Bill Text: NY A07790 | 2023-2024 | General Assembly | Amended


Bill Title: Expands insurance coverage requirements for human donor milk; removes the requirement for inpatient use.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Engrossed) 2024-05-28 - RETURNED TO ASSEMBLY [A07790 Detail]

Download: New_York-2023-A07790-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         7790--A

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                      June 15, 2023
                                       ___________

        Introduced  by  M.  of  A.  SOLAGES,  BICHOTTE HERMELYN -- read once and
          referred to the Committee on Insurance -- recommitted to the Committee
          on Insurance in accordance with Assembly Rule 3, sec. 2  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee

        AN  ACT  to  amend  the insurance law, in relation to expanding coverage
          requirements for human donor milk

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Paragraph  38  of  subsection  (i) of section 3216 of the
     2  insurance law, as added by section 10 of part MM of chapter  57  of  the
     3  laws  of  2018  and as renumbered by chapter 739 of the laws of 2022, is
     4  amended to read as follows:
     5    (38) Every policy that provides coverage  for  hospital,  surgical  or
     6  medical  care shall provide the following coverage for pasteurized donor
     7  human milk (PDHM), which may include fortifiers as medically indicated[,
     8  for inpatient use], for which a licensed medical practitioner has issued
     9  an order for an infant who is medically or physically unable to  receive
    10  maternal breast milk or participate in breast feeding or whose mother is
    11  medically or physically unable to produce maternal breast milk at all or
    12  in  sufficient quantities or participate in breast feeding despite opti-
    13  mal lactation support. Such infant shall: (i) have  a  documented  birth
    14  weight  of  less  than  one  thousand five hundred grams; or (ii) have a
    15  congenital or acquired condition that places the infant at a  high  risk
    16  for development of necrotizing enterocolitis.
    17    §  2.  Paragraph 20 of subsection (l) of section 3221 of the insurance
    18  law, as added by section 11 of part MM of chapter  57  of  the  laws  of
    19  2018, is amended to read as follows:
    20    (20)  Every  insurer delivering a group or blanket policy or issuing a
    21  group or blanket policy for delivery in this state that provides  cover-
    22  age  for  hospital, surgical or medical care shall provide the following

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11129-03-4

        A. 7790--A                          2

     1  coverage for pasteurized donor human  milk  (PDHM),  which  may  include
     2  fortifiers  as  medically  indicated[,  for  inpatient use], for which a
     3  licensed medical practitioner has issued an order for an infant  who  is
     4  medically  or  physically  unable  to  receive  maternal  breast milk or
     5  participate in breast feeding or whose mother is medically or physically
     6  unable to produce maternal breast milk at all or in  sufficient  quanti-
     7  ties or participate in breast feeding despite optimal lactation support.
     8  Such  infant  shall: (i) have a documented birth weight of less than one
     9  thousand five hundred grams; or  (ii)  have  a  congenital  or  acquired
    10  condition  that  places  the  infant  at  a high risk for development of
    11  necrotizing enterocolitis.
    12    § 3. Subsection (oo) of section 4303 of the insurance law, as added by
    13  section 12 of part MM of chapter 57 of the laws of 2018, is  amended  to
    14  read as follows:
    15    (oo)  A  medical  expense  indemnity  corporation,  a hospital service
    16  corporation or a health service corporation that provides  coverage  for
    17  hospital,  surgical or medical care shall provide the following coverage
    18  for pasteurized donor human milk (PDHM), which may include fortifiers as
    19  medically indicated[, for inpatient use], for which a  licensed  medical
    20  practitioner has issued an order for an infant who is medically or phys-
    21  ically  unable  to receive maternal breast milk or participate in breast
    22  feeding or whose mother is medically or  physically  unable  to  produce
    23  maternal  breast  milk at all or in sufficient quantities or participate
    24  in breast feeding despite optimal lactation support. Such infant  shall:
    25  (i)  have  a  documented  birth  weight  of  less than one thousand five
    26  hundred grams; or (ii) have a  congenital  or  acquired  condition  that
    27  places  the infant at a high risk for development of necrotizing entero-
    28  colitis.
    29    § 4. This act shall take effect on the first of January next  succeed-
    30  ing  the date on which it shall have become a law and shall apply to all
    31  policies issued, renewed, modified, altered or amended on or after  such
    32  date.  Effectively immediately, the addition, amendment and/or repeal of
    33  any  rule  or regulation necessary for the implementation of this act on
    34  its effective date are authorized to be made and completed on or  before
    35  such date.
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