Bill Text: NY A01103 | 2013-2014 | General Assembly | Amended

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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; includes expenses for assessment, evaluation, treatment, management, and follow-up care.

Spectrum: Moderate Partisan Bill (Democrat 32-5)

Status: (Introduced - Dead) 2014-06-03 - held for consideration in insurance [A01103 Detail]

Download: New_York-2013-A01103-Amended.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        1103--A
                              2013-2014 Regular Sessions
                                 I N  A S S E M B L Y
                                      (PREFILED)
                                    January 9, 2013
                                      ___________
       Introduced  by  M.  of  A.  GUNTHER,  ORTIZ,  ROSENTHAL, WRIGHT, JAFFEE,
         JACOBS, PERRY, CLARK, HOOPER,  KELLNER,  McKEVITT,  DINOWITZ,  DUPREY,
         BOYLAND,  ZEBROWSKI, TITONE, RIVERA, ABINANTI, COLTON, DenDEKKER, RAIA
         -- Multi-Sponsored by -- M. of A.  ABBATE,  BENEDETTO,  COOK,  CROUCH,
         CUSICK,  GALEF,  GIGLIO, GOTTFRIED, MAGNARELLI, MILLMAN, PAULIN, SCAR-
         BOROUGH, SCHIMEL, SKARTADOS, SWEENEY, THIELE, WEISENBERG -- 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  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 30 to read as follows:
    3    (30)  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.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02404-03-4
       A. 1103--A                          2
    1    S 2. Subsection (l) of section 3221 of the insurance law is amended by
    2  adding a new paragraph 19 to read as follows:
    3    (19)  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  3.  Section  4303  of  the insurance law is amended by adding a new
   17  subsection (oo) to read as follows:
   18    (OO) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
   19  COMPREHENSIVE  TYPE  COVERAGE  SHALL  INCLUDE COVERAGE EQUAL TO OR ABOVE
   20  MEDICARE'S STANDARD OF COVERAGE FOR  PROSTHETIC  DEVICES.    THIS  SHALL
   21  INCLUDE  COVERAGE  NOT  ONLY  FOR  THE  PROVISION OF A PROSTHETIC DEVICE
   22  REQUIRED TO BE WORN OR USED BY A POLICY HOLDER BUT ALSO  THE  REPAIR  OR
   23  REPLACEMENT  OF  A  PROSTHETIC  DEVICE  REQUIRED TO BE WORN OR USED BY A
   24  POLICY HOLDER. COVERAGE SHALL INCLUDE EXPENSES  FOR  ASSESSMENT,  EVALU-
   25  ATION,  TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT BE
   26  DENIED ON THE GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS  NOT  FOR  A
   27  FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
   28  THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
   29  INCLUDE  SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING
   30  APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
   31    S 4. This act shall take effect on the ninetieth day  after  it  shall
   32  have  become  a  law  and  shall apply to policies and contracts issued,
   33  renewed, modified, altered or amended on or after such effective date.