Important Information Regarding Timothy’s Law
On December 22, 2006, legislation known as “Timothy’s
Law” was signed into reality. This law changed the
coverage requirements for the diagnosis and treatment of
mental, nervous and emotional disorders under most group
insurance health insurance policies and contracts in New
York State.
Timothy’s Law became effective January 1, 2007.
Because of the short time between the law being signed and
when it took effect, insurance companies have been working
to ensure compliance with the law.
Timothy’s Law requires the health plans provide no less
than thirty days inpatient care and twenty days of
outpatient care for the diagnosis and treatment of mental,
nervous and emotional disorders. Additionally, treatment
of adult and children with biologically based conditions
are required to be covered. These conditions include
schizophrenia/psychotic disorders, major depression,
bipolar disorder, delusional disorders, panic disorder,
obsessive-compulsive disorder, bulimia and anorexia and
for the treatment of children with serious emotional
disturbances.
Timothy’s Law also requires that all insured health
plans in New York include mental health benefits
comparable to other health benefits under the insurance
plan. Any deductible, co-payment or coinsurance applied
to benefits for the health conditions specified by
Timothy’s Law may be no greater than those applied to
medical services under the particular plan.
CSEA State employees covered under the Empire Plan who
have received mental health services on or after January 1st
of this year have begun to receive letters and possibly a
refund check(s) from ValueOptions/GHI for overpayment of
participating provider co-pays or for the reprocessing of
non-participating provider claims using this medical
deductible.
Since Timothy’s Law emphasizes the
importance of receiving mental health services, what
better time to be reminded that the Empire Plan has a
Clinical Referral Line (which is available 24 hours a day,
seven days a week), which is staffed by licensed
clinicians experienced in mental health disorders who are
available to help individuals with mental health
questions/concerns or need help finding a provider.
Empire Plan enrollees can reach the Clinical Referral line
by calling 1-877-7-NYSHIP, select Option 3.
