New York Announces New Program to Help Residents Access Coverage

October 2018 ~

The state of New York has announced plans to establish a new Behavioral Health Ombudsman Program designed to educate individuals, families, and health care providers on their legal rights to coverage, help them access treatment and services, and investigate and resolve complaints regarding denial of health insurance coverage.

The new Ombudsman Program, named the Community Health Access to Addiction and Mental Healthcare Project (CHAMP) will be overseen by three state agencies: the Office of Alcoholism and Substance Abuse Services, the Office of Mental Health and the Department of Financial Services.

The 2018-19 Budget includes $1.5 million to establish the new Ombudsman program in partnership with Community Service Society (CSS), the Legal Action Center and the NYS Council for Community Behavioral Healthcare, organizations with a proven record and a statewide network that has helped individuals, families, and small businesses gain access to affordable, quality health coverage.

These organizations will help individuals and families navigate the complex health care system to obtain timely access to and/or continue substance use disorder and/or mental health care, as well as aid in helping to resolve complaints when care is denied and identify areas where insurers may have an inadequate network of treatment programs and providers.

Additionally, the groups will also work with the Ombudsman’s office and with their partner network, which includes Chambers’ of Commerce, social service organizations and ethnic and immigration advocacy groups, to conduct community outreach, education and presentations on health insurance and New Yorkers’ rights.

Arlene González-Sánchez, Commissioner of the Office of Alcoholism and Substance Abuse Services (OASAS) said, “This program will help to educate people on their rights, and help them access the treatment and services they need without the stress of having to navigate the complicated insurance system on their own. Ensuring that people with substance use disorders are able to receive these services, regardless of their insurance situation, is a vital part of the support that we can provide for them.”

Dr. Ann Sullivan, Commissioner of the NYS Office of Mental Health (OMH) said, “About 1 in five New Yorkers require behavioral health services, and often many do not receive treatment because of stigma and other barriers to treatment. This can be a matter of life and death, and the new Behavioral Health Ombudsman Program will help to improve access to insurance coverage for substance use disorder and mental health services.”

Maria T. Vullo, Superintendent of the NYS Department of Financial Services said, “DFS is steadfast in its commitment to insurance coverage parity for mental health and substance use disorder.  Insurers are required to provide coverage for mental health and substance use disorder on par with medical and surgical benefits.  DFS is proud to work with all stakeholders to ensure that health insurers comply with parity protections so that New Yorkers in need of services for mental health and substance use disorder receive necessary treatment and are not improperly charged for benefits to which they are entitled.”



Source(s): New York State Office of Mental Health; HMA Weekly Roundup October 17, 2018;