Bill Text: NY A06369 | 2023-2024 | General Assembly | Introduced

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Bill Title: Provides for increased podiatry care and benefits under individual and group accident and health insurance policies and contracts within non-profit medical and dental indemnity, or health and hospital service corporations.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced) 2024-01-03 - referred to insurance [A06369 Detail]

Download: New_York-2023-A06369-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          6369

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                      April 5, 2023
                                       ___________

        Introduced  by M. of A. WEPRIN -- Multi-Sponsored by -- M. of A. COLTON,
          GUNTHER -- read once and referred to the Committee on Insurance

        AN ACT to amend the insurance law, in relation to coverage and  benefits
          of accident and health insurance policies for podiatric care

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Paragraph 2 of subsection (i) of section 3216 of the insur-
     2  ance law is amended to read as follows:
     3    (2) If a policy provides for reimbursement for any podiatrical service
     4  within the lawful scope  of  practice  of  a  licensed  podiatrist,  the
     5  insured  shall  be  entitled  to the same reimbursement for such service
     6  whether it is performed by a physician or licensed podiatrist.
     7    § 2. Subsection (k) of section 3221 of the insurance law is amended by
     8  adding a new paragraph 23 to read as follows:
     9    (23) Every policy which  provides  coverage  for  podiatric  care,  as
    10  defined in  section seven thousand one of the education law, provided by
    11  a  doctor of podiatry licensed pursuant to article one hundred forty-one
    12  of the education law, may be subject to reasonable  deductible,  co-pay-
    13  ment  and  co-insurance  amounts,  reasonable  fee or benefit limits and
    14  reasonable utilization review, provided that any  such  amounts,  limits
    15  and  review:  (A)  shall  not  function  to direct treatment in a manner
    16  discriminative against podiatric care; and (B) individually and  collec-
    17  tively shall be no different than those applicable under that same poli-
    18  cy  to  care  or services provided by other health professionals in  the
    19  diagnosis, treatment and management of the same or  similar  conditions,
    20  disorders  or  injuries. Nothing in this paragraph shall be construed as
    21  impeding or preventing either the provision  or  coverage  of  podiatric
    22  care  and  services  by  duly    licensed doctors of podiatry within the
    23  lawful scope of podiatric care in hospital  facilities  on  a  staff  or
    24  employee basis.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10419-01-3
        A. 6369                             2

     1    §  3.  Section  4303  of  the insurance law is amended by adding a new
     2  subsection (vv) to read as follows:
     3    (vv)  Every  contract  issued  by  a  health  service corporation or a
     4  medical expense indemnity corporation that includes coverage for  physi-
     5  cian  services  in  a physician's office, that provides major medical or
     6  similar comprehensive-type coverage, and coverage for podiatric care  as
     7  defined  in section seven thousand one of the education law, provided by
     8  a doctor of podiatry licensed pursuant to article one hundred  forty-one
     9  of  the  education law, may be subject to reasonable deductible, co-pay-
    10  ment and co-insurance amounts, reasonable  fee  or  benefit  limits  and
    11  reasonable  utilization  review,  provided that any such amounts, limits
    12  and review:  (1) shall not function to  direct  treatment  in  a  manner
    13  discriminative  against podiatric care; and (2) individually and collec-
    14  tively shall be no different than those applicable under the same policy
    15  to care or services provided by other health professionals in the  diag-
    16  nosis,  treatment  and  management  of  the  same or similar conditions,
    17  disorders or injuries. Nothing in this subsection shall be construed  as
    18  impeding  or  preventing  either the provisions or coverage of podiatric
    19  care and services by duly licensed doctors of podiatry within the lawful
    20  scope of podiatric care in hospital facilities on a  staff  or  employee
    21  basis.
    22    §  4. This act shall take effect on the first of January next succeed-
    23  ing the date on which it shall have become a  law  and  shall  apply  to
    24  policies  and contracts issued, renewed, modified, altered or amended on
    25  or after such effective date.