Bill Text: NY A04206 | 2011-2012 | General Assembly | Introduced


Bill Title: Requires health insurers to provide full coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder; establishes an advisory panel on health insurance coverage for autism spectrum disorder to annually compile a list of treatments and therapy options for which health insurers will be required to provide coverage; establishes a toll-free, 24 hour a day, autism and health insurance coverage hotline to receive and act upon complaints and questions from families with autistic children, relating to insurance coverage for autism spectrum disorder.

Spectrum: Slight Partisan Bill (Democrat 45-18)

Status: (Introduced - Dead) 2012-09-04 - enacting clause stricken [A04206 Detail]

Download: New_York-2011-A04206-Introduced.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         4206
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                   February 2, 2011
                                      ___________
       Introduced  by  M.  of  A. P. RIVERA, McENENY, V. LOPEZ, CAHILL, LIFTON,
         WEISENBERG, CLARK, SPANO,  MAYERSOHN,  BENEDETTO,  J. RIVERA,  THIELE,
         LATIMER,  SCHROEDER, TITONE, PHEFFER, CAMARA, MAISEL, JAFFEE -- Multi-
         Sponsored by -- M. of A. AUBRY,  BRENNAN,  CONTE,  DUPREY,  GABRYSZAK,
         JEFFRIES,  LUPARDO,  MARKEY,  McDONOUGH, McKEVITT, J. MILLER, MILLMAN,
         MOLINARO, NOLAN, PEOPLES-STOKES, REILLY, ROBINSON,  SAYWARD,  SWEENEY,
         TOBACCO,  TOWNS, WEINSTEIN, ZEBROWSKI -- read once and referred to the
         Committee on Insurance
       AN ACT to amend the insurance  law,  in  relation  to  requiring  health
         insurers to provide full coverage for the prevention, early detection,
         diagnosis and treatment of autism spectrum disorder
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1.  The insurance law is amended by adding a new  section  342
    2  to read as follows:
    3    S  342. COVERAGE FOR AUTISM SPECTRUM DISORDER. (A) (1) THERE IS HEREBY
    4  ESTABLISHED WITHIN THE DEPARTMENT AN ADVISORY PANEL ON HEALTH  INSURANCE
    5  COVERAGE  FOR  AUTISM SPECTRUM DISORDER. SUCH PANEL SHALL BE COMPOSED OF
    6  NINE MEMBERS WHO ARE EXPERTS IN HEALTH CARE AND  APPOINTED  AS  FOLLOWS:
    7  SEVEN MEMBERS WHO ARE OFFICERS OR EMPLOYEES OF THE DEPARTMENT OF HEALTH,
    8  OFFICE  OF  MENTAL  HEALTH  OR  THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL
    9  DISABILITIES SHALL BE APPOINTED BY THE GOVERNOR; AND THE TEMPORARY PRES-
   10  IDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY SHALL EACH APPOINT A
   11  MEMBER WHO IS A REPRESENTATIVE OF AN AUTISM ADVOCACY GROUP. EACH  MEMBER
   12  SHALL  SERVE A TERM OF TWO YEARS. THE GOVERNOR SHALL DESIGNATE THE CHAIR
   13  OF THE PANEL FROM AMONG HIS OR HER APPOINTEES. VACANCIES IN THE  MEMBER-
   14  SHIP  OF  THE  PANEL SHALL BE FILLED IN THE MANNER PROVIDED FOR ORIGINAL
   15  APPOINTMENTS.
   16    (2) THE MEMBERS OF THE PANEL SHALL RECEIVE NO COMPENSATION  FOR  THEIR
   17  SERVICES  BUT  SHALL  BE  ALLOWED  THEIR  ACTUAL  AND NECESSARY EXPENSES
   18  INCURRED IN THE PERFORMANCE OF THEIR DUTIES PURSUANT TO THIS SUBSECTION.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD00127-01-1
       A. 4206                             2
    1    (3) THE ADVISORY PANEL ON HEALTH INSURANCE COVERAGE FOR  AUTISM  SPEC-
    2  TRUM  DISORDER SHALL ANNUALLY, ON OR BEFORE SEPTEMBER FIRST, COMPILE AND
    3  SUBMIT TO THE SUPERINTENDENT A LIST OF SUCCESSFUL TREATMENT AND  THERAPY
    4  OPTIONS FOR AUTISM SPECTRUM DISORDER THAT WILL BE REQUIRED TO BE COVERED
    5  PURSUANT  TO  PARAGRAPH  TWENTY-FIVE  OF SUBSECTION (I) OF SECTION THREE
    6  THOUSAND TWO HUNDRED SIXTEEN, PARAGRAPH SEVENTEEN OF SUBSECTION  (1)  OF
    7  SECTION  THREE  THOUSAND  TWO  HUNDRED TWENTY-ONE AND SUBSECTION (EE) OF
    8  SECTION FOUR THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
    9    (4) WITHIN FORTY-FIVE DAYS OF RECEIPT OF EACH LIST SUBMITTED  PURSUANT
   10  TO  PARAGRAPH  THREE OF THIS SUBSECTION, THE SUPERINTENDENT SHALL, ON AN
   11  EMERGENCY BASIS, PROMULGATE AND IMPLEMENT RULES AND REGULATIONS  REQUIR-
   12  ING COVERAGE FOR THE TREATMENT AND THERAPY OPTIONS INCLUDED IN EACH SUCH
   13  LIST.
   14    (B)  (1)  WITHIN  ONE  HUNDRED  EIGHTY  DAYS  OF THE SUBMISSION OF THE
   15  INITIAL LIST TO  THE  SUPERINTENDENT  PURSUANT  TO  PARAGRAPH  THREE  OF
   16  SUBSECTION (A) OF THIS SECTION, THE DEPARTMENT SHALL ESTABLISH AND OPER-
   17  ATE  AN  AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE. THE HOTLINE SHALL
   18  BE A TOLL-FREE, TWENTY-FOUR HOUR A DAY CONSUMER CALL CENTER FOR FAMILIES
   19  WITH AUTISTIC CHILDREN WHO HAVE COMPLAINTS ABOUT OR QUESTIONS ON  INSUR-
   20  ERS  AND  COVERAGE FOR AUTISM SPECTRUM DISORDER. ALL COMPLAINTS RECEIVED
   21  BY SUCH HOTLINE SHALL BE DOCUMENTED  AND  REFERRED  TO  THE  APPROPRIATE
   22  OFFICIAL IN THE DEPARTMENT FOR CORRECTIVE ACTION.
   23    (2) THE DEPARTMENT MAY CONTRACT WITH A QUALIFIED NOT-FOR-PROFIT CORPO-
   24  RATION  FOR  THE PROVISION AND OPERATION OF THE HOTLINE REQUIRED BY THIS
   25  SUBSECTION. ANY SUCH CONTRACT SHALL ONLY BE AWARDED AFTER THE DEPARTMENT
   26  HAS CONDUCTED A REQUEST FOR  PROPOSALS  PROCESS.  THE  DEPARTMENT  SHALL
   27  SELECT  A NOT-FOR-PROFIT CORPORATION WHICH HAS THE RESOURCES AND ABILITY
   28  TO OPERATE A STATEWIDE HOTLINE,  AND  IS  STAFFED  BY  EMPLOYEES  AND/OR
   29  VOLUNTEERS WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISORDER.
   30    (3)  IF  THE  DEPARTMENT  ELECTS  TO ESTABLISH AND OPERATE THE HOTLINE
   31  USING ITS OWN PERSONNEL AND RESOURCES, SUCH HOTLINE SHALL BE STAFFED  BY
   32  OFFICERS  AND EMPLOYEES WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISOR-
   33  DER. UNTIL THE STATE CIVIL SERVICE  COMMISSION  SHALL  HAVE  ESTABLISHED
   34  CIVIL  SERVICE  TITLES  AND  COMPETITIVE  EXAMINATIONS  FOR POSITIONS AS
   35  EMPLOYEES OF THE HOTLINE, THE SUPERINTENDENT IS AUTHORIZED AND  DIRECTED
   36  TO  APPOINT AND EMPLOY SUCH QUALIFIED OFFICERS AND EMPLOYEES AS SHALL BE
   37  NECESSARY TO OPERATE THE AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE.
   38    (4) THE SUPERINTENDENT IS AUTHORIZED TO PROMULGATE AND  IMPLEMENT  ANY
   39  RULES  AND  REGULATIONS  NECESSARY  TO  CARRY OUT THE PROVISIONS OF THIS
   40  SUBSECTION.
   41    S 2. Paragraph 25 of subsection (i) of section 3216 of  the  insurance
   42  law,  as added by chapter 557 of the laws of 2006, is amended to read as
   43  follows:
   44    (25) Every policy which provides coverage for hospital,  surgical,  or
   45  medical  care coverage shall [not exclude] INCLUDE FULL coverage for THE
   46  PREVENTION, EARLY DETECTION, diagnosis and treatment of [medical  condi-
   47  tions  otherwise  covered  by the policy solely because the treatment is
   48  provided to diagnose or treat] autism spectrum disorder.   For  purposes
   49  of  this  section,  "autism  spectrum  disorder" means a neurobiological
   50  condition that includes autism, Asperger syndrome, Rett's  syndrome,  or
   51  pervasive developmental disorder.
   52    S  3.  Paragraph 17 of subsection (l) of section 3221 of the insurance
   53  law, as added by chapter 557 of the laws of 2006, is amended to read  as
   54  follows:
   55    (17) A group or blanket accident or health insurance policy or issuing
   56  a  group  or  blanket  policy  for delivery in this state which provides
       A. 4206                             3
    1  coverage for hospital, surgical, or medical  care  coverage  shall  [not
    2  exclude]  INCLUDE  FULL  coverage  for  THE PREVENTION, EARLY DETECTION,
    3  diagnosis and treatment of [medical conditions otherwise covered by  the
    4  policy  because  the  treatment is provided to diagnose or treat] autism
    5  spectrum disorder.   For purposes  of  this  section,  "autism  spectrum
    6  disorder" means a neurobiological condition that includes autism, Asper-
    7  ger syndrome, Rett's syndrome, or pervasive developmental disorder.
    8    S 4. Subsection (ee) of section 4303 of the insurance law, as added by
    9  chapter 557 of the laws of 2006, is amended to read as follows:
   10    (ee)  A  medical  expense  indemnity  corporation,  a hospital service
   11  corporation or a health service corporation which provides coverage  for
   12  hospital, surgical, or medical care coverage shall [not exclude] INCLUDE
   13  FULL  coverage for THE PREVENTION, EARLY DETECTION, diagnosis and treat-
   14  ment of [medical conditions  otherwise  covered  by  the  policy  solely
   15  because  the treatment is provided to diagnose or treat] autism spectrum
   16  disorder.   For purposes of this  section,  "autism  spectrum  disorder"
   17  means   a  neurobiological  condition  that  includes  autism,  Asperger
   18  syndrome, Rett's syndrome, or pervasive developmental disorder.
   19    S 5. This act shall take effect on the thirtieth day  after  it  shall
   20  have become a law.
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