§ 3241. Network coverage. (a) (1) An insurer, a corporation organized\npursuant to article forty-three of this chapter, a municipal cooperative\nhealth benefit plan certified pursuant to article forty-seven of this\nchapter, or a student health plan established or maintained pursuant to\nsection one thousand one hundred twenty-four of this chapter, that\nissues a health insurance policy or contract with a network of health\ncare providers shall ensure that the network is adequate to meet the\nhealth and mental health needs of insureds and provide an appropriate\nchoice of providers sufficient to render the services covered under the\npolicy or contract. The superintendent shall review the network of\nhealth care providers for adequacy at the time of the superintendent's\ninitial approval of a health insurance policy or contract; at least\nevery three years thereafter; and upon application for expansion of any\nservice area associated with the policy or contract in conformance with\nthe standards set forth in subdivision five of section four thousand\nfour hundred three of the public health law. The superintendent shall\ndetermine standards for network adequacy for mental health and substance\nuse disorder treatment services, including sub-acute care in a\nresidential facility, assertive community treatment services, critical\ntime intervention services and mobile crisis intervention services, in\nconsultation with the commissioner of the office of mental health and\nthe commissioner of the office of addiction services and supports. To\nthe extent that the network has been determined by the commissioner of\nhealth to meet the standards set forth in subdivision five of section\nfour thousand four hundred three of the public health law, such network\nshall be deemed adequate by the superintendent.\n (2) The superintendent, in consultation with the commissioner of\nhealth, the commissioner of the office of mental health, and the\ncommissioner of the office of addiction services and supports, shall\npropose regulations setting forth standards for network adequacy for\nmental health and substance use disorder treatment services, including\nsub-acute care in a residential facility, assertive community treatment\nservices, critical time intervention services and mobile crisis\nintervention services, by December thirty-first, two thousand\ntwenty-three.\n (b)(1)(A) An insurer, a corporation organized pursuant to article\nforty-three of this chapter, a municipal cooperative health benefit plan\ncertified pursuant to article forty-seven of this chapter, a health\nmaintenance organization certified pursuant to article forty-four of the\npublic health law or a student health plan established or maintained\npursuant to section one thousand one hundred twenty-four of this\nchapter, that issues a comprehensive group or group remittance health\ninsurance policy or contract that covers out-of-network health care\nservices shall make available and, if requested by the policyholder or\ncontractholder, provide at least one option for coverage for at least\neighty percent of the usual and customary cost of each out-of-network\nhealth care service after imposition of a deductible or any permissible\nbenefit maximum.\n (B) If there is no coverage available pursuant to subparagraph (A) of\nthis paragraph in a rating region, then the superintendent may require\nan insurer, a corporation organized pursuant to article forty-three of\nthis chapter, a municipal cooperative health benefit plan certified\npursuant to article forty-seven of this chapter, a health maintenance\norganization certified pursuant to article forty-four of the public\nhealth law, or a student health plan established or maintained pursuant\nto section one thousand one hundred twenty-four of this chapter issuing\na comprehensive group or group remittance health insurance policy or\ncontract in the rating region, to make available and, if requested by\nthe policyholder or contracthol
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