Bill Text: NY A02561 | 2009-2010 | General Assembly | Introduced
Bill Title: An act to amend the insurance law, in relation to requiring that provision be made for pregnancy termination procedures in every individual or group policy or contract which provides coverage or indemnity for hospital, surgical or medical care and which offers maternity care coverage
Spectrum: Partisan Bill (Democrat 11-0)
Status: (Introduced - Dead) 2010-01-06 - referred to insurance [A02561 Detail]
Download: New_York-2009-A02561-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 2561 2009-2010 Regular Sessions I N A S S E M B L Y January 20, 2009 ___________ Introduced by M. of A. GLICK, JOHN, JACOBS, DINOWITZ, WEINSTEIN, EDDING- TON -- Multi-Sponsored by -- M. of A. CYMBROWITZ, GALEF, GREENE, O'DONNELL, ORTIZ, PAULIN, SCARBOROUGH -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring that provision be made for pregnancy termination procedures in every indi- vidual or group policy or contract which provides coverage or indem- nity for hospital, surgical or medical care and which offers maternity care coverage 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 10-a to read as follows: 3 (10-A) (A) EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL 4 COVERAGE AND WHICH OFFERS MATERNITY CARE COVERAGE PURSUANT TO PARAGRAPH 5 TEN OF THIS SUBSECTION SHALL ALSO PROVIDE COVERAGE FOR PREGNANCY TERMI- 6 NATION PROCEDURES WHICH ARE PERFORMED BY A LICENSED PHYSICIAN, UPON THE 7 POLICYHOLDER OR UPON HIS SPOUSE OR UPON A NONSPOUSE WHO IS DEPENDENT 8 UPON THE POLICYHOLDER, IN ANY LICENSED HOSPITAL OR MEDICAL FACILITY 9 APPROVED BY THE STATE COMMISSIONER OF HEALTH, TO THE SAME EXTENT THAT 10 COVERAGE IS PROVIDED FOR ILLNESS OR DISEASE UNDER THE POLICY, SUBJECT TO 11 THE PROVISIONS OF THIS PARAGRAPH. 12 (B) PROVISION FOR SUCH COVERAGE SHALL BE SUBJECT TO ANY GUIDELINES 13 WHICH ARE NOW OR HEREAFTER ISSUED BY THE MEDICAL SPECIALTY SOCIETIES 14 RECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES OF OBSTETRICS 15 AND GYNECOLOGY, FOR PREGNANCY TERMINATIONS AND ABORTIONS. 16 (C) SUCH COVERAGE SHALL BE PROVIDED IN A MANNER WHICH ENSURES THE 17 CONFIDENTIALITY AND PRIVACY OF THE OCCURRENCE OF THE PROCEDURES 18 PERFORMED TO THE PERSON FOR WHOM COVERAGE IS PROVIDED. 19 (D) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE 20 AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04523-01-9 A. 2561 2 1 WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY, BUT 2 SUCH COVERAGE SHALL NOT BE SUBJECT TO THE REIMBURSEMENT PERIOD LIMITA- 3 TION OR MINIMUM PERIOD OF COVERAGE LIMITATION APPLICABLE TO MATERNITY 4 CARE COVERAGE. 5 (E) COVERAGE UNDER THIS PARAGRAPH SHALL NOT RESTRICT OR ELIMINATE 6 EXISTING COVERAGE PROVIDED BY THE POLICY AND NOTHING IN THIS PARAGRAPH 7 SHALL BE CONSTRUED TO DENY OR RESTRICT IN ANY WAY ANY EXISTING RIGHT OR 8 BENEFIT PROVIDED UNDER LAW OR BY CONTRACT. 9 S 2. Subsection (k) of section 3221 of the insurance law is amended by 10 adding a new paragraph 5-a to read as follows: 11 (5-A) (A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIV- 12 ERY IN THIS STATE WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL COVERAGE 13 AND WHICH OFFERS MATERNITY CARE COVERAGE PURSUANT TO PARAGRAPH FIVE OF 14 THIS SUBSECTION SHALL ALSO PROVIDE COVERAGE FOR PREGNANCY TERMINATION 15 PROCEDURES WHICH ARE PERFORMED BY A LICENSED PHYSICIAN, UPON THE POLICY 16 BENEFICIARY CERTIFICATE HOLDER OR UPON HIS SPOUSE OR UPON A NONSPOUSE 17 WHO IS DEPENDENT UPON THE POLICY BENEFICIARY CERTIFICATE HOLDER, IN ANY 18 LICENSED HOSPITAL OR MEDICAL FACILITY APPROVED BY THE STATE COMMISSIONER 19 OF HEALTH, TO THE SAME EXTENT THAT COVERAGE IS PROVIDED FOR ILLNESS OR 20 DISEASE UNDER THE POLICY, SUBJECT TO THE PROVISIONS OF THIS PARAGRAPH. 21 (B) PROVISION FOR SUCH COVERAGE SHALL BE SUBJECT TO ANY GUIDELINES 22 WHICH ARE NOW OR HEREAFTER ISSUED BY THE MEDICAL SPECIALTY SOCIETIES 23 RECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES OF OBSTETRICS 24 AND GYNECOLOGY, FOR PREGNANCY TERMINATIONS AND ABORTIONS. 25 (C) SUCH COVERAGE SHALL BE PROVIDED IN A MANNER WHICH ENSURES THE 26 CONFIDENTIALITY AND PRIVACY OF THE OCCURRENCE OF THE PROCEDURES 27 PERFORMED TO THE PERSON FOR WHOM COVERAGE IS PROVIDED. 28 (D) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE 29 AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT 30 WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY, BUT 31 SUCH COVERAGE SHALL NOT BE SUBJECT TO THE REIMBURSEMENT PERIOD LIMITA- 32 TION OR MINIMUM PERIOD OF COVERAGE LIMITATION APPLICABLE TO MATERNITY 33 CARE COVERAGE. 34 (E) COVERAGE UNDER THIS PARAGRAPH SHALL NOT RESTRICT OR ELIMINATE 35 EXISTING COVERAGE PROVIDED BY THE POLICY AND NOTHING IN THIS PARAGRAPH 36 SHALL BE CONSTRUED TO DENY OR RESTRICT IN ANY WAY ANY EXISTING RIGHT OR 37 BENEFIT PROVIDED UNDER LAW OR BY CONTRACT. 38 S 3. Section 4303 of the insurance law is amended by adding a new 39 subsection (c-1) to read as follows: 40 (C-1) (A) EVERY CONTRACT ISSUED BY A CORPORATION SUBJECT TO THE 41 PROVISIONS OF THIS ARTICLE WHICH PROVIDES HOSPITAL SERVICE, MEDICAL 42 EXPENSE INDEMNITY, OR BOTH, AND WHICH OFFERS MATERNITY CARE COVERAGE 43 PURSUANT TO SUBSECTION (C) OF THIS SECTION SHALL ALSO PROVIDE COVERAGE 44 FOR PREGNANCY TERMINATION PROCEDURES WHICH ARE PERFORMED BY A LICENSED 45 PHYSICIAN, UPON THE CONTRACT BENEFICIARY CERTIFICATE HOLDER OR UPON HIS 46 SPOUSE OR UPON A NONSPOUSE WHO IS DEPENDENT UPON THE CONTRACT BENEFICI- 47 ARY CERTIFICATE HOLDER, IN ANY LICENSED HOSPITAL OR MEDICAL FACILITY 48 APPROVED BY THE STATE COMMISSIONER OF HEALTH, TO THE SAME EXTENT THAT 49 COVERAGE IS PROVIDED FOR ILLNESS OR DISEASE UNDER THE CONTRACT, SUBJECT 50 TO THE PROVISIONS OF THIS SUBSECTION. 51 (B) PROVISION FOR SUCH COVERAGE SHALL BE SUBJECT TO ANY GUIDELINES 52 WHICH ARE NOW OR HEREAFTER ISSUED BY THE MEDICAL SPECIALTY SOCIETIES 53 RECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES OF OBSTETRICS 54 AND GYNECOLOGY, FOR PREGNANCY TERMINATIONS AND ABORTIONS. A. 2561 3 1 (C) SUCH COVERAGE SHALL BE PROVIDED IN A MANNER WHICH ENSURES THE 2 CONFIDENTIALITY AND PRIVACY OF THE OCCURRENCE OF THE PROCEDURES 3 PERFORMED TO THE PERSON FOR WHOM COVERAGE IS PROVIDED. 4 (D) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE 5 AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT 6 WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN CONTRACT, BUT 7 SUCH COVERAGE SHALL NOT BE SUBJECT TO THE REIMBURSEMENT PERIOD LIMITA- 8 TION OR MINIMUM PERIOD OF COVERAGE LIMITATION APPLICABLE TO MATERNITY 9 CARE COVERAGE. 10 (E) COVERAGE UNDER THIS SUBSECTION SHALL NOT RESTRICT OR ELIMINATE 11 EXISTING COVERAGE PROVIDED BY THE CONTRACT AND NOTHING IN THIS 12 SUBSECTION SHALL BE CONSTRUED TO DENY OR RESTRICT IN ANY WAY ANY EXIST- 13 ING RIGHT OR BENEFIT PROVIDED UNDER LAW OR BY CONTRACT. 14 S 4. This act shall take effect on the first of January next succeed- 15 ing the date on which it shall have become a law and shall only apply to 16 policies and contracts issued, renewed, modified, altered or amended on 17 or after such date.