Bill Text: NY A03821 | 2009-2010 | General Assembly | Introduced
Bill Title: An act to amend the insurance law, in relation to requiring individual and group or blanket accident or health insurance policies and hospital service corporations, health service corporations, and medical indemnity corporations, which provide hospital, surgical or medical coverage to include coverage for the purchase of cranial prostheses when prescribed as medically necessary
Spectrum: Partisan Bill (Democrat 6-0)
Status: (Introduced - Dead) 2010-01-06 - referred to insurance [A03821 Detail]
Download: New_York-2009-A03821-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 3821 2009-2010 Regular Sessions I N A S S E M B L Y January 28, 2009 ___________ Introduced by M. of A. CYMBROWITZ, GALEF -- Multi-Sponsored by -- M. of A. HOOPER, MAYERSOHN, TOWNS -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring individual and group or blanket accident or health insurance policies and hospi- tal service corporations, health service corporations, and medical indemnity corporations, which provide hospital, surgical or medical coverage to include coverage for the purchase of cranial prostheses when prescribed as medically necessary 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 26 to read as follows: 3 (26) (A) EVERY INDIVIDUAL POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMI- 4 LAR COMPREHENSIVE-TYPE COVERAGE SHALL INCLUDE COVERAGE FOR THE PURCHASE 5 OF CRANIAL PROSTHESES WORN FOR PERMANENT OR TEMPORARY HAIR LOSS SUFFERED 6 AS A RESULT OF ACCIDENT, INJURY OR DISEASE, OR THE TREATMENT OF SUCH 7 CONDITIONS, PROVIDED THAT THE TREATING PHYSICIAN OR OTHER LICENSED 8 HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT 9 OF THE EDUCATION LAW ISSUES A WRITTEN ORDER FOR SUCH PURCHASE TO SIGNIFY 10 HIS OR HER OPINION THAT SUCH PURCHASE IS MEDICALLY NECESSARY TO PROMOTE 11 THE PATIENT'S PHYSICAL OR PSYCHOLOGICAL WELL-BEING OR TO PROMOTE THE 12 HEALING PROCESS. 13 (B) SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND COIN- 14 SURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSIST- 15 ENT WITH THOSE REQUIRED FOR OTHER BENEFITS UNDER THE POLICY. SUCH 16 COVERAGE MAY BE LIMITED TO ONE CRANIAL PROSTHESIS PER COVERED PERSON FOR 17 THE LIFETIME OF THE POLICY. 18 S 2. Subsection (k) of section 3221 of the insurance law is amended by 19 adding a new paragraph 15 to read as follows: EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06541-01-9 A. 3821 2 1 (15) (A) EVERY GROUP OR BLANKET POLICY WHICH PROVIDES MAJOR MEDICAL OR 2 SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL INCLUDE COVERAGE FOR THE 3 PURCHASE OF CRANIAL PROSTHESES WORN FOR PERMANENT OR TEMPORARY HAIR LOSS 4 SUFFERED AS A RESULT OF ACCIDENT, INJURY OR DISEASE, OR THE TREATMENT OF 5 SUCH CONDITIONS, PROVIDED THAT THE TREATING PHYSICIAN OR OTHER LICENSED 6 HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT 7 OF THE EDUCATION LAW ISSUES A WRITTEN ORDER FOR SUCH PURCHASE TO SIGNIFY 8 HIS OR HER OPINION THAT SUCH PURCHASE IS MEDICALLY NECESSARY TO PROMOTE 9 THE PATIENT'S PHYSICAL OR PSYCHOLOGICAL WELL-BEING OR TO PROMOTE THE 10 HEALING PROCESS. 11 (B) SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND COIN- 12 SURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSIST- 13 ENT WITH THOSE REQUIRED FOR OTHER BENEFITS UNDER THE POLICY. SUCH 14 COVERAGE MAY BE LIMITED TO ONE CRANIAL PROSTHESIS PER COVERED PERSON FOR 15 THE LIFETIME OF THE POLICY. 16 S 3. Section 4303 of the insurance law is amended by adding a new 17 subsection (ff) to read as follows: 18 (FF)(1) EVERY CONTRACT ISSUED BY A CORPORATION SUBJECT TO THE 19 PROVISIONS OF THIS ARTICLE WHICH PROVIDES MAJOR MEDICAL OR SIMILAR 20 COMPREHENSIVE-TYPE COVERAGE, SHALL INCLUDE COVERAGE FOR THE PURCHASE OF 21 CRANIAL PROSTHESES WORN FOR PERMANENT OR TEMPORARY HAIR LOSS SUFFERED AS 22 A RESULT OF ACCIDENT, INJURY OR DISEASE, OR THE TREATMENT OF SUCH CONDI- 23 TIONS, PROVIDED THAT THE TREATING PHYSICIAN OR OTHER LICENSED HEALTH 24 CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE 25 EDUCATION LAW ISSUES A WRITTEN ORDER FOR SUCH PURCHASE TO SIGNIFY HIS OR 26 HER OPINION THAT SUCH PURCHASE IS MEDICALLY NECESSARY TO PROMOTE THE 27 PATIENT'S PHYSICAL OR PSYCHOLOGICAL WELL-BEING OR TO PROMOTE THE HEALING 28 PROCESS. 29 (2) SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND COIN- 30 SURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSIST- 31 ENT WITH THOSE REQUIRED FOR OTHER BENEFITS UNDER THE POLICY. SUCH 32 COVERAGE MAY BE LIMITED TO ONE CRANIAL PROSTHESIS PER COVERED PERSON FOR 33 THE LIFETIME OF THE POLICY. 34 S 4. This act shall take effect on the ninetieth day after it shall 35 have become a law and shall apply according to its terms to all poli- 36 cies, contracts and certificates issued, renewed, modified, altered or 37 amended on or after such date.