Bill Text: NY A07076 | 2021-2022 | General Assembly | Introduced

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Bill Title: Requires insurance companies to provide coverage for monoclonal antibody treatment for the novel coronavirus (COVID-19).

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2022-01-05 - referred to insurance [A07076 Detail]

Download: New_York-2021-A07076-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7076

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                     April 21, 2021
                                       ___________

        Introduced by M. of A. ABINANTI -- read once and referred to the Commit-
          tee on Insurance

        AN  ACT  to  amend the insurance law, in relation to requiring insurance
          companies to provide coverage for monoclonal  antibody  treatment  for
          the novel coronavirus (COVID-19)

          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 36 to read as follows:
     3    (36)  (A)  Every policy delivered or issued for delivery in this state
     4  that provides medical,  major  medical,  or  similar  comprehensive-type
     5  coverage  and  provides  coverage  for  prescription drugs shall provide
     6  coverage for prescribed monoclonal  antibody  treatment  for  the  novel
     7  coronavirus (COVID-19). Such coverage may be subject to co-pays, coinsu-
     8  rance  or deductibles, provided that the co-pays, coinsurance or deduct-
     9  ibles are at least as favorable to an insured as  the  co-pays,  coinsu-
    10  rance or deductibles that apply to coverage for other treatments for the
    11  novel coronavirus (COVID-19).
    12    (B) An insurer providing coverage under this paragraph and any partic-
    13  ipating  entity  through  which the insurer offers health services shall
    14  not:
    15    (i) vary the terms of the policy for the purpose or with the effect of
    16  avoiding compliance with this paragraph;
    17    (ii) provide incentives (monetary or otherwise) to encourage a covered
    18  person to accept less than the minimum protections available under  this
    19  paragraph;
    20    (iii)  penalize  in  any  way or reduce or limit the compensation of a
    21  health care practitioner for recommending or providing care to a covered
    22  person in accordance with this paragraph;
    23    (iv) provide incentives (monetary or otherwise) to a health care prac-
    24  titioner relating to the services provided pursuant  to  this  paragraph

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10737-01-1
        A. 7076                             2

     1  intended  to  induce or have the effect of inducing such practitioner to
     2  provide care to a covered person in  a  manner  inconsistent  with  this
     3  paragraph; or
     4    (v)  achieve compliance with this paragraph by imposing an increase in
     5  cost sharing for an intravenous or injected anticancer medication.
     6    § 2. Subsection (l) of section 3221 of the insurance law is amended by
     7  adding a new paragraph 21 to read as follows:
     8    (21) (A) Every group or blanket policy delivered or issued for  deliv-
     9  ery  in  this  state  that  provides  medical, major medical, or similar
    10  comprehensive-type coverage and provides coverage for prescription drugs
    11  shall provide coverage for prescribed monoclonal antibody treatment  for
    12  the  novel  coronavirus  (COVID-19).  Such  coverage  may  be subject to
    13  co-pays, coinsurance or deductibles, provided that the co-pays,  coinsu-
    14  rance  or  deductibles  are  at  least as favorable to an insured as the
    15  co-pays, coinsurance or deductibles that apply  to  coverage  for  other
    16  treatments for the novel coronavirus (COVID-19).
    17    (B) An insurer providing coverage under this paragraph and any partic-
    18  ipating  entity  through  which the insurer offers health services shall
    19  not:
    20    (i) vary the terms of the policy for the purpose or with the effect of
    21  avoiding compliance with this paragraph;
    22    (ii) provide incentives (monetary or otherwise) to encourage a covered
    23  person to accept less than the minimum protections available under  this
    24  paragraph;
    25    (iii)  penalize  in  any  way or reduce or limit the compensation of a
    26  health care practitioner for recommending or providing care to a covered
    27  person in accordance with this paragraph;
    28    (iv) provide incentives (monetary or otherwise) to a health care prac-
    29  titioner relating to the services provided pursuant  to  this  paragraph
    30  intended  to  induce or have the effect of inducing such practitioner to
    31  provide care to a covered person in  a  manner  inconsistent  with  this
    32  paragraph; or
    33    (v)  achieve compliance with this paragraph by imposing an increase in
    34  cost sharing for an intravenous or injected anticancer medication.
    35    § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
    36  subsection (ss) to read as follows:
    37    (ss)  (1)  Every  contract  issued  by  a  corporation  subject to the
    38  provisions of this article that  provides  medical,  major  medical,  or
    39  similar   comprehensive-type   coverage   and   provides   coverage  for
    40  prescription drugs shall  provide  coverage  for  prescribed  monoclonal
    41  antibody  treatment  for the novel coronavirus (COVID-19). Such coverage
    42  may be subject to co-pays, coinsurance or deductibles, provided that the
    43  co-pays, coinsurance or deductibles are at  least  as  favorable  to  an
    44  insured  as the co-pays, coinsurance or deductibles that apply to cover-
    45  age for other treatments for the novel coronavirus (COVID-19).
    46    (2) An insurer  providing  coverage  under  this  subsection  and  any
    47  participating  entity  through  which the insurer offers health services
    48  shall not:
    49    (A) vary the terms of the policy for the purpose or with the effect of
    50  avoiding compliance with this subsection;
    51    (B) provide incentives (monetary or otherwise) to encourage a  covered
    52  person  to accept less than the minimum protections available under this
    53  subsection;
    54    (C) penalize in any way or reduce  or  limit  the  compensation  of  a
    55  health care practitioner for recommending or providing care to a covered
    56  person in accordance with this subsection;
        A. 7076                             3

     1    (D)  provide incentives (monetary or otherwise) to a health care prac-
     2  titioner relating to the services provided pursuant to  this  subsection
     3  intended  to  induce or have the effect of inducing such practitioner to
     4  provide care to a covered person in  a  manner  inconsistent  with  this
     5  subsection; or
     6    (E) achieve compliance with this subsection by imposing an increase in
     7  cost sharing for an intravenous or injected anticancer medication.
     8    §  4.  This  act shall take effect on the ninetieth day after it shall
     9  have become a law. Effective immediately, the addition, amendment and/or
    10  repeal of any rule or regulation necessary  for  the  implementation  of
    11  this  act  on its effective date are authorized to be made and completed
    12  on or before such date.