S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    419
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 8, 2025
                                ___________
 
 Introduced  by  M.  of  A.  R. CARROLL  -- read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  requiring  certain
   insurance policies to cover neuropsychological exams for dyslexia

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph 39 of subsection  (i)  of  section  3216  of  the
 insurance  law,  as  added by a chapter of the laws of 2024 amending the
 insurance law relating to requiring certain insurance policies to  cover
 neuropsychological  exams for dyslexia, as proposed in legislative bills
 numbers S. 5481-A and A. 2898-A, is amended to read as follows:
   [(39)] (40) (A) Every policy  that  provides  coverage  for  physician
 services,  medical, major medical or similar comprehensive-type coverage
 shall, UPON THE REFERRAL OF A PHYSICIAN, provide coverage for  [testing]
 COMPREHENSIVE  NEUROPSYCHOLOGICAL  EXAMINATIONS for [suspected] dyslexia
 WHEN PERFORMED BY A HEALTH CARE  PROFESSIONAL  LICENSED,  CERTIFIED,  OR
 AUTHORIZED PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW AND ACTING WITH-
 IN  THEIR  SCOPE  OF  PRACTICE AND in accordance with this paragraph and
 shall not exclude coverage for the screening, diagnosis or treatment  of
 medical conditions otherwise covered by the policy.
   (B)  [Coverage shall include comprehensive neuropsychological examina-
 tions for the  purposes  of  diagnosing  dyslexia  and  determining  the
 psychological, emotional, and educational wellness needs of the individ-
 ual tested.] NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO PREVENT THE
 MEDICAL  MANAGEMENT  OR  UTILIZATION REVIEW OF THE SERVICES OR PREVENT A
 POLICY FROM REQUIRING THAT SERVICES BE PROVIDED  THROUGH  A  NETWORK  OF
 PARTICIPATING PROVIDERS.
   §  2. Subsection (u) of section 3221 of the insurance law, as added by
 a chapter of the laws of 2024 amending the  insurance  law  relating  to
 requiring  certain  insurance policies to cover neuropsychological exams
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD02832-01-5
 A. 419                              2
 
 for dyslexia, as proposed in legislative bills numbers S. 5481-A and  A.
 2898-A, is amended to read as follows:
   (u)  (1)  Every  policy that provides coverage for physician services,
 medical, major medical or  similar  comprehensive-type  coverage  shall,
 UPON THE REFERRAL OF A PHYSICIAN, provide coverage for [testing] COMPRE-
 HENSIVE  NEUROPSYCHOLOGICAL  EXAMINATIONS  for [suspected] dyslexia WHEN
 PERFORMED BY A HEALTH CARE PROFESSIONAL LICENSED, CERTIFIED, OR  AUTHOR-
 IZED  PURSUANT  TO  TITLE  EIGHT  OF THE EDUCATION LAW AND ACTING WITHIN
 THEIR SCOPE OF PRACTICE AND in accordance with this subsection and shall
 not exclude coverage  for  the  screening,  diagnosis  or  treatment  of
 medical conditions otherwise covered by the policy.
   (2)  [Coverage shall include comprehensive neuropsychological examina-
 tions for the  purposes  of  diagnosing  dyslexia  and  determining  the
 psychological, emotional, and educational wellness needs of the individ-
 ual  tested.]  NOTHING  IN THIS SUBSECTION SHALL BE CONSTRUED TO PREVENT
 THE MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES OR  PREVENT
 A  POLICY  FROM REQUIRING THAT SERVICES BE PROVIDED THROUGH A NETWORK OF
 PARTICIPATING PROVIDERS.
   § 3. Subsection (vv) of section 4303 of the insurance law, as added by
 a chapter of the laws of 2024 amending the  insurance  law  relating  to
 requiring  certain  insurance policies to cover neuropsychological exams
 for dyslexia, as proposed in legislative bills numbers S. 5481-A and  A.
 2898-A, is amended to read as follows:
   (vv)  (1) Every [policy] CONTRACT that provides coverage for physician
 services, medical, major medical or similar comprehensive-type  coverage
 shall,  UPON THE REFERRAL OF A PHYSICIAN, provide coverage for [testing]
 COMPREHENSIVE NEUROPSYCHOLOGICAL EXAMINATIONS for  [suspected]  dyslexia
 WHEN  PERFORMED  BY  A  HEALTH CARE PROFESSIONAL LICENSED, CERTIFIED, OR
 AUTHORIZED PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW AND ACTING WITH-
 IN THEIR SCOPE OF PRACTICE AND in accordance with  this  subsection  and
 shall  not exclude coverage for the screening, diagnosis or treatment of
 medical conditions otherwise covered by the [policy] CONTRACT.
   (2) [Coverage shall include comprehensive neuropsychological  examina-
 tions  for  the  purposes  of  diagnosing  dyslexia  and determining the
 psychological, emotional, and educational wellness needs of the individ-
 ual tested.] NOTHING IN THIS SUBSECTION SHALL BE  CONSTRUED  TO  PREVENT
 THE  MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES OR PREVENT
 A CONTRACT FROM REQUIRING THAT SERVICES BE PROVIDED THROUGH A NETWORK OF
 PARTICIPATING PROVIDERS.
   § 4. This act shall take effect on the  same  date  and  in  the  same
 manner  as  a  chapter  of  the  laws of 2024 amending the insurance law
 relating to requiring certain insurance policies to  cover  neuropsycho-
 logical  exams for dyslexia, as proposed in legislative bills numbers S.
 5481-A and A. 2898-A, takes effect.