Bill Text: NY A00497 | 2009-2010 | General Assembly | Introduced

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Bill Title: Relates to mandatory health insurance coverage for providing prosthetic devices equal to or above Medicare's standard of coverage; includes the repair or replacement of a prosthetic device required to be worn or used by a policy holder; coverage includes expenses for assessment, evaluation, treatment, management, and follow-up care.

Spectrum: Moderate Partisan Bill (Democrat 31-8)

Status: (Introduced - Dead) 2011-01-05 - referred to insurance [A00497 Detail]

Download: New_York-2009-A00497-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                          497
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                      (PREFILED)
                                    January 5, 2011
                                      ___________
       Introduced  by  M.  of  A.  GUNTHER,  PHEFFER, ORTIZ, ROSENTHAL, WRIGHT,
         JAFFEE, JACOBS, PERRY, CLARK, HOOPER, KELLNER, SPANO, CALHOUN,  McKEV-
         ITT,  DINOWITZ  --  Multi-Sponsored  by -- M. of A. ABBATE, BENEDETTO,
         BING, CONTE, COOK, CROUCH, CUSICK, GALEF, GIGLIO, GOTTFRIED,  LANCMAN,
         LATIMER, MAGNARELLI, MAISEL, McENENY, J. MILLER, PAULIN, RAIA, REILLY,
         J. RIVERA,  SCHROEDER,  SWEENEY,  THIELE,  WEISENBERG -- 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 28 to read as follows:
    3    (28)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
    4  COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE  EQUAL  TO  OR  ABOVE
    5  MEDICARE'S  STANDARD  OF  COVERAGE  FOR PROSTHETIC DEVICES.   THIS SHALL
    6  INCLUDE COVERAGE NOT ONLY FOR  THE  PROVISION  OF  A  PROSTHETIC  DEVICE
    7  REQUIRED  TO  BE  WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR
    8  REPLACEMENT OF A PROSTHETIC DEVICE REQUIRED TO BE  WORN  OR  USED  BY  A
    9  POLICY  HOLDER.  COVERAGE  SHALL INCLUDE EXPENSES FOR ASSESSMENT, EVALU-
   10  ATION, TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT  BE
   11  DENIED  ON  THE  GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS NOT FOR A
   12  FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
   13  THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
   14  INCLUDE SHOES OR  ANY  OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING
   15  APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
   16    S 2. Subsection (l) of section 3221 of the insurance law is amended by
   17  adding a new paragraph 18 to read as follows:
   18    (18)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
   19  COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE  EQUAL  TO  OR  ABOVE
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD01490-01-1
       A. 497                              2
    1  MEDICARE'S  STANDARD  OF  COVERAGE  FOR PROSTHETIC DEVICES.   THIS SHALL
    2  INCLUDE COVERAGE NOT ONLY FOR  THE  PROVISION  OF  A  PROSTHETIC  DEVICE
    3  REQUIRED  TO  BE  WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR
    4  REPLACEMENT  OF  A  PROSTHETIC  DEVICE  REQUIRED TO BE WORN OR USED BY A
    5  POLICY HOLDER. COVERAGE SHALL INCLUDE EXPENSES  FOR  ASSESSMENT,  EVALU-
    6  ATION,  TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT BE
    7  DENIED ON THE GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS  NOT  FOR  A
    8  FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
    9  THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
   10  INCLUDE  SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING
   11  APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
   12    S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
   13  subsection (hh) to read as follows:
   14    (HH)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
   15  COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE  EQUAL  TO  OR  ABOVE
   16  MEDICARE'S  STANDARD  OF  COVERAGE  FOR PROSTHETIC DEVICES.   THIS SHALL
   17  INCLUDE COVERAGE NOT ONLY FOR  THE  PROVISION  OF  A  PROSTHETIC  DEVICE
   18  REQUIRED  TO  BE  WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR
   19  REPLACEMENT OF A PROSTHETIC DEVICE REQUIRED TO BE  WORN  OR  USED  BY  A
   20  POLICY  HOLDER.  COVERAGE  SHALL INCLUDE EXPENSES FOR ASSESSMENT, EVALU-
   21  ATION, TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT  BE
   22  DENIED  ON  THE  GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS NOT FOR A
   23  FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
   24  THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
   25  INCLUDE SHOES OR  ANY  OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING
   26  APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
   27    S  4.  This  act shall take effect on the ninetieth day after it shall
   28  have become a law and shall apply  to  policies  and  contracts  issued,
   29  renewed, modified, altered or amended on or after such effective date.