Bill Text: NY S04889 | 2023-2024 | General Assembly | Introduced
Bill Title: Provides for coverage for the treatment of asthma.
Spectrum: Partisan Bill (Democrat 6-0)
Status: (Engrossed) 2024-05-28 - referred to insurance [S04889 Detail]
Download: New_York-2023-S04889-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 4889 2023-2024 Regular Sessions IN SENATE February 16, 2023 ___________ Introduced by Sens. RIVERA, BAILEY, MAY, SEPULVEDA -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the social services law and the insurance law, in relation to coverage for the treatment of asthma The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph (r) of subdivision 2 of section 365-a of the 2 social services law, as added by section 32 of part C of chapter 58 of 3 the laws of 2008, is amended to read as follows: 4 (r) asthma self-management training services for persons or parents of 5 persons diagnosed with asthma including information on proper use of 6 devices such as spacers, valved holding chambers and masks, and triggers 7 in the environment which should be avoided or managed, when such 8 services are ordered by a physician, registered physician's assistant, 9 registered nurse practitioner, or licensed midwife and provided by a 10 licensed, registered, or certified health care professional, as deter- 11 mined by the commissioner of health, who is certified as an asthma 12 educator by the National Asthma Educator Certification Board, or a 13 successor national certification board; provided, however, that the 14 provisions of this paragraph shall not take effect unless all necessary 15 approvals under federal law and regulation have been obtained to receive 16 federal financial participation in the costs of health care services 17 provided pursuant to this paragraph. Nothing in this paragraph shall be 18 construed to modify any licensure, certification or scope of practice 19 provision under title eight of the education law. 20 § 2. Subsection (i) of section 3216 of the insurance law is amended by 21 adding a new paragraph 15-b to read as follows: 22 (15-b) (A) Every policy which provides medical coverage that includes 23 coverage for physician services in a physician's office and every policy 24 which provides major medical or similar comprehensive-type coverage EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD02413-01-3S. 4889 2 1 shall include coverage for the following equipment and supplies for the 2 treatment of asthma, and for children under nineteen years of age addi- 3 tional equipment and supplies for use in school, if recommended or 4 prescribed by a physician or other licensed health care provider legally 5 authorized to prescribe under title eight of the education law: rescue 6 inhaler treatments and nebulizers; spacers, valved holding chambers, 7 masks and/or other such devices used to assist in getting medication 8 into the lungs. In addition, the commissioner of the department of 9 health shall provide and periodically update by rule or regulation a 10 list of additional asthma equipment and related supplies such as are 11 medically necessary for the treatment of asthma, for which there shall 12 also be coverage. Such policies shall also include coverage for asthma 13 self-management education to ensure that persons with asthma, or persons 14 who have a child or children with asthma, are educated as to the proper 15 self-management and treatment of their condition, including information 16 on proper use of devices and triggers in the environment which should be 17 avoided or managed. Such coverage for self-management education and 18 education relating to devices shall be limited to visits medically 19 necessary upon the diagnosis of asthma, where a physician diagnoses a 20 significant change in the patient's symptoms or conditions which neces- 21 sitate changes in a patient's self-management, or where reeducation or 22 refresher education is necessary. Such education may be provided by the 23 physician or other licensed health care provider legally authorized to 24 prescribe under title eight of the education law, or their staff, as 25 part of an office visit for asthma diagnosis or treatment, or by a 26 certified asthma nurse educator, upon the referral of a physician or 27 other licensed health care provider legally authorized to prescribe 28 under title eight of the education law. Education provided by the certi- 29 fied asthma nurse educator, may be limited to group settings wherever 30 practicable. Coverage for self-management education and education relat- 31 ing to devices shall also include home visits when medically necessary. 32 (B) Such coverage may be subject to annual deductibles and coinsurance 33 as may be deemed appropriate by the superintendent and as are consistent 34 with those established for other benefits within a given policy. 35 § 3. Subsection (k) of section 3221 of the insurance law is amended by 36 adding a new paragraph 23 to read as follows: 37 (23) (A) Every policy which provides medical coverage that includes 38 coverage for physician services in a physician's office and every policy 39 which provides major medical or similar comprehensive-type coverage 40 shall include coverage for the following equipment and supplies for the 41 treatment of asthma, and for children under nineteen years of age addi- 42 tional equipment and supplies for use in school, if recommended or 43 prescribed by a physician or other licensed health care provider legally 44 authorized to prescribe under title eight of the education law: rescue 45 inhaler treatments and nebulizers; spacers, valved holding chambers, 46 masks and/or other such devices used to assist in getting medication 47 into the lungs. In addition, the commissioner of the department of 48 health shall provide and periodically update by rule or regulation a 49 list of additional asthma equipment and related supplies such as are 50 medically necessary for the treatment of asthma, for which there shall 51 also be coverage. Such policies shall also include coverage for asthma 52 self-management education to ensure that persons with asthma, or persons 53 who have a child or children with asthma, are educated as to the proper 54 self-management and treatment of their condition, including information 55 on proper use of devices and triggers in the environment which should be 56 avoided or managed. Such coverage for self-management education andS. 4889 3 1 education relating to devices shall be limited to visits medically 2 necessary upon the diagnosis of asthma, where a physician diagnoses a 3 significant change in the patient's symptoms or conditions which neces- 4 sitate changes in a patient's self-management, or where reeducation or 5 refresher education is necessary. Such education may be provided by the 6 physician or other licensed health care provider legally authorized to 7 prescribe under title eight of the education law, or their staff, as 8 part of an office visit for asthma diagnosis or treatment, or by a 9 certified asthma nurse educator, upon the referral of a physician or 10 other licensed health care provider legally authorized to prescribe 11 under title eight of the education law. Education provided by the certi- 12 fied asthma nurse educator, may be limited to group settings wherever 13 practicable. Coverage for self-management education and education relat- 14 ing to devices shall also include home visits when medically necessary. 15 (B) Such coverage may be subject to annual deductibles and coinsurance 16 as may be deemed appropriate by the superintendent and as are consistent 17 with those established for other benefits within a given policy. 18 § 4. This act shall take effect on the first of January next succeed- 19 ing the date on which it shall have become a law and shall apply to all 20 policies issued, renewed, altered or modified on or after such date.
