N.Y. Mandates Coverage for Maternal Depression Screening

Health Insurance Report™ helps you track and analyze legal, legislative, and regulatory developments affecting the health-insurance industry throughout implementation of the Affordable Care Act...

By John Herzfeld

April 25 — The New York agency that regulates health insurance plans issued guidance April 25 requiring coverage of preventive screening for maternal depression without copayments, coinsurance or deductibles.

The guidance from the state Department of Financial Services (DFS) follows recommendations issued in January by the U.S. Preventive Services Task Force, an independent medical panel named by the federal Agency for Healthcare Research and Quality.

The task force’s recommendations serve as a trigger for preventive care coverage requirements under the Affordable Care Act.

In announcing the state DFS mandate, Gov. Andrew M. Cuomo (D) said: “We took this action to make sure that all pregnant and postpartum women can receive the full treatment services to which they are entitled.”

He added, “Health insurers have an obligation to cover charges for essential preventative services, and our administration will not hesitate to hold them accountable to that responsibility.”

Before the latest federal task force recommendations, specific coverage requirements for depression screening were limited to adults who aren’t pregnant, where depression care supports were in place, the DFS said. If care supports weren’t in place, the department said, screening was recommended based upon professional judgment.

In the guidance, the DFS said it strongly urges that health insurance issuers start providing coverage for the expanded maternal depression screening as soon as possible and no later than within six months.

Consumer Choice

The department also said that insurers, when providing coverage for maternal depression screening, must allow consumers direct access to a specialist of their own choosing. It further reminded insurers of legal requirements that mental health services be offered on par with other health services.

The DFS accompanied the announcement with statements of support from representatives of the American Psychiatric Association, the National Institute for Reproductive Health and other groups.

Lois Uttley, director of Raising Women’s Voices-NY, called the requirement “great news for pregnant women and new mothers across New York State.”

She said in a statement that “families will benefit tremendously from early detection of pregnancy-related depression and initiation of treatment.”

To contact the reporter on this story: John Herzfeld in New York at jherzfeld@bna.com

To contact the editor responsible for this story: Janey Cohen at jcohen@bna.com

For More Information

The DFS guidance is at http://src.bna.com/enL.