Timothy's Law

Last updated

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

Contents

History

The law was named after Timothy, a boy from Schenectady, NY who died by suicide at age 12 on March 16, 2001. Timothy had been diagnosed with several behavioral disorders including severe depression but had exhausted the mental health benefits on his family's health plan. As a result, the O'Clairs were forced to relinquish full custody of their child in order to make him eligible for Medicaid which paid for all the services which Timothy needed. However, when Timothy returned home, he once again was bound by the limits of his parents medical insurance benefits. [2] In 2003, 2 years after Timothy's death, Timothy's parents joined other mental health advocates and lent Timothy's name to the parity movement in the state of New York and petitioned the state government to pass a law that would require health plans to provide coverage for mental health ailments and behavioral disorders that were comparable to coverage for physical ailments.

"Timothy's Law" was sponsored by Senators Thomas Morahan and Thomas Libous and passed the state senate on September 15, 2006. [3] It was sponsored by Assembly Members Paul Tonko and Peter Rivera and passed the Assembly consecutively for 5 years. Timothy's Law was sent to the governor on December 13, 2006 who later signed it into law. A condition of Timothy's Law passing the NY state legislature was it have a 2-year sunset clause to provide for an actuarial study on the cost effectiveness (the shortest sunset of any law in NY state history). Timothy's Law became effective January 1, 2007. [3] In May, 2009, the Superintendent of the New York State Insurance Department released the actuarial study on the cost effectiveness of Timothy's Law, and reported that the law had considerably increased mental health parity at a nominal cost to employers. It stated that neither consumers nor brokers viewed the mandates as a significant issue relative to cost or their overall purchasing decision. [4]

After both houses of the NY legislature voted to make Timothy's Law permanent in the 2009 session, Governor Patterson signed the bill into law on July 11, 2009. [5] "Timothy's Law" was originally set to expire on December 31, 2009. [4]

Major provisions

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

Related Research Articles

<span class="mw-page-title-main">Medicare (United States)</span> U.S. government health insurance for the old and disabled

Medicare is a government national health insurance program in the United States, begun in 1965 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status as determined by the SSA, including people with end stage renal disease and amyotrophic lateral sclerosis.

<span class="mw-page-title-main">Actuarial science</span> Statistics applied to risk in insurance and other financial products

Actuarial science is the discipline that applies mathematical and statistical methods to assess risk in insurance, pension, finance, investment and other industries and professions. More generally, actuaries apply rigorous mathematics to model matters of uncertainty.

Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity.

<span class="mw-page-title-main">Consolidated Omnibus Budget Reconciliation Act of 1985</span> U.S. Law

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) is a law passed by the U.S. Congress on a reconciliation basis and signed by President Ronald Reagan that, among other things, mandates an insurance program which gives some employees the ability to continue health insurance coverage after leaving employment. COBRA includes amendments to the Employee Retirement Income Security Act of 1974 (ERISA). The law deals with a great variety of subjects, such as tobacco price supports, railroads, private pension plans, emergency department treatment, disability insurance, and the postal service, but it is perhaps best known for Title X, which amends the Internal Revenue Code and the Public Health Service Act to deny income tax deductions to employers for contributions to a group health plan unless such plan meets certain continuing coverage requirements. The violation for failing to meet those criteria was subsequently changed to an excise tax.

<span class="mw-page-title-main">Employee Retirement Income Security Act of 1974</span> U.S. tax and labor law

The Employee Retirement Income Security Act of 1974 (ERISA) is a U.S. federal tax and labor law that establishes minimum standards for pension plans in private industry. It contains rules on the federal income tax effects of transactions associated with employee benefit plans. ERISA was enacted to protect the interests of employee benefit plan participants and their beneficiaries by:

<span class="mw-page-title-main">Mental Health Parity Act</span>

The Mental Health Parity Act (MHPA) is legislation signed into United States law on September 26, 1996 that requires annual or lifetime dollar limits on mental health benefits to be no lower than any such dollar limits for medical and surgical benefits offered by a group health plan or health insurance issuer offering coverage in connection with a group health plan. Prior to MHPA and similar legislation, insurers were not required to cover mental health care and so access to treatment was limited, underscoring the importance of the act.

<span class="mw-page-title-main">Massachusetts health care reform</span>

The Massachusetts health care reform, commonly referred to as Romneycare, was a healthcare reform law passed in 2006 and signed into law by Governor Mitt Romney with the aim of providing health insurance to nearly all of the residents of the Commonwealth of Massachusetts.

The Healthy Americans Act(HAA), also known as the Wyden-Bennett Act, is a Senate bill that had proposed to improve health care in the United States, with changes that included the establishment of universal health care. It would transition away from employer-provided health insurance, to employer-subsidized insurance, having instead individuals choose their health care plan from state-approved private insurers. It sought to make the cost of health insurance more transparent to consumers, with the expectation being that this would increase market pressures to drive health insurance costs down. The proposal created a system that would be paid for by both public and private contributions. It would establish Healthy Americans Private Insurance Plans (HAPIs) and require those who do not already have health insurance coverage, and who do not oppose health insurance on religious grounds, to enroll themselves and their children in a HAPI. According to its sponsors, it would guarantee universal, affordable, comprehensive, portable, high-quality, private health coverage that is as good or better than Members of Congress have today; A 2008 preliminary analysis by the Congressional Budget Office concluded it would be "essentially" self-financing in the first year that it was fully implemented.

Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.

<span class="mw-page-title-main">Public Law 110-343</span> US law

Public Law 110-343 is a US Act of Congress signed into law by U.S. President George W. Bush, which was designed to mitigate the growing financial crisis of the late-2000s by giving relief to so-called "Troubled Assets."

The history of health care reform in the United States has spanned many decades with health care reform having been the subject of political debate since the early part of the 20th century. Recent reforms remain an active political issue. Alternative reform proposals were offered by both of the major candidates in the 2008, 2016, and 2020 presidential elections.

The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement.

Ryan's Law is a South Carolina law which requires insurance companies to cover treatments for autism. The law states that insurance companies must provide up to $50,000, annually, on behavioral therapy, up to the age of 16. The law provides coverage for various treatments, including Applied Behavior Analysis, which was previously denied as "experimental". Ryan's Law also prohibits insurers from refusing other medical care to children because of their autism. The law does not apply to people who are self-insured.

There were a number of different health care reforms proposed during the Obama administration. Key reforms address cost and coverage and include obesity, prevention and treatment of chronic conditions, defensive medicine or tort reform, incentives that reward more care instead of better care, redundant payment systems, tax policy, rationing, a shortage of doctors and nurses, intervention vs. hospice, fraud, and use of imaging technology, among others.

<span class="mw-page-title-main">Affordable Care Act</span> U.S. federal statute also known as Obamacare

The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965.

A contraceptive mandate is a government regulation or law that requires health insurers, or employers that provide their employees with health insurance, to cover some contraceptive costs in their health insurance plans.

The Affordable Care Act (ACA) is divided into 10 titles and contains provisions that became effective immediately, 90 days after enactment, and six months after enactment, as well as provisions phased in through to 2020. Below are some of the key provisions of the ACA. For simplicity, the amendments in the Health Care and Education Reconciliation Act of 2010 are integrated into this timeline.

In the United States, essential health benefits (EHBs) are a set of ten benefits, defined under the Affordable Care Act (ACA) of 2010, that must be covered by individually-purchased health insurance and plans in small-group markets both inside and outside of health insurance marketplaces. Large-group health plans, self-insured ERISA plans, and ERISA-governed multi-employer welfare arrangements that are not subject to state insurance law are exempted from the requirement.

<span class="mw-page-title-main">American Health Care Act of 2017</span> Proposed U.S. law

The American Health Care Act of 2017 was a bill in the 115th United States Congress. The bill, which was passed by the United States House of Representatives but not by the United States Senate, would have partially repealed the Affordable Care Act (ACA).

<span class="mw-page-title-main">Families First Coronavirus Response Act</span> 2020 US federal law, "Phase 2" of pandemic relief

The Families First Coronavirus Response Act is an Act of Congress meant to respond to the economic impacts of the ongoing COVID-19 pandemic. The act provides funding for free coronavirus testing, 14-day paid leave for American workers affected by the pandemic, and increased funding for food stamps.

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 2007-02-14.
  3. 1 2 Senate Passes "Timothy's Law" to Provide Mental Health Parity New York State Senate Press Release (2006-09-15). Retrieved on 2009-08-25.
  4. 1 2 Report by the Superintendent of Insurance On the Cost and Effectiveness of New York’s 2006 Mental Health Parity Legislation (“Timothy’s Law”) Archived 2009-08-15 at the Wayback Machine NYS. Insurance Department Report (2009-05). Retrieved on 2009-08-25.
  5. Senate Passes One Hundred Critical Bills New York Senate Blog (2009-07). Retrieved on 2009-13-09.
  6. Pérez-Peña, Richard (2006-12-23). "Pataki Signs Bill on Parity in Health Care". New York Times. Retrieved 2007-02-14.