Bill Text: NY A01009 | 2013-2014 | General Assembly | Introduced

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Bill Title: Provides for increased podiatry care and benefits under individual and group accident and health insurance policies and contracts within non-profit medical and dental indemnity, or health and hospital service corporations.

Spectrum: Partisan Bill (Democrat 9-0)

Status: (Introduced - Dead) 2014-01-08 - referred to insurance [A01009 Detail]

Download: New_York-2013-A01009-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         1009
                              2013-2014 Regular Sessions
                                 I N  A S S E M B L Y
                                      (PREFILED)
                                    January 9, 2013
                                      ___________
       Introduced  by M. of A. WEPRIN -- Multi-Sponsored by -- M. of A. COLTON,
         GALEF, GIBSON, GUNTHER, HOOPER, MILLMAN, PERRY, TITONE, WEISENBERG  --
         read once and referred to the Committee on Insurance
       AN  ACT to amend the insurance law, in relation to coverage and benefits
         of accident and health insurance policies for podiatric care
         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Paragraph 2 of subsection (i) of section 3216 of the insur-
    2  ance law is amended to read as follows:
    3    (2) If a policy provides for reimbursement for any podiatrical service
    4  within  the  lawful  scope  of  practice  of  a licensed podiatrist, the
    5  insured shall be entitled to THE SAME  reimbursement  for  such  service
    6  whether it is performed by a physician or licensed podiatrist.
    7    S 2. Subsection (k) of section 3221 of the insurance law is amended by
    8  adding a new paragraph 19 to read as follows:
    9    (19)  EVERY  POLICY  WHICH  PROVIDES  COVERAGE  FOR PODIATRIC CARE, AS
   10  DEFINED IN  SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED BY
   11  A DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED  FORTY-ONE
   12  OF  THE  EDUCATION LAW, MAY BE SUBJECT TO REASONABLE DEDUCTIBLE, CO-PAY-
   13  MENT AND CO-INSURANCE AMOUNTS, REASONABLE  FEE  OR  BENEFIT  LIMITS  AND
   14  REASONABLE  UTILIZATION  REVIEW,  PROVIDED THAT ANY SUCH AMOUNTS, LIMITS
   15  AND REVIEW: (A) SHALL NOT FUNCTION  TO  DIRECT  TREATMENT  IN  A  MANNER
   16  DISCRIMINATIVE  AGAINST PODIATRIC CARE; AND (B) INDIVIDUALLY AND COLLEC-
   17  TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THAT SAME POLI-
   18  CY TO CARE OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS  IN    THE
   19  DIAGNOSIS,  TREATMENT  AND MANAGEMENT OF THE SAME OR SIMILAR CONDITIONS,
   20  DISORDERS OR INJURIES. NOTHING IN THIS PARAGRAPH SHALL BE  CONSTRUED  AS
   21  IMPEDING  OR  PREVENTING  EITHER  THE PROVISION OR COVERAGE OF PODIATRIC
   22  CARE AND SERVICES BY DULY   LICENSED  DOCTORS  OF  PODIATRY  WITHIN  THE
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD03814-01-3
       A. 1009                             2
    1  LAWFUL  SCOPE  OF  PODIATRIC  CARE  IN HOSPITAL FACILITIES ON A STAFF OR
    2  EMPLOYEE BASIS.
    3    S  3.  Section  4303  of  the insurance law is amended by adding a new
    4  subsection (jj) to read as follows:
    5    (JJ) EVERY CONTRACT ISSUED  BY  A  HEALTH  SERVICE  CORPORATION  OR  A
    6  MEDICAL  EXPENSE INDEMNITY CORPORATION THAT INCLUDES COVERAGE FOR PHYSI-
    7  CIAN SERVICES IN A PHYSICIAN'S OFFICE, THAT PROVIDES  MAJOR  MEDICAL  OR
    8  SIMILAR  COMPREHENSIVE-TYPE COVERAGE, AND COVERAGE FOR PODIATRIC CARE AS
    9  DEFINED IN SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED  BY
   10  A  DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE
   11  OF THE EDUCATION LAW, MAY BE SUBJECT TO REASONABLE  DEDUCTIBLE,  CO-PAY-
   12  MENT  AND  CO-INSURANCE  AMOUNTS,  REASONABLE  FEE OR BENEFIT LIMITS AND
   13  REASONABLE UTILIZATION REVIEW, PROVIDED THAT ANY  SUCH  AMOUNTS,  LIMITS
   14  AND  REVIEW:    (1)  SHALL  NOT FUNCTION TO DIRECT TREATMENT IN A MANNER
   15  DISCRIMINATIVE AGAINST PODIATRIC CARE; AND (2) INDIVIDUALLY AND  COLLEC-
   16  TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THE SAME POLICY
   17  TO  CARE OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS IN THE DIAG-
   18  NOSIS, TREATMENT AND MANAGEMENT  OF  THE  SAME  OR  SIMILAR  CONDITIONS,
   19  DISORDERS  OR INJURIES. NOTHING IN THIS SUBSECTION SHALL BE CONSTRUED AS
   20  IMPEDING OR PREVENTING EITHER THE PROVISIONS OR  COVERAGE  OF  PODIATRIC
   21  CARE AND SERVICES BY DULY LICENSED DOCTORS OF PODIATRY WITHIN THE LAWFUL
   22  SCOPE  OF  PODIATRIC  CARE IN HOSPITAL FACILITIES ON A STAFF OR EMPLOYEE
   23  BASIS.
   24    S 4. This act shall take effect on the first of January next  succeed-
   25  ing  the  date  on  which  it shall have become a law and shall apply to
   26  policies and contracts issued, renewed, modified, altered or amended  on
   27  or after such effective date.