Bill Text: NY S03405 | 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.
Sponsorship: Partisan Bill (Democrat 1)
Status: (Introduced - Dead) 2012-01-11 - PRINT NUMBER 3405A [S03405 Detail]
Download: New_York-2011-S03405-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
3405
2011-2012 Regular Sessions
I N S E N A T E
February 18, 2011
___________
Introduced by Sen. PARKER -- read twice and ordered printed, and when
printed to be committed 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.
19 (3) THE ADVISORY PANEL ON HEALTH INSURANCE COVERAGE FOR AUTISM SPEC-
20 TRUM DISORDER SHALL ANNUALLY, ON OR BEFORE SEPTEMBER FIRST, COMPILE AND
21 SUBMIT TO THE SUPERINTENDENT A LIST OF SUCCESSFUL TREATMENT AND THERAPY
22 OPTIONS FOR AUTISM SPECTRUM DISORDER THAT WILL BE REQUIRED TO BE COVERED
23 PURSUANT TO PARAGRAPH TWENTY-FIVE OF SUBSECTION (I) OF SECTION THREE
24 THOUSAND TWO HUNDRED SIXTEEN, PARAGRAPH SEVENTEEN OF SUBSECTION (1) OF
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00127-01-1
S. 3405 2
1 SECTION THREE THOUSAND TWO HUNDRED TWENTY-ONE AND SUBSECTION (EE) OF
2 SECTION FOUR THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
3 (4) WITHIN FORTY-FIVE DAYS OF RECEIPT OF EACH LIST SUBMITTED PURSUANT
4 TO PARAGRAPH THREE OF THIS SUBSECTION, THE SUPERINTENDENT SHALL, ON AN
5 EMERGENCY BASIS, PROMULGATE AND IMPLEMENT RULES AND REGULATIONS REQUIR-
6 ING COVERAGE FOR THE TREATMENT AND THERAPY OPTIONS INCLUDED IN EACH SUCH
7 LIST.
8 (B) (1) WITHIN ONE HUNDRED EIGHTY DAYS OF THE SUBMISSION OF THE
9 INITIAL LIST TO THE SUPERINTENDENT PURSUANT TO PARAGRAPH THREE OF
10 SUBSECTION (A) OF THIS SECTION, THE DEPARTMENT SHALL ESTABLISH AND OPER-
11 ATE AN AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE. THE HOTLINE SHALL
12 BE A TOLL-FREE, TWENTY-FOUR HOUR A DAY CONSUMER CALL CENTER FOR FAMILIES
13 WITH AUTISTIC CHILDREN WHO HAVE COMPLAINTS ABOUT OR QUESTIONS ON INSUR-
14 ERS AND COVERAGE FOR AUTISM SPECTRUM DISORDER. ALL COMPLAINTS RECEIVED
15 BY SUCH HOTLINE SHALL BE DOCUMENTED AND REFERRED TO THE APPROPRIATE
16 OFFICIAL IN THE DEPARTMENT FOR CORRECTIVE ACTION.
17 (2) THE DEPARTMENT MAY CONTRACT WITH A QUALIFIED NOT-FOR-PROFIT CORPO-
18 RATION FOR THE PROVISION AND OPERATION OF THE HOTLINE REQUIRED BY THIS
19 SUBSECTION. ANY SUCH CONTRACT SHALL ONLY BE AWARDED AFTER THE DEPARTMENT
20 HAS CONDUCTED A REQUEST FOR PROPOSALS PROCESS. THE DEPARTMENT SHALL
21 SELECT A NOT-FOR-PROFIT CORPORATION WHICH HAS THE RESOURCES AND ABILITY
22 TO OPERATE A STATEWIDE HOTLINE, AND IS STAFFED BY EMPLOYEES AND/OR
23 VOLUNTEERS WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISORDER.
24 (3) IF THE DEPARTMENT ELECTS TO ESTABLISH AND OPERATE THE HOTLINE
25 USING ITS OWN PERSONNEL AND RESOURCES, SUCH HOTLINE SHALL BE STAFFED BY
26 OFFICERS AND EMPLOYEES WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISOR-
27 DER. UNTIL THE STATE CIVIL SERVICE COMMISSION SHALL HAVE ESTABLISHED
28 CIVIL SERVICE TITLES AND COMPETITIVE EXAMINATIONS FOR POSITIONS AS
29 EMPLOYEES OF THE HOTLINE, THE SUPERINTENDENT IS AUTHORIZED AND DIRECTED
30 TO APPOINT AND EMPLOY SUCH QUALIFIED OFFICERS AND EMPLOYEES AS SHALL BE
31 NECESSARY TO OPERATE THE AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE.
32 (4) THE SUPERINTENDENT IS AUTHORIZED TO PROMULGATE AND IMPLEMENT ANY
33 RULES AND REGULATIONS NECESSARY TO CARRY OUT THE PROVISIONS OF THIS
34 SUBSECTION.
35 S 2. Paragraph 25 of subsection (i) of section 3216 of the insurance
36 law, as added by chapter 557 of the laws of 2006, is amended to read as
37 follows:
38 (25) Every policy which provides coverage for hospital, surgical, or
39 medical care coverage shall [not exclude] INCLUDE FULL coverage for THE
40 PREVENTION, EARLY DETECTION, diagnosis and treatment of [medical condi-
41 tions otherwise covered by the policy solely because the treatment is
42 provided to diagnose or treat] autism spectrum disorder. For purposes
43 of this section, "autism spectrum disorder" means a neurobiological
44 condition that includes autism, Asperger syndrome, Rett's syndrome, or
45 pervasive developmental disorder.
46 S 3. Paragraph 17 of subsection (l) of section 3221 of the insurance
47 law, as added by chapter 557 of the laws of 2006, is amended to read as
48 follows:
49 (17) A group or blanket accident or health insurance policy or issuing
50 a group or blanket policy for delivery in this state which provides
51 coverage for hospital, surgical, or medical care coverage shall [not
52 exclude] INCLUDE FULL coverage for THE PREVENTION, EARLY DETECTION,
53 diagnosis and treatment of [medical conditions otherwise covered by the
54 policy because the treatment is provided to diagnose or treat] autism
55 spectrum disorder. For purposes of this section, "autism spectrum
S. 3405 3
1 disorder" means a neurobiological condition that includes autism, Asper-
2 ger syndrome, Rett's syndrome, or pervasive developmental disorder.
3 S 4. Subsection (ee) of section 4303 of the insurance law, as added by
4 chapter 557 of the laws of 2006, is amended to read as follows:
5 (ee) A medical expense indemnity corporation, a hospital service
6 corporation or a health service corporation which provides coverage for
7 hospital, surgical, or medical care coverage shall [not exclude] INCLUDE
8 FULL coverage for THE PREVENTION, EARLY DETECTION, diagnosis and treat-
9 ment of [medical conditions otherwise covered by the policy solely
10 because the treatment is provided to diagnose or treat] autism spectrum
11 disorder. For purposes of this section, "autism spectrum disorder"
12 means a neurobiological condition that includes autism, Asperger
13 syndrome, Rett's syndrome, or pervasive developmental disorder.
14 S 5. This act shall take effect on the thirtieth day after it shall
15 have become a law.
