Bill Text: NY A00770 | 2009-2010 | General Assembly | Introduced

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Bill Title: An act to amend the insurance law, in relation to mandatory health insurance coverage for providing prosthetic devices

Spectrum: Moderate Partisan Bill (Democrat 36-11)

Status: (Introduced - Dead) 2010-06-09 - held for consideration in insurance [A00770 Detail]

Download: New_York-2009-A00770-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                          770
                              2009-2010 Regular Sessions
                                 I N  A S S E M B L Y
                                      (PREFILED)
                                    January 7, 2009
                                      ___________
       Introduced  by  M.  of  A.  GUNTHER,  PHEFFER, ORTIZ, ROSENTHAL, WRIGHT,
         JAFFEE, JACOBS, PERRY, CLARK, HOOPER, KELLNER, SPANO, CALHOUN,  McKEV-
         ITT,  ERRIGO,  SCOZZAFAVA  --  Multi-Sponsored  by -- M. of A. ALFANO,
         BENEDETTO, BENJAMIN, BING, CHRISTENSEN, CONTE, COOK,  CROUCH,  CUSICK,
         ESPAILLAT,  GALEF,  GIGLIO,  GOTTFRIED,  JOHN, KOON, LANCMAN, LATIMER,
         MAGNARELLI, MAISEL, McENENY, MILLER, PAULIN, RAIA, REILLY,  J. RIVERA,
         SCHROEDER,  SWEENEY,  THIELE,  WALKER,  WEISENBERG  --  read  once and
         referred to the Committee on Insurance
       AN ACT to amend the insurance  law,  in  relation  to  mandatory  health
         insurance coverage for providing prosthetic devices
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
    2  amended by adding a new paragraph 26 to read as follows:
    3    (26)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
    4  COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE  EQUAL  TO  OR  ABOVE
    5  MEDICARE'S  STANDARD  OF  COVERAGE  FOR PROSTHETIC DEVICES.   THIS SHALL
    6  INCLUDE COVERAGE NOT ONLY FOR  THE  PROVISION  OF  A  PROSTHETIC  DEVICE
    7  REQUIRED  TO  BE  WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR
    8  REPLACEMENT OF A PROSTHETIC DEVICE REQUIRED TO BE  WORN  OR  USED  BY  A
    9  POLICY  HOLDER.  COVERAGE  SHALL INCLUDE EXPENSES FOR ASSESSMENT, EVALU-
   10  ATION, TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT  BE
   11  DENIED  ON  THE  GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS NOT FOR A
   12  FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
   13  THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
   14  INCLUDE SHOES OR  ANY  OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING
   15  APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
   16    S 2. Subsection (l) of section 3221 of the insurance law is amended by
   17  adding a new paragraph 18 to read as follows:
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02318-01-9
       A. 770                              2
    1    (18)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
    2  COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE  EQUAL  TO  OR  ABOVE
    3  MEDICARE'S  STANDARD  OF  COVERAGE  FOR PROSTHETIC DEVICES.   THIS SHALL
    4  INCLUDE COVERAGE NOT ONLY FOR  THE  PROVISION  OF  A  PROSTHETIC  DEVICE
    5  REQUIRED  TO  BE  WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR
    6  REPLACEMENT OF A PROSTHETIC DEVICE REQUIRED TO BE  WORN  OR  USED  BY  A
    7  POLICY  HOLDER.  COVERAGE  SHALL INCLUDE EXPENSES FOR ASSESSMENT, EVALU-
    8  ATION, TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT  BE
    9  DENIED  ON  THE  GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS NOT FOR A
   10  FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
   11  THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
   12  INCLUDE SHOES OR  ANY  OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING
   13  APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
   14    S  3.  Section  4303  of  the insurance law is amended by adding a new
   15  subsection (ff) to read as follows:
   16    (FF) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
   17  COMPREHENSIVE  TYPE  COVERAGE  SHALL  INCLUDE COVERAGE EQUAL TO OR ABOVE
   18  MEDICARE'S STANDARD OF COVERAGE FOR  PROSTHETIC  DEVICES.    THIS  SHALL
   19  INCLUDE  COVERAGE  NOT  ONLY  FOR  THE  PROVISION OF A PROSTHETIC DEVICE
   20  REQUIRED TO BE WORN OR USED BY A POLICY HOLDER BUT ALSO  THE  REPAIR  OR
   21  REPLACEMENT  OF  A  PROSTHETIC  DEVICE  REQUIRED TO BE WORN OR USED BY A
   22  POLICY HOLDER. COVERAGE SHALL INCLUDE EXPENSES  FOR  ASSESSMENT,  EVALU-
   23  ATION,  TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT BE
   24  DENIED ON THE GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS  NOT  FOR  A
   25  FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
   26  THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
   27  INCLUDE  SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING
   28  APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
   29    S 4. This act shall take effect on the ninetieth day  after  it  shall
   30  have  become  a  law  and  shall apply to policies and contracts issued,
   31  renewed, modified, altered or amended on or after such effective date.