February 26, 2025

Hochul official again rejects using opioid settlement funds for overdose prevention centers

The Hochul administration is maintaining its position again this year that the state can not use settlement funds from lawsuits against opioid companies to fund overdose prevention centers.

Those are centers in which people with an addiction can use drugs under medical supervision. The goal is to keep that person alive so they can continue to battle their addiction and reach recovery. But opponents say they encourage drug use.

New York has received millions of dollars in settlement funds from the various lawsuits filed against opioid manufacturers, distributors and retailers over their role in exacerbating addiction to those drugs.

The Legislature created the Opioid Settlement Fund Advisory Board to develop recommendations each year on how that money should be used. They had about $46 million to work with in their latest report, which was issued last year.

Part of those recommendations included diverting funding to help sustain overdose prevention centers. A few are already operating downstate.

Chinazo Cunningham, commissioner of the state Office of Addiction Services and Supports, wrote in a letter to the board ahead of its meeting Thursday that overdose prevention centers would not be receiving that money.

“We must inform you that the state is unable to move forward with the specific recommendations related to overdose prevention centers,” Cunningham wrote.

The Hochul administration views those centers as contrary to federal law and hasn’t blessed their operation in New York. The board’s members knew it was a long shot for that position to change.

Cunningham also said the administration will not address the board’s request that Hochul issue an emergency declaration over the state’s ongoing opioid crisis, arguing that such an ask fell outside their statutory power.

“Certain positions expressed by the board fall outside the statutory authority granted to the board, and therefore the agencies will not be addressing these positions directly,” she wrote.

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See below presser.

Also attached is the DOH adopted rule on network adequacy published today.  We sent you the DFS adopted rule last week once it was published in the NYS Register.  It is linked in the content below.

From: Press Office <Press.Office@exec.ny.gov>
Date: Wed, Feb 26, 2025 at 1:39 PM
Subject: GOVERNOR HOCHUL EXPANDS ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT FOR NEW YORKERS

GOVERNOR HOCHUL EXPANDS ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT FOR NEW YORKERS

New Network Adequacy Standards To Reduce Appointment Wait Times and Make Provider Directories Easier To Navigate

Regulations Adopted by the Department of Financial Services and Department of Health Build Upon Initiatives To Strengthen Health Care Statewide

Governor Kathy Hochul today announced that new network adequacy regulations for behavioral health services will now entitle New Yorkers to an initial appointment for behavioral health care within 10 business days of the request, or seven calendar days following hospital discharge. Under the regulations adopted by the New York State Department of Financial Services and State Department of Health, insurers unable to meet these timeframes will have to offer out-of-network mental health or substance use disorder coverage without increasing the cost for the consumer.

“New Yorkers deserve a speedy and effective process to receive the services they need,” Governor Hochul said. “The regulations established by the Department of Financial Services and Department of Health will standardize wait times, allow for same cost-sharing and update directories — providing individuals more access to mental health and substance use disorder care statewide.”

Additionally, insurers are required to update their provider directories to include clearer details on the availability of behavioral health services, including provider locations (city/town and zip code), telehealth availability and languages spoken by the provider.

New York State Department of Financial Services Superintendent Adrienne Harris said, “This regulation helps New Yorkers to get mental health and substance use disorder treatments more quickly. The Department is dedicated to eliminating obstacles to care, and this initiative furthers our mission to create a more inclusive, transparent, and resilient health care system across the State.”

New York State Health Commissioner Dr. James McDonald said, “Network adequacy is about making sure third-party payers have enough health care providers to meet their patient’s needs. These regulations will help New Yorkers who too often wait weeks or even months for an initial appointment for mental health or substance use disorder treatment.”

New York State Office of Mental Health Commissioner Dr. Ann Sullivan said, “New Yorkers should be able to access high-quality behavioral health care services whenever and wherever they are in need. These new network adequacy regulations will ensure that commercial insurance carriers provide this coverage in a timely manner by setting a standard and so that people needing this care can easily access it when they need it. These changes highlight Governor Hochul’s continued focus on strengthening our mental health care system and expanding access statewide.”

The regulation establishes important consumer protections including:

• Standard Wait Times: Initial appointment time of 10 business days or less, and other appointment wait time standards for insurers for behavioral health services;
• Same Cost-Sharing: Requirements for insurers to assist consumers in accessing in-network providers within those standards. When an in-network provider is not available within those standards, the regulation will require insurers to allow access to an out-of-network provider who can meet those standards, at the in-network cost-sharing rate;
• Updated Directories: Specific information to be included in provider directories, including provider affiliations with facilities and restrictions on a provider’s scope of services, such as age of patients or mental health conditions treated; and
• Insurer Compliance: Insurers and managed care organizations must now submit to DFS and DOH an annual certification regarding an insurer’s access plan that must include collection of data and monitoring of its behavioral health network.

The DFS regulation, which applies to commercial health insurance plans, takes effect on July 1, 2025. A copy is available on the DFS website.

Additionally, DOH has proposed an identical regulation for HMOs — including Medicaid managed care plans, child health plus and the essential plan. This regulation goes into effect on July 1, 2025, and is available on the DOH website.

Today’s announcement builds upon Governor Hochul’s ongoing efforts to expand access to critical health services. Over the last two years, Governor Hochul has made multi-billion-dollar investments in safety-net hospitals, passed the largest Medicaid rate increases in more than a decade and announced $2.6 billion in capital transformation funding to help transform and modernize New York’s health care facilities.

Additionally, Governor Hochul signed legislation to prevent medical debt from negatively impacting New Yorkers’ access to credit in 2023.

Governor Hochul has made strengthening mental health care statewide a priority of her administration. Adopted in FY 2024, her landmark $1 billion multi-year plan has bolstered prevention efforts, greatly expanded community access to mental health supports, and has developed supports for New Yorkers with the highest needs.

This investment is tripling the number of Certified Community Behavioral Health Clinics statewide, adding 42 new Assertive Community Treatment teams and creating 50 Critical Time Intervention teams — all crucial to providing outpatient care to help individuals live in their community. The Governor’s plan has also created nearly 1,300 new units of specialized housing for individuals living with mental illness, with about 2,200 units in the pipeline to be developed.

Governor Hochul has also added 325 inpatient beds at state-operated psychiatric centers — the largest expansion of this capacity in years — and restored 550 beds that were offline at community-based hospitals. Under the Governor’s direction, the state also established new hospital admission and discharge regulations to ensure quality care and safe, thoughtful discharge plans to help connect individuals leaving emergency and inpatient care with community-based support.

The FY 2026 Budget continues this work by providing $16.5 million to counties for Assisted Outpatient Treatment programs, $10 million to expand Clubhouses, and Youth Safe Spaces and $2 million to support community-determined wellness in historically marginalized neighborhoods. The Budget also proposes investing $1.5 million to expand Teen Mental Health First Aid to 10th graders, $4 million to establish hospital-based Peer Bridger Services and expand the Intensive and Sustained Engagement Teams, and $160 million to expand forensic inpatient capacity on Ward’s Island in New York City.

Additionally, Governor Hochul’s FY26 Executive Budget invests $1 million into strengthening oversight and compliance of commercial health insurance coverage, including through new surveillance, educating consumers and providers and assisting with complaints. The Governor’s Budget also proposes a more robust process for holding managed care plans accountable for their performance by imposing additional fines on those failing to meet Medicaid model contract requirements.

State Senator Samra G. Brouk said, “We must ensure that those suffering through a mental health or substance use crisis can get the care they need quickly. I applaud Governor Hochul’s plan to adopt new network adequacy regulations for behavioral health services, as it will reduce wait times and open doors to care for New Yorkers in need.”

State Senator Gustavo Rivera said, “These new network adequacy regulations will allow New Yorkers to get connected with behavioral health services in a faster, more efficient way, all without breaking the bank. I want to thank Governor Hochul for recognizing the needs of New Yorkers and the urgency of this moment. I applaud the Governor for taking concrete steps to make behavioral health services more accessible to those who need them.”

Assemblymember Jo Anne Simon said, “Timely access to mental health care is essential for ensuring that New Yorkers get the support they need when they need it. The Governor’s new regulations are an important step toward holding insurers accountable for maintaining adequate networks of providers, which has been a major barrier to care. The new regulations will also keep New Yorkers healthy by making it easier for people to get out of network services when the existing networks are inadequate.”

Assemblymember David Weprin said, “I commend the Governor and Department of Financial Services for their work in ensuring that New Yorkers receive timely and appropriate mental health and substance use disorder care. Accessibility to these critical services are crucial to the well being of our communities.”

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