagnosis and treatment of chemical abuse and chemical dependence[;]”22 insurance companies cannot have separate maximums, independent deductibles or coinsurance amounts, separate out-of-pocket limits, or other limitations on coverage or benefits for mental, nervous or
SEN. LIBOUS, NEW YORK STATE SENATE, INTRODUCER’S MEMORANDUM IN SUPPORT, S.
8482, 229th Sess. (N.Y. 2006) [hereinafter INTRODUCER’S generally TIMOTHY’S LAW, ch. 748, N.Y. INS. LAW §§ 3221,
4303 (McKinney 2006 & McKinney
physicians nervous or
services must provide equal coverage for emotional disorders or ailments” and “[s]uch
the “diagnosis and treatment of mental, coverage shall be provided under the terms
and conditions otherwise applicable under the [insurance] contract, including network variations, exclusions, co-pays, coinsurance, deductibles . . .” § 4303 (h)(1)-(2)(A).
See § 4303 (h)(1)-(2)(A).
Timothy’s Law, supra note 1
See also INTRODUCER’S MEMORANDUM IN SUPPORT,
supra note 17.
INTRODUCER’S MEMORANDUM IN SUPPORT, supra note 17.
§§ 3221(l)(5)(A), 4303(h)(1).
Id. §§ 3221(l)(6)(A), 4303(k).