New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 514 - Clinical Review Criteria for the Treatment of Mental Illness
Section 514.2 - Legal base
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Section 7.07 of the Mental Hygiene Law grants the Office of Mental Health the power and responsibility to see that people with mental illness are provided with care and treatment and that the personal and civil rights of people who receive care and treatment are protected.
(b) Section 7.09 of the Mental Hygiene Law grants the Commissioner of Mental Health the power and responsibility to adopt regulations that are necessary and proper to implement matters under their jurisdiction.
(c) Section 4902 of the Public Health Law requires Utilization Review Agents for health insurance policies under the jurisdiction of the Department of Health to use evidence-based and peer reviewed Clinical Review Criteria that is appropriate to the age of the patient and which has been deemed appropriate and approved for such use by the Commissioner of the Office of Mental Health, in consultation with the Commissioner of Health and the Superintendent of Financial Services for any treatment or service for a Mental Health Condition.
(d) Section 4902 of the Insurance Law requires Utilization Review Agents for health insurance policies under the jurisdiction of the Department of Financial Services to use evidence-based and peer reviewed Clinical Review Criteria that is appropriate to the age of the patient and which has been deemed appropriate and approved for such use by the Commissioner of the Office of Mental Health, in consultation with the Commissioner of Health and the Superintendent of Financial Services for any treatment or service for a Mental Health Condition.
(e) Sections 3216 (i)(35)(f), 3221 (i)(5)(f), and 4303 (g)(7) of the Insurance Law require insurers and corporations that issue health insurance policies or contracts approved by the Department of Financial Services to provide coverage of inpatient and outpatient care for the treatment of Mental Illness, as specified in the Insurance Law, consistent with the Federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (29 U.S.C. § 1185a).
