Bill Text: NY A10314 | 2019-2020 | General Assembly | Introduced
Bill Title: Requires insurance policies to provide coverage for pre-term labor hospitalizations, home visits to monitor pre-term labor patients and counseling.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-04-22 - referred to insurance [A10314 Detail]
Download: New_York-2019-A10314-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 10314 IN ASSEMBLY April 22, 2020 ___________ Introduced by M. of A. BICHOTTE -- read once and referred to the Commit- tee on Insurance AN ACT to amend the insurance law, in relation to requiring insurance policies to provide coverage for pre-term labor hospitalizations, home visits to monitor pre-term labor patients and counseling The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Item (i) of subparagraph (A) of paragraph 10 of subsection 2 (i) of section 3216 of the insurance law, as amended by chapter 238 of 3 the laws of 2010, is amended and two new subparagraphs (C) and (D) are 4 added to read as follows: 5 (i) Every policy which provides hospital, surgical or medical coverage 6 shall provide coverage for maternity care, including hospital, surgical 7 or medical care to the same extent that hospital, surgical or medical 8 coverage is provided for illness or disease under the policy. Such 9 maternity care coverage, other than coverage for perinatal compli- 10 cations, shall include inpatient hospital coverage for expectant mothers 11 in pre-term labor, inpatient hospital coverage for mother and for 12 newborn for at least forty-eight hours after childbirth for any delivery 13 other than a caesarean section, and for at least ninety-six hours after 14 a caesarean section. Such coverage for maternity care shall include the 15 services of a midwife licensed pursuant to article one hundred forty of 16 the education law, practicing consistent with section sixty-nine hundred 17 fifty-one of the education law and affiliated or practicing in conjunc- 18 tion with a facility licensed pursuant to article twenty-eight of the 19 public health law, but no insurer shall be required to pay for duplica- 20 tive routine services actually provided by both a licensed midwife and a 21 physician. 22 (C) Coverage provided under this subsection for care and treatment 23 during pregnancy shall include provision for part-time or intermittent 24 home nursing care by or under the supervision of a registered profes- 25 sional nurse to monitor expectant mothers who have been diagnosed by a 26 physician as having experienced pre-term labor, and for the adminis- 27 tration of Makena (17-alpha hydroxyprogesterone) by such nurse. As used EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD16189-01-0A. 10314 2 1 in this subsection, "pre-term labor" means the commencement of regular 2 contractions of the uterus causing palpable changes in the cervix that 3 start between twenty weeks and thirty-six weeks and six days of pregnan- 4 cy, including, but not limited to, effacement and dilation. 5 (D) Coverage provided under this subsection for care and treatment 6 during pregnancy shall include provisions for visits with a physician, 7 psychiatrist or psychologist or a licensed clinical social worker within 8 the lawful scope of his or her practice who provides psychiatric or 9 psychological services or for the diagnosis and treatment of mental, 10 nervous or emotional disorders and ailments for assistance with 11 emotional issues experienced by an expectant mother and the family of an 12 expectant mother who has: 13 (i) lost a fetus through miscarriage or stillbirth; 14 (ii) lost a child within a month after the birth of the child; or 15 (iii) been diagnosed by a physician as having experienced pre-term 16 labor. 17 § 2. Item (i) of subparagraph (A) of paragraph 5 of subsection (k) of 18 section 3221 of the insurance law, as amended by chapter 238 of the laws 19 of 2010, is amended and two new subparagraphs (C) and (D) are added to 20 read as follows: 21 (i) Every group or blanket policy delivered or issued for delivery in 22 this state which provides hospital, surgical or medical coverage shall 23 include coverage for maternity care, including hospital, surgical or 24 medical care to the same extent that coverage is provided for illness or 25 disease under the policy. Such maternity care coverage, other than 26 coverage for perinatal complications, shall include inpatient hospital 27 coverage for expectant mothers in pre-term labor, inpatient hospital 28 coverage for mother and newborn for at least forty-eight hours after 29 childbirth for any delivery other than a caesarean section, and for at 30 least ninety-six hours after a caesarean section. Such coverage for 31 maternity care shall include the services of a midwife licensed pursuant 32 to article one hundred forty of the education law, practicing consistent 33 with section sixty-nine hundred fifty-one of the education law and 34 affiliated or practicing in conjunction with a facility licensed pursu- 35 ant to article twenty-eight of the public health law, but no insurer 36 shall be required to pay for duplicative routine services actually 37 provided by both a licensed midwife and a physician. 38 (C) Coverage provided under this subsection for care and treatment 39 during pregnancy shall include provision for part-time or intermittent 40 home nursing care by or under the supervision of a registered profes- 41 sional nurse to monitor expectant mothers who have been diagnosed by a 42 physician as having experienced pre-term labor, and for the adminis- 43 tration of Makena (17-alpha hydroxyprogesterone) by such nurse. As used 44 in this subsection, "pre-term labor" means the commencement of regular 45 contractions of the uterus causing palpable changes in the cervix that 46 start between twenty weeks and thirty-six weeks and six days of pregnan- 47 cy, including, but not limited to, effacement and dilation. 48 (D) Coverage provided under this subsection for care and treatment 49 during pregnancy shall include provisions for visits with a physician, 50 psychiatrist or psychologist or a licensed clinical social worker within 51 the lawful scope of his or her practice who provides psychiatric or 52 psychological services or for the diagnosis and treatment of mental, 53 nervous or emotional disorders and ailments for assistance with 54 emotional issues experienced by an expectant mother and the family of an 55 expectant mother who has: 56 (i) lost a fetus through miscarriage or stillbirth;A. 10314 3 1 (ii) lost a child within a month after the birth of the child; or 2 (iii) been diagnosed by a physician as having experienced pre-term 3 labor. 4 § 3. Subparagraph (A) of paragraph 1 of subsection (c) of section 4303 5 of the insurance law, as amended by chapter 238 of the laws of 2010, is 6 amended and two new paragraphs 3 and 4 are added to read as follows: 7 (A) Every contract issued by a corporation subject to the provisions 8 of this article which provides hospital service, medical expense indem- 9 nity or both shall provide coverage for maternity care including hospi- 10 tal, surgical or medical care to the same extent that hospital service, 11 medical expense indemnity or both are provided for illness or disease 12 under the contract. Such maternity care coverage, other than coverage 13 for perinatal complications, shall include inpatient hospital coverage 14 for expectant mothers in pre-term labor, inpatient hospital coverage for 15 mother and for newborn for at least forty-eight hours after childbirth 16 for any delivery other than a caesarean section, and for at least nine- 17 ty-six hours following a caesarean section. Such coverage for maternity 18 care shall include the services of a midwife licensed pursuant to arti- 19 cle one hundred forty of the education law, practicing consistent with 20 section sixty-nine hundred fifty-one of the education law and affiliated 21 or practicing in conjunction with a facility licensed pursuant to arti- 22 cle twenty-eight of the public health law, but no insurer shall be 23 required to pay for duplicative routine services actually provided by 24 both a licensed midwife and a physician. 25 (3) Coverage provided under this subsection for care and treatment 26 during pregnancy shall include provision for part-time or intermittent 27 home nursing care by or under the supervision of a registered profes- 28 sional nurse to monitor expectant mothers who have been diagnosed by a 29 physician as having experienced pre-term labor, and for the adminis- 30 tration of Makena (17-alpha hydroxyprogesterone) by such nurse. As used 31 in this subsection, "pre-term labor" means the commencement of regular 32 contractions of the uterus causing palpable changes in the cervix that 33 start between twenty weeks and thirty-six weeks and six days of pregnan- 34 cy, including, but not limited to, effacement and dilation. 35 (4) Coverage provided under this subsection for care and treatment 36 during pregnancy shall include provisions for visits with a physician, 37 psychiatrist or psychologist or a licensed clinical social worker within 38 the lawful scope of his or her practice who provides psychiatric or 39 psychological services or for the diagnosis and treatment of mental, 40 nervous or emotional disorders and ailments for assistance with 41 emotional issues experienced by an expectant mother and the family of an 42 expectant mother who has: 43 (A) lost a fetus through miscarriage or stillbirth; 44 (B) lost a child within a month after the birth of the child; or 45 (C) been diagnosed by a physician as having experienced pre-term 46 labor. 47 § 4. This act shall take effect on the sixtieth day after it shall 48 have become a law. Effective immediately the addition, amendment and/or 49 repeal of any rule or regulation necessary for the implementation of 50 this act on its effective date are authorized to be made and completed 51 on or before such date.
