New York State Department of Financial Services launches Real Care Real Access campaign on behavioral health network adequacy rules

The New York State Department of Financial Services, together with the New York State Office of Mental Health, launched a statewide public awareness campaign to educate New Yorkers on rights and insurer obligations under New York’s behavioral health network adequacy rules for mental health and substance use disorder care. The “Real Care, Real Access to Behavioral Health Services” campaign also points consumers to a new website explaining patient rights and how to file complaints when those rights are not met. The campaign spotlights requirements for state-regulated individual and group health insurance coverage, including plans purchased through the New York State of Health Marketplace, Medicaid Managed Care, Child Health Plus, and the Essential Plan. Covered individuals are entitled to an initial outpatient behavioral health appointment within ten business days of request, or within seven calendar days for a follow-up after discharge from a hospital or emergency room. Health plans must maintain accurate online provider directories and have staff who can help members find appropriate in-network providers, including providing a condition-specific list of available in-network providers within three business days of request. Where an in-network appointment cannot be scheduled within specified wait times, members (or their designees) can submit an access complaint, triggering a three-business-day window for the plan to locate an in-network provider; if none is available, the plan must approve out-of-network care at in-network cost-sharing levels. The rules do not apply to self-funded Employee Retirement Income Security Act (ERISA) plans. The multilingual advertising campaign runs through June across digital and out-of-home platforms, including social media, transit placements, television, radio, search, and streaming services.