STATE OF NEW YORK ________________________________________________________________________ 1963 2025-2026 Regular Sessions IN ASSEMBLY January 14, 2025 ___________ Introduced by M. of A. SOLAGES, MITAYNES, EPSTEIN, TAYLOR, GONZALEZ-RO- JAS, JACOBSON, SIMON, DAVILA, JACKSON -- read once and referred to the Committee on Insurance AN ACT to amend the public health law, in relation to universal newborn nurse home visiting services; to amend the insurance law, in relation to requiring health insurance coverage for universal newborn nurse home visiting services; authorizing the department of health to apply for certain waivers; and directing the superintendent of financial services to require an insurer, health carrier or health benefit plan to notify enrollees annually of universal newborn nurse home visiting services The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new section 2 2500-n to read as follows: 3 § 2500-n. Universal newborn nurse home visiting services. 1. As used 4 in this section, "community" means a geographic region, county, tribe or 5 other group of individuals living in proximity as defined by the depart- 6 ment by rule. 7 2. (a) The commissioner shall design, implement and maintain a volun- 8 tary statewide program to provide universal newborn nurse home visiting 9 services to all families with newborns residing in this state to support 10 healthy child development and strengthen families. The commissioner 11 shall design the universal newborn nurse home visiting program to be 12 flexible so as to meet the needs of the communities where the program 13 operates. 14 (b) In designing the program described in paragraph (a) of this subdi- 15 vision, the commissioner shall consult, coordinate and collaborate, as 16 necessary, with insurers that offer health benefit plans in this state, 17 hospitals, local public health authorities, the early intervention EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04521-01-5A. 1963 2 1 program, existing early childhood home visiting programs, community- 2 based organizations and social service providers. 3 3. The program shall provide nurse home visiting services that are: 4 (a) based on criteria established by the United States Department of 5 Health and Human Services for an evidence-based early childhood home 6 visiting service delivery model; 7 (b) provided by registered nurses licensed in this state to families 8 caring for newborns up to the age of six months, including foster and 9 adoptive newborns; 10 (c) provided in the family's home; and 11 (d) aimed at improving outcomes in one or more of the following 12 domains: 13 (i) child health; 14 (ii) child development and school readiness; 15 (iii) family economic self-sufficiency; 16 (iv) birth parent health; 17 (v) positive parenting; 18 (vi) reducing child mistreatment; 19 (vii) reducing juvenile delinquency; 20 (viii) reducing family violence; or 21 (ix) reducing crime. 22 4. The services provided in the program must: 23 (a) be voluntary and carry no negative consequences for a family that 24 declines to participate; 25 (b) be offered in every community in this state; 26 (c) include an evidence-based assessment of the physical, social and 27 emotional factors affecting the family; 28 (d) be offered to all families with newborns residing in the community 29 where the program operates; 30 (e) include at least one visit during a newborn's first three months 31 of life with the opportunity for the family to choose up to three addi- 32 tional visits; 33 (f) include a follow-up visit no later than three months after the 34 last visit; and 35 (g) provide information and referrals to address each family's identi- 36 fied needs. 37 5. The authority shall collect and analyze data generated by the 38 program to assess the effectiveness of the program in meeting the aims 39 described in paragraph (d) of subdivision three of this section and 40 shall work with other state agencies to develop protocols for sharing 41 data, including the timely sharing of data with primary care providers 42 of care to the families with newborns receiving the services. 43 6. The commissioner shall adopt by rule, consistent with the 44 provisions of this section, criteria for universal newborn nurse home 45 visiting services that must be covered by health benefit plans. 46 § 2. Subsection (i) of section 3216 of the insurance law is amended by 47 adding a new paragraph 40 to read as follows: 48 (40)(A) Every policy which provides hospital, surgical or medical 49 coverage shall provide coverage for universal newborn nurse home visit- 50 ing services as prescribed by the department of health by rule under 51 section twenty-five hundred-l of the public health law. The coverage 52 must be provided without any cost-sharing, coinsurance or deductible 53 applicable to the services. 54 (B) Insurers must offer universal newborn nurse home visiting services 55 in their health benefit plans but an individual enrolled in the plan isA. 1963 3 1 not required to receive the services as a condition of coverage and may 2 not be penalized or in any way discouraged from declining the services. 3 (C) An insurer must notify an individual enrolled in the plan about 4 the universal newborn nurse home visiting services whenever such indi- 5 vidual adds a newborn to coverage under the plan. 6 (D) An insurer may use in-network providers or may contract with local 7 public health authorities to provide the services. 8 (E) This paragraph does not require an insurer to reimburse the cost 9 of the services in any specific manner. The services may be reimbursed 10 using: 11 (i) a value-based payment methodology; 12 (ii) a claim invoicing process; 13 (iii) capitated payments; 14 (iv) a payment methodology that takes into account the need for a 15 community-based entity providing the services to expand its capacity to 16 provide the services and address health disparities; or 17 (v) any other methodology agreed to by the insurer and the provider of 18 the services. 19 (F) Insurers shall report to the department of public health, in the 20 form and manner prescribed by the department of public health, data 21 regarding claims submitted for services covered under this paragraph to 22 monitor the provision of the universal newborn nurse home visiting 23 services. 24 § 3. Subsection (k) of section 3221 of the insurance law is amended by 25 adding a new paragraph 24 to read as follows: 26 (24)(A) Every group or blanket policy delivered or issued for deliv- 27 ery in this state which provides hospital, surgical or medical 28 coverage shall include coverage for universal newborn nurse home visit- 29 ing services as prescribed by the department of health by rule under 30 section twenty-five hundred-l of the public health law. The coverage 31 must be provided without any cost-sharing, coinsurance or deductible 32 applicable to the services. 33 (B) Insurers must offer universal newborn nurse home visiting services 34 in their health benefit plans but an individual enrolled in the plan is 35 not required to receive the services as a condition of coverage and may 36 not be penalized or in any way discouraged from declining the services. 37 (C) An insurer must notify an individual enrolled in the plan about 38 the universal newborn nurse home visiting services whenever such indi- 39 vidual adds a newborn to coverage under the plan. 40 (D) An insurer may use in-network providers or may contract with local 41 public health authorities to provide the services. 42 (E) This paragraph does not require an insurer to reimburse the cost 43 of the services in any specific manner. The services may be reimbursed 44 using: 45 (i) a value-based payment methodology; 46 (ii) a claim invoicing process; 47 (iii) capitated payments; 48 (iv) a payment methodology that takes into account the need for a 49 community-based entity providing the services to expand its capacity to 50 provide the services and address health disparities; or 51 (v) any other methodology agreed to by the insurer and the provider of 52 the services. 53 (F) Insurers shall report to the department of public health, in the 54 form and manner prescribed by the department of public health, data 55 regarding claims submitted for services covered under this paragraph toA. 1963 4 1 monitor the provision of the universal newborn nurse home visiting 2 services. 3 § 4. Section 4303 of the insurance law is amended by adding a new 4 subsection (ww) to read as follows: 5 (ww)(1) A medical expense indemnity corporation, a hospital service 6 corporation or a health service corporation that provides coverage for 7 hospital, surgical or medical care shall include coverage for universal 8 newborn nurse home visiting services as prescribed by the department of 9 health by rule under section twenty-five hundred-l of the public health 10 law. The coverage must be provided without any cost-sharing, coinsurance 11 or deductible applicable to the services. 12 (2) Insurers must offer universal newborn nurse home visiting services 13 in their health benefit plans but an individual enrolled in the plan is 14 not required to receive the services as a condition of coverage and may 15 not be penalized or in any way discouraged from declining the services. 16 (3) An insurer must notify an individual enrolled in the plan about 17 the universal newborn nurse home visiting services whenever such indi- 18 vidual adds a newborn to coverage under the plan. 19 (4) An insurer may use in-network providers or may contract with local 20 public health authorities to provide the services. 21 (5) This paragraph does not require an insurer to reimburse the cost 22 of the services in any specific manner. The services may be reimbursed 23 using: 24 (A) a value-based payment methodology; 25 (B) a claim invoicing process; 26 (C) capitated payments; 27 (D) a payment methodology that takes into account the need for a 28 community-based entity providing the services to expand its capacity to 29 provide the services and address health disparities; or 30 (E) any other methodology agreed to by the insurer and the provider of 31 the services. 32 (6) Insurers shall report to the department of public health, in the 33 form and manner prescribed by the department of public health, data 34 regarding claims submitted for services covered under this paragraph to 35 monitor the provision of the universal newborn nurse home visiting 36 services. 37 § 5. The department of health may request a waiver for state inno- 38 vation under 42 U.S.C. 18052 to obtain federal financial participation 39 in the cost of services provided under sections two, three and four of 40 this act. 41 § 6. The superintendent of financial services shall require an insur- 42 er, health carrier or health benefit plan to notify enrollees annually 43 of universal newborn nurse home visiting services covered by such enrol- 44 lees' health benefit plan. The notice shall be delivered by mail unless 45 the enrollee and health carrier have agreed on another method of notifi- 46 cation. The superintendent of financial services is authorized to 47 promulgate necessary rules and regulations for the purposes of providing 48 such notification. 49 § 7. This act shall take effect on the ninetieth day after it shall 50 have become a law and shall apply to any policy issued, delivered, 51 renewed, and/or modified on or after the effective date of this act. 52 Effective immediately, the addition, amendment and/or repeal of any rule 53 or regulation necessary for the implementation of this act on its effec- 54 tive date are authorized to be made and completed on or before such 55 effective date.