Bill Text: NY A01178 | 2015-2016 | General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relates to mandatory health insurance coverage for providing prosthetic devices.
Spectrum: Moderate Partisan Bill (Democrat 28-9)
Status: (Engrossed - Dead) 2016-06-14 - REFERRED TO RULES [A01178 Detail]
Download: New_York-2015-A01178-Introduced.html
Bill Title: Relates to mandatory health insurance coverage for providing prosthetic devices.
Spectrum: Moderate Partisan Bill (Democrat 28-9)
Status: (Engrossed - Dead) 2016-06-14 - REFERRED TO RULES [A01178 Detail]
Download: New_York-2015-A01178-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 1178 2015-2016 Regular Sessions I N A S S E M B L Y January 8, 2015 ___________ Introduced by M. of A. GUNTHER, ORTIZ, ROSENTHAL, WRIGHT, JAFFEE, PERRY, CLARK, HOOPER, DINOWITZ, ZEBROWSKI, TITONE, RIVERA, ABINANTI, COLTON, DenDEKKER, McKEVITT, DUPREY, RAIA -- Multi-Sponsored by -- M. of A. ABBATE, BENEDETTO, COOK, CROUCH, CUSICK, GALEF, GIGLIO, GOTTFRIED, MAGNARELLI, McDONOUGH, PAULIN, SCARBOROUGH, SCHIMEL, SKARTADOS, THIELE -- 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 32 to read as follows: 3 (32) 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 19 to read as follows: 18 (19) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR 19 COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE EQUAL TO OR ABOVE 20 MEDICARE'S STANDARD OF COVERAGE FOR PROSTHETIC DEVICES. THIS SHALL 21 INCLUDE COVERAGE NOT ONLY FOR THE PROVISION OF A PROSTHETIC DEVICE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00990-02-5 A. 1178 2 1 REQUIRED TO BE WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR 2 REPLACEMENT OF A PROSTHETIC DEVICE REQUIRED TO BE WORN OR USED BY A 3 POLICY HOLDER. COVERAGE SHALL INCLUDE EXPENSES FOR ASSESSMENT, EVALU- 4 ATION, TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT BE 5 DENIED ON THE GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS NOT FOR A 6 FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN 7 THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT 8 INCLUDE SHOES OR ANY OTHER ARTICLE CONSIDERED AS ORDINARY WEARING 9 APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED. 10 S 3. Section 4303 of the insurance law is amended by adding a new 11 subsection (pp) to read as follows: 12 (PP) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR 13 COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE EQUAL TO OR ABOVE 14 MEDICARE'S STANDARD OF COVERAGE FOR PROSTHETIC DEVICES. THIS SHALL 15 INCLUDE COVERAGE NOT ONLY FOR THE PROVISION OF A PROSTHETIC DEVICE 16 REQUIRED TO BE WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR 17 REPLACEMENT OF A PROSTHETIC DEVICE REQUIRED TO BE WORN OR USED BY A 18 POLICY HOLDER. COVERAGE SHALL INCLUDE EXPENSES FOR ASSESSMENT, EVALU- 19 ATION, TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT BE 20 DENIED ON THE GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS NOT FOR A 21 FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN 22 THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT 23 INCLUDE SHOES OR ANY OTHER ARTICLE CONSIDERED AS ORDINARY WEARING 24 APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED. 25 S 4. This act shall take effect on the ninetieth day after it shall 26 have become a law and shall apply to policies and contracts issued, 27 renewed, modified, altered or amended on or after such effective date.