The Peru Gazette

NYS Real Care photo

Albany, February 27, 2029, News Release – 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.