Bill Text: NY A04120 | 2021-2022 | General Assembly | Introduced


Bill Title: Relates to mandatory health insurance coverage for providing prosthetic devices.

Spectrum: Moderate Partisan Bill (Democrat 19-5)

Status: (Introduced - Dead) 2022-01-05 - referred to insurance [A04120 Detail]

Download: New_York-2021-A04120-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                          4120

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                    February 1, 2021
                                       ___________

        Introduced  by  M. of A. GUNTHER, L. ROSENTHAL, PERRY, DINOWITZ, ZEBROW-
          SKI, J. RIVERA, COLTON, ABINANTI, SIMON, LALOR, MIKULIN -- Multi-Spon-
          sored  by  --  M.  of  A.  ABBATE,  BENEDETTO,  COOK,  CUSICK,  GALEF,
          J. M. GIGLIO,  GOTTFRIED,  LUPARDO,  MAGNARELLI, McDONOUGH, MONTESANO,
          PAULIN, THIELE -- read once and referred to the Committee on Insurance

        AN ACT to amend the insurance  law,  in  relation  to  mandatory  health
          insurance coverage for providing prosthetic devices

          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 36 to read as follows:
     3    (36)  Every  policy  which provides medical, major medical, or similar
     4  comprehensive  type  coverage  shall  provide  coverage  for  prosthetic
     5  devices,  including  repairs  and  replacements,  that  are intended for
     6  medically necessary rehabilitative and habilitative purposes as required
     7  by 42 U.S.C. §18022.  As  such,  prosthetic  device  coverage  shall  be
     8  subject  to  annual deductibles and coinsurance as deemed appropriate by
     9  the superintendent in amounts no greater  than  other  essential  health
    10  benefits  covered by the policy. The term "prosthetic device" as used in
    11  this paragraph includes an artificial limb and all of the components and
    12  related services that comprise prosthetic care  but  shall  not  include
    13  shoes  or  any  other  article  considered  as ordinary wearing apparel,
    14  whether or not specially constructed.
    15    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    16  adding a new paragraph 21 to read as follows:
    17    (21) Every policy which provides medical, major  medical,  or  similar
    18  comprehensive  type  coverage  shall  provide  coverage  for  prosthetic
    19  devices, including repairs  and  replacements,  that  are  intended  for
    20  medically necessary rehabilitative and habilitative purposes as required
    21  by  42  U.S.C.  §18022.  As  such,  prosthetic  device coverage shall be
    22  subject to annual deductibles and coinsurance as deemed  appropriate  by

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02480-01-1

        A. 4120                             2

     1  the  superintendent  in  amounts  no greater than other essential health
     2  benefits covered by the policy. The term "prosthetic device" as used  in
     3  this paragraph includes an artificial limb and all of the components and
     4  related  services  that  comprise  prosthetic care but shall not include
     5  shoes or any other  article  considered  as  ordinary  wearing  apparel,
     6  whether or not specially constructed.
     7    §  3.  Section  4303  of  the insurance law is amended by adding a new
     8  subsection (ss) to read as follows:
     9    (ss) Every policy which provides medical, major  medical,  or  similar
    10  comprehensive  type  coverage  shall  provide  coverage  for  prosthetic
    11  devices, including repairs  and  replacements,  that  are  intended  for
    12  medically necessary rehabilitative and habilitative purposes as required
    13  by  42  U.S.C.  §18022.  As  such,  prosthetic  device coverage shall be
    14  subject to annual deductibles and coinsurance as deemed  appropriate  by
    15  the  superintendent  in  amounts  no greater than other essential health
    16  benefits covered by the policy. The term "prosthetic device" as used  in
    17  this  subsection  includes  an artificial limb and all of the components
    18  and related services that comprise prosthetic care but shall not include
    19  shoes or any other  article  considered  as  ordinary  wearing  apparel,
    20  whether or not specially constructed.
    21    §  4.  This  act shall take effect on the ninetieth day after it shall
    22  have become a law and shall apply  to  policies  and  contracts  issued,
    23  renewed, modified, altered or amended on or after such effective date.
feedback