Bill Text: NY S09642 | 2023-2024 | General Assembly | Introduced

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Bill Title: Provides insurance coverage for cranial prostheses for a diagnosed health condition, chronic illness, or injury.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-05-16 - REFERRED TO INSURANCE [S09642 Detail]

Download: New_York-2023-S09642-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          9642

                    IN SENATE

                                      May 16, 2024
                                       ___________

        Introduced  by  Sen. MANNION -- 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  providing  insurance
          coverage for cranial prostheses

          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 39 to read as follows:
     3    (39)  (A)  Every  policy  which provides coverage for prostheses shall
     4  provide coverage for cranial  prostheses  for  individuals  experiencing
     5  permanent or temporary medical hair loss provided:
     6    (i)  a  licensed  provider  prescribes  such  cranial prosthesis for a
     7  covered person's course of treatment for the diagnosed health condition,
     8  chronic illness, or injury, including,  but  not  limited  to,  alopecia
     9  areata, alopecia medicamentosa, scarring alopecia, and lupus;
    10    (ii)  the  policy  provides  coverage  for  a  cranial prosthesis to a
    11  covered person no more frequently than once every twelve months; and
    12    (iii) the coverage is limited to seven hundred fifty dollars for  each
    13  instance  of coverage, and shall be subject to any cost-sharing require-
    14  ments that are otherwise applicable.
    15    (B) For purposes of this  paragraph,  the  term  "cranial  prosthesis"
    16  means a wig or hairpiece.
    17    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    18  adding a new paragraph 22 to read as follows:
    19    (22)  (A) Every group or blanket policy delivered or issued for deliv-
    20  ery in this state that provides coverage  for  protheses  shall  provide
    21  coverage  for  cranial prostheses for individuals experiencing permanent
    22  or temporary medical hair loss provided:
    23    (i) a licensed provider  prescribes  the  cranial  prosthesis  for  an
    24  enrollee's  course  of  treatment  for  the  diagnosed health condition,
    25  chronic illness, or injury, including,  but  not  limited  to,  alopecia
    26  areata, alopecia medicamentosa, scarring alopecia, and lupus;
    27    (ii) the policy provides coverage for a cranial prosthesis to an indi-
    28  vidual enrollee no more frequently than once every twelve months; and

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15672-01-4
        S. 9642                             2

     1    (iii)  the coverage is limited to seven hundred fifty dollars for each
     2  instance of coverage, and shall be subject to any cost-sharing  require-
     3  ments that are otherwise applicable.
     4    (B)  For  purposes  of  this  paragraph, the term "cranial prosthesis"
     5  means a wig or hairpiece.
     6    § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
     7  subsection (vv) to read as follows:
     8    (vv) (1) A hospital service corporation, health service corporation or
     9  medical  expense  indemnity  fund which provides coverage for prostheses
    10  shall provide coverage for cranial prostheses for individuals experienc-
    11  ing permanent or temporary medical hair loss provided:
    12    (A) a licensed provider  prescribes  the  cranial  prosthesis  for  an
    13  enrollee's  or subscriber's course of treatment for the diagnosed health
    14  condition, chronic illness, or injury, including, but  not  limited  to,
    15  alopecia areata, alopecia medicamentosa, scarring alopecia, and lupus;
    16    (B)  the  contract  provides  coverage  for a cranial prosthesis to an
    17  individual enrollee or subscriber no more  frequently  than  once  every
    18  twelve months; and
    19    (C)  the  coverage  is limited to seven hundred fifty dollars for each
    20  instance of coverage, and shall be subject to any cost-sharing  require-
    21  ments that are otherwise applicable.
    22    (2) For the purposes of this subsection, the term "cranial prosthesis"
    23  means a wig or hairpiece.
    24    §  4.  This  act  shall take effect immediately and shall apply to any
    25  policy issued, delivered, renewed, and/or  modified  on  or  after  such
    26  effective date of this act.