Bill Text: NY A01442 | 2017-2018 | General Assembly | Introduced
Bill Title: Requires group health plans and health insurance issuers to cover costs for scalp hair prostheses worn for hair loss suffered as a result of alopecia areata, alopecia totalis or alopecia universalis.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Introduced - Dead) 2018-01-03 - referred to insurance [A01442 Detail]
Download: New_York-2017-A01442-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 1442 2017-2018 Regular Sessions IN ASSEMBLY January 12, 2017 ___________ Introduced by M. of A. CAHILL -- Multi-Sponsored by -- M. of A. ENGLE- BRIGHT, GALEF, PERRY -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring certain health insurance policies to cover costs for scalp hair prosthesis worn for hair loss suffered as a result of alopecia areata, alopecia totalis or alopecia universalis 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 34 to read as follows: 3 (34) (A) A group health plan, and a health insurance issuer offering 4 health insurance coverage in connection with a group health plan, shall 5 provide coverage for scalp hair prosthesis for a participant or benefi- 6 ciary who has scalp hair loss as a result of alopecia areata, alopecia 7 totalis or alopecia universalis if the attending physician of the 8 participant or beneficiary certifies in writing the medical necessity of 9 that proposed course of rehabilitative treatment. 10 (B) As used in this paragraph, the term "scalp hair prosthesis" 11 includes any artificial substitutes for scalp hair. 12 (C) The coverage required under this paragraph is not subject to 13 dollar limits, deductibles, and coinsurance provisions that are less 14 favorable than those for other prosthesis coverage under the plan or 15 coverage, except that a group health plan or health insurance issuer may 16 provide that the plan or issuer will only pay for eighty percent of the 17 customary and usual costs of the scalp hair prosthesis exclusive of any 18 deductible. 19 § 2. Subsection (k) of section 3221 of the insurance law is amended by 20 adding a new paragraph 22 to read as follows: 21 (22) (A) A group health plan, and a health insurance issuer offering 22 health insurance coverage in connection with a group health plan, shall EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01394-01-7A. 1442 2 1 provide coverage for scalp hair prosthesis for a participant or benefi- 2 ciary who has scalp hair loss as a result of alopecia areata, alopecia 3 totalis or alopecia universalis if the attending physician of the 4 participant or beneficiary certifies in writing the medical necessity of 5 that proposed course of rehabilitative treatment. 6 (B) As used in this paragraph, the term "scalp hair prosthesis" 7 includes any artificial substitutes for scalp hair. 8 (C) The coverage required under this paragraph is not subject to 9 dollar limits, deductibles, and coinsurance provisions that are less 10 favorable than those for other prosthesis coverage under the plan or 11 coverage, except that a group health plan or health insurance issuer may 12 provide that the plan or issuer will only pay for eighty percent of the 13 customary and usual costs of the scalp hair prosthesis exclusive of any 14 deductible. 15 § 3. Section 4303 of the insurance law is amended by adding a new 16 subsection (oo) to read as follows: 17 (oo) (1) A group health plan, and a health insurance issuer offering 18 health insurance coverage in connection with a group health plan, shall 19 provide coverage for scalp hair prosthesis for a participant or benefi- 20 ciary who has scalp hair loss as a result of alopecia areata, alopecia 21 totalis or alopecia universalis if the attending physician of the 22 participant or beneficiary certifies in writing the medical necessity of 23 that proposed course of rehabilitative treatment. 24 (2) As used in this subsection, the term "scalp hair prosthesis" 25 includes any artificial substitutes for scalp hair. 26 (3) The coverage required under this subsection is not subject to 27 dollar limits, deductibles, and coinsurance provisions that are less 28 favorable than those for other prosthesis coverage under the plan or 29 coverage, except that a group health plan or health insurance issuer may 30 provide that the plan or issuer will only pay for eighty percent of the 31 customary and usual costs of the scalp hair prosthesis exclusive of any 32 deductible. 33 § 4. This act shall take effect on the first of January next succeed- 34 ing the date on which it shall have become a law and shall apply accord- 35 ing to its terms to all policies, contracts and certificates issued, 36 renewed, modified, altered or amended on or after such effective date.
