Bill Text: NY A02962 | 2019-2020 | General Assembly | Introduced
Bill Title: Relates to insurance coverage of early intervention services.
Spectrum: Strong Partisan Bill (Democrat 15-1)
Status: (Introduced - Dead) 2020-01-08 - referred to insurance [A02962 Detail]
Download: New_York-2019-A02962-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 2962 2019-2020 Regular Sessions IN ASSEMBLY January 28, 2019 ___________ Introduced by M. of A. PAULIN, COLTON, CAHILL, ABINANTI, JAFFEE, GALEF, PRETLOW, WEPRIN, ORTIZ, RIVERA, GOODELL, MAGNARELLI, GUNTHER -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT, GOTTFRIED, PERRY -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to coverage of early intervention services The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (a) of section 3235-a of the insurance law, as 2 added by section 3 of part C of chapter 1 of the laws of 2002, is 3 amended and two new subsections (e) and (f) are added to read as 4 follows: 5 (a) No policy of accident and health insurance, including contracts 6 issued pursuant to article forty-three of this chapter, shall exclude 7 coverage for otherwise covered services [solely on the basis that the8services constitute early intervention program services] that are 9 provided under title two-A of article twenty-five of the public health 10 law. 11 (e) Where a service provided to an insured under the early inter- 12 vention program is a covered service under the insurer's policy or 13 contract, the individualized family services plan, upon certification by 14 the early intervention official, as defined in section twenty-five 15 hundred forty-one of the public health law, or such official's designee, 16 shall be deemed to meet any precertification, preauthorization, and 17 medical necessity requirements imposed on benefits under the policy or 18 contract; provided, however, that the provider shall remove or redact 19 any information contained in the insured's individualized family 20 services plan that is not required by the insurer for payment purposes. 21 Payment for a service covered under the policy or contract that is 22 provided under the early intervention program shall be at rates estab- EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00618-01-9A. 2962 2 1 lished by the commissioner of health for such service pursuant to regu- 2 lations. 3 (f) No insurer, including a health maintenance organization issued a 4 certificate of authority under article forty-four of the public health 5 law and a corporation organized under article forty-three of this chap- 6 ter, shall deny payment of an early intervention claim based on the 7 following: 8 (1) the location where services are provided; 9 (2) the duration of the child's condition and/or that the child's 10 condition is not amenable to significant improvement within a certain 11 period of time as specified in the policy; or 12 (3) that the provider of services is not a network or participating 13 provider. 14 § 2. This act shall take effect immediately.