Bill Text: NY A03821 | 2009-2010 | General Assembly | Introduced

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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

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                           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.