Timothy's Law

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Timothy's Law is the nickname for a New York state mandate signed into law on December 22 2006 by Governor George E. Pataki which took effect January 1 2007. The law requires health plans sold in the state provide comparable coverage for mental health ailments as it does for physical aliments, often called "parity."[1]

[edit] History

The law was named after Timothy O’Clair, a boy from Schenectady, NY who committed suicide at age 12 on March 12 2001. Timothy had been diagnosed with several behavioral disorders but had exhausted the mental health benefits on his family's health plan.[2] For the next five years, Timothy's parents petitioned the state government to pass a law that would require health plans to provide coverage for mental health ailments comparable with coverage for physical ailments.[3]

"Timothy's Law" was sponsored by Senator Thomas W. Libous and passed the state senate on September 15 2006.[4] It passed the Assembly and was sent to the governor on December 13 2006 who later signed it into law. The lateness of the passing of the law caused difficulties for health insurers to update their policies and provide training to employees in time for the law's January 1st effective date.[3]

[edit] Major provisions

The legislation included several provisions that affect the way health insurers in the state cover mental health services.

  • Coverage must be included in plans for at least 30 days of inpatient care and at least 20 days of outpatient treatment with a psychiatrist or psychologist in a state-certified facility, a facility operated by the state, or a group or academic practice.
  • Plans must have premiums and patient cost-sharing for services that are consistent with the costs for physical treatments.
  • Plans for employers with 51 or more eligible employees must provide unlimited coverage for biologically-based mental illnesses, defined as schizophrenia/psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive-compulsive disorder, bulimia, anorexia, and binge eating. Plans for employers with 50 or less employees must offer this coverage as an option.
  • Children under age 18 with must be covered for serious suicidal symptoms or other life-threatening self-destructive behaviors, significant psychotic symptoms, behavior caused by emotional disturbance that places 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.
  • The law requires the state to develop a method to help small employers pay for the additional biologically-based coverage if elected.[3]

[edit] References

  1. ^ Text of Bill #S8482 provided by the New York State Psychiatric Association last accessed 2007-02-14
  2. ^ Timothy's Story. timothyslaw.org. Retrieved on 2007-02-14.
  3. ^ a b c Pérez-Peña, Richard. "Pataki Signs Bill on Parity in Health Care", New York Times, 2006-12-23. Retrieved on 2007-02-14. 
  4. ^ SENATE PASSES "TIMOTHY'S LAW" TO PROVIDE MENTAL HEALTH PARITY New York State Senate Press Release (2006-09-15). Retrieved on 2007-02-14