NY State Senate Bill 2009-S2366

Archive: Last Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 23, 2010	notice of petition - requested
Jan 06, 2010	referred to insurance
Oct 09, 2009	print number 2366a
Oct 09, 2009	amend and recommit to insurance
Feb 19, 2009	referred to insurance

Bill Amendments

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A (Active)

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2009-S2366 - Details

See Assembly Version of this Bill:: A6001
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L

2009-S2366 - Summary

Relates to autism spectrum disorders in individuals twenty-one years or less; directs the department of health to promulgate rules and regulations establishing standards for qualified autism services providers and upon such promulgation, payment for treatment of autism spectrum disorders covered shall only be made available to autism services providers who meet such standards; further directs the department of health shall further establish standards to be utilized by managed care plans for the credentialing of autism service providers and authorizes that the department of insurance may require that a managed care plan grant credentials to any autism service provider whom the department determines meets or exceeds the department's credentialing standards.

2009-S2366 - Sponsor Memo

                                 BILL NUMBER:  S2366

 TITLE OF BILL :
An act to amend the insurance law, in relation to autism spectrum
disorders


 PURPOSE :
Provides for insurance coverage of individuals 21 years or younger for
the diagnosis and treatment of autism spectrum disorder.

 SUMMARY OF PROVISIONS :
Section 1. Amends section 3216 of the insurance law to provide
insurance coverage for the diagnosis and treatment of autism spectrum
disorders in individuals 21 years of age or less, up to a maximum
benefit of $36,000.

Section 2. Amends section 3221 of the insurance law to provide
insurance coverage for the diagnosis and treatment of autism spectrum
disorders in individuals 21 years of age or less, up to a maximum
benefit of $36,000.

Section 3. Amends section 4303 of the insurance law to provide
insurance coverage for the diagnosis and treatment of autism spectrum
disorders in individuals 21 years of age or less, up to a maximum
benefit of $36,000.

Section 4. Effective date.

 JUSTIFICATION :
Autism is a complex neurobiological disorder that severely affects the
way an individual diagnosed with autism relates to others socially and
their ability to communicate and learn. Today, 1 in 150 individuals is
diagnosed with autism, making it more common than pediatric cancer,
diabetes, and AIDS combined. It occurs in all racial, ethnic, and
social groups and is four times more likely to strike boys than girls.
Although it is considered a life span disorder of varying severity,
autism is treatable. Early diagnosis and intense early intervention
have been proven to provide the same benefits to individuals with
autism that medication or medical procedures provide to individuals
afflicted with other similar physical or bioneurological disorders.
However, many children with autism are not properly diagnosed until
years after the first symptoms appear.  Furthermore, although
insurance companies and health maintenance organizations routinely
cover treatment for similar neurobiological disorders, most health
insurance plans in the state of New York do not cover autism
treatment.

In the absence of coverage, families often pay as much as they can
out-of-pocket for services that can cost upwards of $50,000 per year.
In the process, many risk their homes and the educations of their
unaffected children - essentially mortgaging their futures. This bill
would expedite diagnosis and treatment by providing insurance parity
for autism sufferers by requiring equitable coverage of the disorder
by insurance companies for individuals 21 years or younger.

 LEGISLATIVE HISTORY :
New Bill.

 FISCAL IMPLICATIONS :
Undetermined.

 EFFECTIVE DATE :
This act shall take effect on the first of January after it shall have
become a law and shall apply to all policies and contracts issued,
renewed, modified, altered or amended, on or after the effective date;
provided, however, that any rules and regulations necessary for the
implementation of this act shall be promulgated on or before such
effective date.

2009-S2366 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2366

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 19, 2009
                               ___________

Introduced by Sens. FUSCHILLO, ADDABBO, DeFRANCISCO, DIAZ, HANNON, HUNT-
  LEY,  KLEIN,  LAVALLE,  McDONALD,  MORAHAN, NOZZOLIO, PADAVAN, ROBACH,
  VOLKER -- read twice and ordered  printed,  and  when  printed  to  be
  committed to the Committee on Insurance

AN ACT to amend the insurance law, in relation to autism spectrum disor-
  ders

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 25 of subsection  (i)  of  section  3216  of  the
insurance  law,  as added by chapter 557 of the laws of 2006, is amended
to read as follows:
  (25) Every policy which provides coverage for hospital,  surgical,  or
medical  care  coverage  shall  not  exclude  coverage for diagnosis and
treatment of medical conditions otherwise covered by the  policy  solely
because  the  treatment is provided to diagnose or treat autism spectrum
disorder. IN INDIVIDUALS TWENTY-ONE YEARS OF AGE OR LESS, THERE SHALL BE
NO LIMITS ON THE NUMBER OF VISITS AN INDIVIDUAL MAY MAKE  TO  AN  AUTISM
PROVIDER.  COVERAGE  UNDER  THIS SUBSECTION MAY BE SUBJECT TO COPAYMENT,
DEDUCTIBLE AND COINSURANCE PROVISIONS OF A HEALTH  INSURANCE  POLICY  TO
THE  EXTENT  THAT  OTHER MEDICAL SERVICE COVERED BY THE HEALTH INSURANCE
POLICY ARE SUBJECT TO SUCH PROVISIONS.  THIS  SUBSECTION  SHALL  NOT  BE
CONSTRUED  AS  LIMITING THE BENEFITS THAT ARE AVAILABLE TO AN INDIVIDUAL
UNDER A HEALTH INSURANCE POLICY. COVERAGE SHALL BE SUBJECT TO A  MAXIMUM
BENEFIT OF THIRTY-SIX THOUSAND DOLLARS. AFTER DECEMBER THIRTY-FIRST, TWO
THOUSAND  TEN,  THE SUPERINTENDENT SHALL, ON AN ANNUAL BASIS, ADJUST THE
MAXIMUM BENEFIT FOR INFLATION USING THE MEDICAL CARE  COMPONENT  OF  THE
UNITED  STATES  DEPARTMENT  OF  LABOR CONSUMER PRICE INDEX FOR ALL URBAN
CONSUMERS. THE SUPERINTENDENT SHALL SUBMIT THE ADJUSTED MAXIMUM  BENEFIT
FOR  PUBLICATION  ANNUALLY  NO  LATER  THAN APRIL FIRST OF EACH CALENDAR
YEAR, AND SUCH PUBLISHED ADJUSTED MAXIMUM BENEFIT SHALL BE APPLICABLE IN
THE FOLLOWING CALENDAR YEAR TO HEALTH INSURANCE POLICIES SUBJECT TO THIS

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06364-03-9

S. 2366                             2

SECTION. PAYMENTS MADE BY AN INSURER ON BEHALF OF A  COVERED  INDIVIDUAL
FOR  ANY  CARE,  TREATMENT,  INTERVENTION,  SERVICE OR ITEM UNRELATED TO
AUTISM SPECTRUM DISORDERS SHALL NOT BE APPLIED TOWARDS ANY MAXIMUM BENE-
FIT ESTABLISHED PURSUANT TO THIS SECTION. EXCEPT FOR INPATIENT SERVICES,
IF  AN  INDIVIDUAL IS RECEIVING TREATMENT FOR AUTISM SPECTRUM DISORDERS,
AN INSURER SHALL HAVE THE RIGHT TO REQUEST A REVIEW  OF  SUCH  TREATMENT
NOT MORE THAN ONCE EVERY TWELVE MONTHS UNLESS SUCH INSURER AND THE INDI-
VIDUAL'S  LICENSED  PHYSICIAN OR LICENSED PSYCHOLOGIST AGREE THAT A MORE
FREQUENT REVIEW IS NECESSARY. THE COST OF OBTAINING ANY REVIEW SHALL  BE
BORNE BY THE INSURER.
  (A) For purposes of this section[,]:
  (I)  "autism spectrum disorder" means a neurobiological condition that
includes autism, Asperger syndrome, Rett's syndrome, or pervasive devel-
opmental disorder.
  (II) "APPLIED BEHAVIOR ANALYSIS" MEANS THE DESIGN, IMPLEMENTATION, AND
EVALUATION OF ENVIRONMENTAL MODIFICATIONS, USING BEHAVIORAL STIMULI  AND
CONSEQUENCES,  TO  PRODUCE  SOCIALLY  SIGNIFICANT  IMPROVEMENT  IN HUMAN
BEHAVIOR, INCLUDING THE USE  OF  DIRECT  OBSERVATION,  MEASUREMENT,  AND
FUNCTIONAL  ANALYSIS  OF THE RELATIONSHIP BETWEEN ENVIRONMENT AND BEHAV-
IOR.
  (III) "AUTISM SERVICES PROVIDER" MEANS ANY PERSON,  ENTITY,  OR  GROUP
THAT PROVIDES TREATMENT OF AUTISM SPECTRUM DISORDERS.
  (IV)  "DIAGNOSIS  OF AUTISM SPECTRUM DISORDERS" MEANS MEDICALLY NECES-
SARY ASSESSMENT, EVALUATIONS, OR TESTS TO DIAGNOSE WHETHER AN INDIVIDUAL
HAS ONE OF THE AUTISM SPECTRUM DISORDERS.
  (V) "EVIDENCE-BASED RESEARCH" MEANS RESEARCH  THAT  APPLIES  RIGOROUS,
SYSTEMATIC,  AND OBJECTIVE PROCEDURES TO OBTAIN VALID KNOWLEDGE RELEVANT
TO AUTISM SPECTRUM DISORDERS.
  (VI) "HABILITATIVE OR REHABILITATIVE CARE" MEANS  PROFESSIONAL,  COUN-
SELING,  AND GUIDANCE SERVICES AND TREATMENT PROGRAMS, INCLUDING APPLIED
BEHAVIOR ANALYSIS, THAT ARE NECESSARY TO DEVELOP, MAINTAIN, AND RESTORE,
TO THE MAXIMUM EXTENT PRACTICABLE, THE FUNCTIONING OF AN INDIVIDUAL.
  (VII) "MEDICALLY NECESSARY" MEANS ANY CARE,  TREATMENT,  INTERVENTION,
SERVICE,  OR ITEM THAT IS PRESCRIBED, PROVIDED, OR ORDERED BY A LICENSED
PHYSICIAN OR A LICENSED PSYCHOLOGIST IN ACCORDANCE WITH ACCEPTED  STAND-
ARDS  OF PRACTICE AND THAT WILL, OR IS REASONABLY EXPECTED TO, DO ANY OF
THE FOLLOWING:
  (1) PREVENT THE ONSET OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY;
  (2) REDUCE  OR  AMELIORATE  THE  PHYSICAL,  MENTAL,  OR  DEVELOPMENTAL
EFFECTS OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY; OR
  (3)  ASSIST  TO  ACHIEVE  OR  MAINTAIN  MAXIMUM FUNCTIONAL CAPACITY IN
PERFORMING DAILY ACTIVITIES, TAKING INTO  ACCOUNT  BOTH  THE  FUNCTIONAL
CAPACITY OF THE INDIVIDUAL AND THE FUNCTIONAL CAPACITIES THAT ARE APPRO-
PRIATE FOR INDIVIDUALS OF THE SAME AGE.
  (VIII)  "PHARMACY  CARE"  MEANS  MEDICATIONS  PRESCRIBED BY A LICENSED
PHYSICIAN AND ANY HEALTH-RELATED SERVICES DEEMED MEDICALLY NECESSARY  TO
DETERMINE THE NEED OR EFFECTIVENESS OF THE MEDICATIONS.
  (IX) "PSYCHIATRIC CARE" MEANS DIRECT OR CONSULTATIVE SERVICES PROVIDED
BY  A PSYCHIATRIST LICENSED IN THE STATE IN WHICH THE PSYCHIATRIST PRAC-
TICES.
  (X)  "PSYCHOLOGICAL  CARE"  MEANS  DIRECT  OR  CONSULTATIVE   SERVICES
PROVIDED  BY  A PSYCHOLOGIST LICENSED IN THE STATE IN WHICH THE PSYCHOL-
OGIST PRACTICES.
  (XI) "THERAPEUTIC CARE" MEANS SERVICES PROVIDED BY LICENSED OR  CERTI-
FIED SPEECH THERAPISTS, OCCUPATIONAL THERAPISTS, OR PHYSICAL THERAPISTS.

S. 2366                             3

  (XII)  "TREATMENT  FOR  AUTISM  SPECTRUM  DISORDERS"  WILL INCLUDE THE
FOLLOWING CARE PRESCRIBED, PROVIDED, OR ORDERED FOR AN INDIVIDUAL  DIAG-
NOSED  WITH ONE OF THE AUTISM SPECTRUM DISORDERS BY A LICENSED PHYSICIAN
OR A LICENSED PSYCHOLOGIST WHO  DETERMINES  THE  CARE  TO  BE  MEDICALLY
NECESSARY:
  (1) HABILITATIVE OR REHABILITATIVE CARE;
  (2) PHARMACY CARE;
  (3) PSYCHIATRIC CARE;
  (4) PSYCHOLOGICAL CARE;
  (5) THERAPEUTIC CARE; AND
  (6)  ANY  CARE  FOR INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS THAT IS
DETERMINED BY THE STATE HEALTH DEPARTMENT, BASED UPON ITS REVIEW OF BEST
PRACTICES OR EVIDENCE-BASED RESEARCH, TO BE MEDICALLY NECESSARY AND THAT
IS PUBLISHED IN THE REGISTER FOR RULEMAKING BY STATE AGENCIES. ANY  SUCH
CARE,  TREATMENT, INTERVENTION, SERVICE, OR ITEM THAT WAS NOT PREVIOUSLY
COVERED WILL BE INCLUDED  IN  ANY  HEALTH  INSURANCE  POLICY  DELIVERED,
EXECUTED,  ISSUED,  AMENDED, ADJUSTED, OR RENEWED ON OR AFTER SIXTY DAYS
FOLLOWING THE DATE OF ITS PUBLICATION IN THE STATE REGISTER.
  (B) THIS PARAGRAPH SHALL NOT BE CONSTRUED AS TO AFFECT ANY  OBLIGATION
TO  PROVIDE  SERVICES  TO  AN  INDIVIDUAL UNDER AN INDIVIDUALIZED FAMILY
SERVICE PLAN, AN INDIVIDUALIZED EDUCATION PROGRAM OR  AN  INDIVIDUALIZED
SERVICE PLAN.
  S  2.  Paragraph 17 of subsection (1) of section 3221 of the insurance
law, as added by chapter 557 of the laws of 2006, is amended to read  as
follows:
  (17) A group or blanket accident or health insurance policy or issuing
a  group  or  blanket  policy  for delivery in this state which provides
coverage for hospital, surgical, or  medical  care  coverage  shall  not
exclude  coverage  for  diagnosis  and  treatment  of medical conditions
otherwise covered by the policy because the  treatment  is  provided  to
diagnose  or  treat  autism spectrum disorder. IN INDIVIDUALS TWENTY-ONE
YEARS OF AGE OR LESS, THERE SHALL BE NO LIMITS ON THE NUMBER  OF  VISITS
AN  INDIVIDUAL  MAY  MAKE  TO  AN  AUTISM  PROVIDER. COVERAGE UNDER THIS
SUBSECTION MAY BE  SUBJECT  TO  COPAYMENT,  DEDUCTIBLE  AND  COINSURANCE
PROVISIONS OF A HEALTH INSURANCE POLICY TO THE EXTENT THAT OTHER MEDICAL
SERVICE  COVERED  BY  THE  HEALTH  INSURANCE  POLICY ARE SUBJECT TO SUCH
PROVISIONS. THIS SUBSECTION SHALL NOT BE CONSTRUED AS LIMITING THE BENE-
FITS THAT ARE AVAILABLE TO AN INDIVIDUAL UNDER A HEALTH INSURANCE  POLI-
CY.  COVERAGE  SHALL BE SUBJECT TO A MAXIMUM BENEFIT OF THIRTY-SIX THOU-
SAND  DOLLARS.  AFTER  DECEMBER  THIRTY-FIRST,  TWO  THOUSAND  TEN,  THE
SUPERINTENDENT SHALL, ON AN ANNUAL BASIS, ADJUST THE MAXIMUM BENEFIT FOR
INFLATION  USING THE MEDICAL CARE COMPONENT OF THE UNITED STATES DEPART-
MENT OF LABOR CONSUMER PRICE INDEX FOR ALL URBAN CONSUMERS.  THE  SUPER-
INTENDENT  SHALL  SUBMIT  THE  ADJUSTED  MAXIMUM BENEFIT FOR PUBLICATION
ANNUALLY NO LATER THAN APRIL FIRST  OF  EACH  CALENDAR  YEAR,  AND  SUCH
PUBLISHED  ADJUSTED MAXIMUM BENEFIT SHALL BE APPLICABLE IN THE FOLLOWING
CALENDAR YEAR TO HEALTH INSURANCE  POLICIES  SUBJECT  TO  THIS  SECTION.
PAYMENTS  MADE  BY  AN INSURER ON BEHALF OF A COVERED INDIVIDUAL FOR ANY
CARE, TREATMENT, INTERVENTION, SERVICE OR ITEM UNRELATED TO AUTISM SPEC-
TRUM DISORDERS SHALL NOT BE APPLIED TOWARDS ANY MAXIMUM  BENEFIT  ESTAB-
LISHED  PURSUANT  TO  THIS SECTION. EXCEPT FOR INPATIENT SERVICES, IF AN
INDIVIDUAL IS RECEIVING TREATMENT  FOR  AUTISM  SPECTRUM  DISORDERS,  AN
INSURER  SHALL  HAVE THE RIGHT TO REQUEST A REVIEW OF SUCH TREATMENT NOT
MORE THAN ONCE EVERY TWELVE MONTHS UNLESS SUCH INSURER AND THE  INDIVID-
UAL'S  LICENSED  PHYSICIAN  OR  LICENSED  PSYCHOLOGIST AGREE THAT A MORE

S. 2366                             4

FREQUENT REVIEW IS NECESSARY. THE COST OF OBTAINING ANY REVIEW SHALL  BE
BORNE BY THE INSURER.
  (A) For purposes of this section[,]:
  (I)  "autism spectrum disorder" means a neurobiological condition that
includes autism, Asperger syndrome, Rett's syndrome, or pervasive devel-
opmental disorder.
  (II) "APPLIED BEHAVIOR ANALYSIS" MEANS THE DESIGN, IMPLEMENTATION, AND
EVALUATION OF ENVIRONMENTAL MODIFICATIONS, USING BEHAVIORAL STIMULI  AND
CONSEQUENCES,  TO  PRODUCE  SOCIALLY  SIGNIFICANT  IMPROVEMENT  IN HUMAN
BEHAVIOR, INCLUDING THE USE  OF  DIRECT  OBSERVATION,  MEASUREMENT,  AND
FUNCTIONAL  ANALYSIS  OF THE RELATIONSHIP BETWEEN ENVIRONMENT AND BEHAV-
IOR.
  (III) "AUTISM SERVICES PROVIDER" MEANS ANY PERSON,  ENTITY,  OR  GROUP
THAT PROVIDES TREATMENT OF AUTISM SPECTRUM DISORDERS.
  (IV)  "DIAGNOSIS  OF AUTISM SPECTRUM DISORDERS" MEANS MEDICALLY NECES-
SARY ASSESSMENT, EVALUATIONS, OR TESTS TO DIAGNOSE WHETHER AN INDIVIDUAL
HAS ONE OF THE AUTISM SPECTRUM DISORDERS.
  (V) "EVIDENCE-BASED RESEARCH" MEANS RESEARCH  THAT  APPLIES  RIGOROUS,
SYSTEMATIC,  AND OBJECTIVE PROCEDURES TO OBTAIN VALID KNOWLEDGE RELEVANT
TO AUTISM SPECTRUM DISORDERS.
  (VI) "HABILITATIVE OR REHABILITATIVE CARE" MEANS  PROFESSIONAL,  COUN-
SELING,  AND GUIDANCE SERVICES AND TREATMENT PROGRAMS, INCLUDING APPLIED
BEHAVIOR ANALYSIS, THAT ARE NECESSARY TO DEVELOP, MAINTAIN, AND RESTORE,
TO THE MAXIMUM EXTENT PRACTICABLE, THE FUNCTIONING OF AN INDIVIDUAL.
  (VII) "MEDICALLY NECESSARY" MEANS ANY CARE,  TREATMENT,  INTERVENTION,
SERVICE,  OR ITEM THAT IS PRESCRIBED, PROVIDED, OR ORDERED BY A LICENSED
PHYSICIAN OR A LICENSED PSYCHOLOGIST IN ACCORDANCE WITH ACCEPTED  STAND-
ARDS  OF PRACTICE AND THAT WILL, OR IS REASONABLY EXPECTED TO, DO ANY OF
THE FOLLOWING:
  (1) PREVENT THE ONSET OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY;
  (2) REDUCE  OR  AMELIORATE  THE  PHYSICAL,  MENTAL,  OR  DEVELOPMENTAL
EFFECTS OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY; OR
  (3)  ASSIST  TO  ACHIEVE  OR  MAINTAIN  MAXIMUM FUNCTIONAL CAPACITY IN
PERFORMING DAILY ACTIVITIES, TAKING INTO  ACCOUNT  BOTH  THE  FUNCTIONAL
CAPACITY OF THE INDIVIDUAL AND THE FUNCTIONAL CAPACITIES THAT ARE APPRO-
PRIATE FOR INDIVIDUALS OF THE SAME AGE.
  (VIII)  "PHARMACY  CARE"  MEANS  MEDICATIONS  PRESCRIBED BY A LICENSED
PHYSICIAN AND ANY HEALTH-RELATED SERVICES DEEMED MEDICALLY NECESSARY  TO
DETERMINE THE NEED OR EFFECTIVENESS OF THE MEDICATIONS.
  (IX) "PSYCHIATRIC CARE" MEANS DIRECT OR CONSULTATIVE SERVICES PROVIDED
BY  A PSYCHIATRIST LICENSED IN THE STATE IN WHICH THE PSYCHIATRIST PRAC-
TICES.
  (X)  "PSYCHOLOGICAL  CARE"  MEANS  DIRECT  OR  CONSULTATIVE   SERVICES
PROVIDED  BY  A PSYCHOLOGIST LICENSED IN THE STATE IN WHICH THE PSYCHOL-
OGIST PRACTICES.
  (XI) "THERAPEUTIC CARE" MEANS SERVICES PROVIDED BY LICENSED OR  CERTI-
FIED SPEECH THERAPISTS, OCCUPATIONAL THERAPISTS, OR PHYSICAL THERAPISTS.
  (XII)  "TREATMENT  FOR  AUTISM  SPECTRUM  DISORDERS"  WILL INCLUDE THE
FOLLOWING CARE PRESCRIBED, PROVIDED, OR ORDERED FOR AN INDIVIDUAL  DIAG-
NOSED  WITH ONE OF THE AUTISM SPECTRUM DISORDERS BY A LICENSED PHYSICIAN
OR A LICENSED PSYCHOLOGIST WHO  DETERMINES  THE  CARE  TO  BE  MEDICALLY
NECESSARY:
  (1) HABILITATIVE OR REHABILITATIVE CARE;
  (2) PHARMACY CARE;
  (3) PSYCHIATRIC CARE;
  (4) PSYCHOLOGICAL CARE;

S. 2366                             5

  (5) THERAPEUTIC CARE; AND
  (6)  ANY  CARE  FOR INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS THAT IS
DETERMINED BY THE STATE HEALTH DEPARTMENT, BASED UPON ITS REVIEW OF BEST
PRACTICES OR EVIDENCE-BASED RESEARCH, TO BE MEDICALLY NECESSARY AND THAT
IS PUBLISHED IN THE GAZETTE FOR RULEMAKING BY STATE AGENCIES.  ANY  SUCH
CARE,  TREATMENT, INTERVENTION, SERVICE, OR ITEM THAT WAS NOT PREVIOUSLY
COVERED WILL BE INCLUDED  IN  ANY  HEALTH  INSURANCE  POLICY  DELIVERED,
EXECUTED,  ISSUED,  AMENDED, ADJUSTED, OR RENEWED ON OR AFTER SIXTY DAYS
FOLLOWING THE DATE OF ITS PUBLICATION IN THE STATE REGISTER.
  (B) THIS PARAGRAPH SHALL NOT BE CONSTRUED AS TO AFFECT ANY  OBLIGATION
TO  PROVIDE  SERVICES  TO  AN  INDIVIDUAL UNDER AN INDIVIDUALIZED FAMILY
SERVICE PLAN, AN INDIVIDUALIZED EDUCATION PROGRAM OR  AN  INDIVIDUALIZED
SERVICE PLAN.
  S 3. Subsection (ee) of section 4303 of the insurance law, as added by
chapter 557 of the laws of 2006, is amended to read as follows:
  (ee)  A  medical  expense  indemnity  corporation,  a hospital service
corporation or a health service corporation which provides coverage  for
hospital,  surgical, or medical care coverage shall not exclude coverage
for diagnosis and treatment of medical conditions otherwise  covered  by
the policy solely because the treatment is provided to diagnose or treat
autism  spectrum  disorder.  IN  INDIVIDUALS  TWENTY-ONE YEARS OF AGE OR
LESS, THERE SHALL BE NO LIMITS ON THE NUMBER OF VISITS AN INDIVIDUAL MAY
MAKE TO AN AUTISM  PROVIDER.  COVERAGE  UNDER  THIS  SUBSECTION  MAY  BE
SUBJECT  TO COPAYMENT, DEDUCTIBLE AND COINSURANCE PROVISIONS OF A HEALTH
INSURANCE POLICY TO THE EXTENT THAT OTHER MEDICAL  SERVICES  COVERED  BY
THE  HEALTH  INSURANCE  POLICY  ARE  SUBJECT  TO  SUCH  PROVISIONS. THIS
SUBSECTION SHALL NOT BE CONSTRUED AS  LIMITING  THE  BENEFITS  THAT  ARE
AVAILABLE  TO  AN  INDIVIDUAL  UNDER A HEALTH INSURANCE POLICY. COVERAGE
SHALL BE SUBJECT TO A MAXIMUM BENEFIT OF  THIRTY-SIX  THOUSAND  DOLLARS.
AFTER DECEMBER THIRTY-FIRST, TWO THOUSAND TEN, THE SUPERINTENDENT SHALL,
ON  AN  ANNUAL BASIS, ADJUST THE MAXIMUM BENEFIT FOR INFLATION USING THE
MEDICAL CARE COMPONENT OF THE UNITED STATES DEPARTMENT OF LABOR CONSUMER
PRICE INDEX FOR ALL URBAN CONSUMERS. THE SUPERINTENDENT SHALL SUBMIT THE
ADJUSTED MAXIMUM BENEFIT FOR PUBLICATION ANNUALLY NO  LATER  THAN  APRIL
FIRST OF EACH CALENDAR YEAR, AND SUCH PUBLISHED ADJUSTED MAXIMUM BENEFIT
SHALL  BE  APPLICABLE IN THE FOLLOWING CALENDAR YEAR TO HEALTH INSURANCE
POLICIES SUBJECT TO THIS SECTION.  PAYMENTS MADE BY AN INSURER ON BEHALF
OF A COVERED INDIVIDUAL FOR ANY CARE, TREATMENT,  INTERVENTION,  SERVICE
OR  ITEM  UNRELATED  TO  AUTISM  SPECTRUM DISORDERS SHALL NOT BE APPLIED
TOWARDS ANY MAXIMUM BENEFIT ESTABLISHED PURSUANT TO THIS SECTION. EXCEPT
FOR INPATIENT SERVICES, IF AN  INDIVIDUAL  IS  RECEIVING  TREATMENT  FOR
AUTISM  SPECTRUM DISORDERS, AN INSURER SHALL HAVE THE RIGHT TO REQUEST A
REVIEW OF SUCH TREATMENT NOT MORE THAN ONCE EVERY TWELVE  MONTHS  UNLESS
SUCH  INSURER  AND  THE  INDIVIDUAL'S  LICENSED  PHYSICIAN  OR  LICENSED
PSYCHOLOGIST AGREE THAT A MORE FREQUENT REVIEW IS NECESSARY. THE COST OF
OBTAINING ANY REVIEW SHALL BE BORNE BY THE INSURER.
  (A) For purposes of this section[,]:
  (I) "autism spectrum disorder" means a neurobiological condition  that
includes autism, Asperger syndrome, Rett's syndrome, or pervasive devel-
opmental disorder.
  (II) "APPLIED BEHAVIOR ANALYSIS" MEANS THE DESIGN, IMPLEMENTATION, AND
EVALUATION  OF ENVIRONMENTAL MODIFICATIONS, USING BEHAVIORAL STIMULI AND
CONSEQUENCES, TO  PRODUCE  SOCIALLY  SIGNIFICANT  IMPROVEMENT  IN  HUMAN
BEHAVIOR,  INCLUDING  THE  USE  OF  DIRECT OBSERVATION, MEASUREMENT, AND
FUNCTIONAL ANALYSIS OF THE RELATIONSHIP BETWEEN ENVIRONMENT  AND  BEHAV-
IOR.

S. 2366                             6

  (III)  "AUTISM  SERVICES  PROVIDER" MEANS ANY PERSON, ENTITY, OR GROUP
THAT PROVIDES TREATMENT OF AUTISM SPECTRUM DISORDERS.
  (IV)  "DIAGNOSIS  OF AUTISM SPECTRUM DISORDERS" MEANS MEDICALLY NECES-
SARY ASSESSMENT, EVALUATIONS, OR TESTS TO DIAGNOSE WHETHER AN INDIVIDUAL
HAS ONE OF THE AUTISM SPECTRUM DISORDERS.
  (V) "EVIDENCE-BASED RESEARCH" MEANS RESEARCH  THAT  APPLIES  RIGOROUS,
SYSTEMATIC,  AND OBJECTIVE PROCEDURES TO OBTAIN VALID KNOWLEDGE RELEVANT
TO AUTISM SPECTRUM DISORDERS.
  (VI) "HABILITATIVE OR REHABILITATIVE CARE" MEANS  PROFESSIONAL,  COUN-
SELING,  AND GUIDANCE SERVICES AND TREATMENT PROGRAMS, INCLUDING APPLIED
BEHAVIOR ANALYSIS, THAT ARE NECESSARY TO DEVELOP, MAINTAIN, AND RESTORE,
TO THE MAXIMUM EXTENT PRACTICABLE, THE FUNCTIONING OF AN INDIVIDUAL.
  (VII) "MEDICALLY NECESSARY" MEANS ANY CARE,  TREATMENT,  INTERVENTION,
SERVICE,  OR ITEM THAT IS PRESCRIBED, PROVIDED, OR ORDERED BY A LICENSED
PHYSICIAN OR A LICENSED PSYCHOLOGIST IN ACCORDANCE WITH ACCEPTED  STAND-
ARDS  OF PRACTICE AND THAT WILL, OR IS REASONABLY EXPECTED TO, DO ANY OF
THE FOLLOWING:
  (1) PREVENT THE ONSET OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY;
  (2) REDUCE  OR  AMELIORATE  THE  PHYSICAL,  MENTAL,  OR  DEVELOPMENTAL
EFFECTS OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY; OR
  (3)  ASSIST  TO  ACHIEVE  OR  MAINTAIN  MAXIMUM FUNCTIONAL CAPACITY IN
PERFORMING DAILY ACTIVITIES, TAKING INTO  ACCOUNT  BOTH  THE  FUNCTIONAL
CAPACITY OF THE INDIVIDUAL AND THE FUNCTIONAL CAPACITIES THAT ARE APPRO-
PRIATE FOR INDIVIDUALS OF THE SAME AGE.
  (VIII)  "PHARMACY  CARE"  MEANS  MEDICATIONS  PRESCRIBED BY A LICENSED
PHYSICIAN AND ANY HEALTH-RELATED SERVICES DEEMED MEDICALLY NECESSARY  TO
DETERMINE THE NEED OR EFFECTIVENESS OF THE MEDICATIONS.
  (IX) "PSYCHIATRIC CARE" MEANS DIRECT OR CONSULTATIVE SERVICES PROVIDED
BY  A PSYCHIATRIST LICENSED IN THE STATE IN WHICH THE PSYCHIATRIST PRAC-
TICES.
  (X)  "PSYCHOLOGICAL  CARE"  MEANS  DIRECT  OR  CONSULTATIVE   SERVICES
PROVIDED  BY  A PSYCHOLOGIST LICENSED IN THE STATE IN WHICH THE PSYCHOL-
OGIST PRACTICES.
  (XI) "THERAPEUTIC CARE" MEANS SERVICES PROVIDED BY LICENSED OR  CERTI-
FIED SPEECH THERAPISTS, OCCUPATIONAL THERAPISTS, OR PHYSICAL THERAPISTS.
  (XII)  "TREATMENT  FOR  AUTISM  SPECTRUM  DISORDERS"  WILL INCLUDE THE
FOLLOWING CARE PRESCRIBED, PROVIDED, OR ORDERED FOR AN INDIVIDUAL  DIAG-
NOSED  WITH ONE OF THE AUTISM SPECTRUM DISORDERS BY A LICENSED PHYSICIAN
OR A LICENSED PSYCHOLOGIST WHO  DETERMINES  THE  CARE  TO  BE  MEDICALLY
NECESSARY:
  (1) HABILITATIVE OR REHABILITATIVE CARE;
  (2) PHARMACY CARE;
  (3) PSYCHIATRIC CARE;
  (4) PSYCHOLOGICAL CARE;
  (5) THERAPEUTIC CARE; AND
  (6)  ANY  CARE  FOR INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS THAT IS
DETERMINED BY THE STATE HEALTH DEPARTMENT, BASED UPON ITS REVIEW OF BEST
PRACTICES OR EVIDENCE-BASED RESEARCH, TO BE MEDICALLY NECESSARY AND THAT
IS PUBLISHED IN THE GAZETTE FOR RULEMAKING BY STATE AGENCIES.  ANY  SUCH
CARE,  TREATMENT, INTERVENTION, SERVICE, OR ITEM THAT WAS NOT PREVIOUSLY
COVERED WILL BE INCLUDED  IN  ANY  HEALTH  INSURANCE  POLICY  DELIVERED,
EXECUTED,  ISSUED,  AMENDED, ADJUSTED, OR RENEWED ON OR AFTER SIXTY DAYS
FOLLOWING THE DATE OF ITS PUBLICATION IN THE STATE REGISTER.
  (B) THIS SUBSECTION SHALL NOT BE CONSTRUED AS TO AFFECT ANY OBLIGATION
TO PROVIDE SERVICES TO AN  INDIVIDUAL  UNDER  AN  INDIVIDUALIZED  FAMILY

S. 2366                             7

SERVICE  PLAN,  AN INDIVIDUALIZED EDUCATION PROGRAM OR AN INDIVIDUALIZED
SERVICE PLAN.
  S  4.    This  act  shall take effect on the first of January after it
shall have become a law and shall apply to all  policies  and  contracts
issued,  renewed, modified, altered or amended on or after the effective
date; provided, however, that any rules and  regulations  necessary  for
the  implementation  of  this act shall be promulgated on or before such
effective date.

co-Sponsors

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2009-S2366A (ACTIVE) - Details

See Assembly Version of this Bill:: A6001
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L

2009-S2366A (ACTIVE) - Summary

2009-S2366A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S2366A          REVISED 10/13/09

 TITLE OF BILL :
An act to amend the insurance law, in relation to autism spectrum
disorders


 PURPOSE :
Provides for insurance coverage of individuals 21 years or younger for
the diagnosis and treatment of autism spectrum disorder.

 SUMMARY OF PROVISIONS :
Section 1. Amends section 3216 of the insurance law to provide
insurance coverage for applied behavior analysis therapy for the
treatment of autism spectrum disorders in individuals 21 years of age
or less, up to a maximum benefit of $36,000.

Section 2. Amends section 3221 of the insurance law to provide
insurance coverage for applied behavior analysis therapy for the
treatment of autism spectrum disorders in individuals 21 years of age
or less, up to a maximum benefit of$36,000.

Section 3. Amends section 4303 of the insurance law to provide
insurance coverage for applied behavior analysis therapy for the
treatment of autism spectrum disorders in individuals 21 years of age
or less, up to a maximum benefit of $36,000.

Section 4. Effective date.

 JUSTIFICATION :
Autism is a complex neurobiological disorder that severely affects the
way autistic individuals relate to others socially and their ability
to communicate and learn. Today, 1 in 150 individuals is diagnosed
with autism, making it more common than pediatric cancer, diabetes,
and AIDS combined. It occurs in all racial, ethnic, and social groups
and is four times more likely to strike boys than girls. Although it
is considered a life span disorder of varying severity, autism is
treatable. Early diagnosis and intense early intervention have been
proven to provide the same benefits to individuals with autism that
medication or medical procedures provide to individuals afflicted with
other similar physical or bioneurological disorders. However, many
children with autism are not properly diagnosed until years after the
first symptoms appear. Furthermore, although insurance companies and
health maintenance organizations routinely cover treatment for similar
neurobiological disorders, most health insurance plans in the state of
New York do not cover autism treatment.

In the absence of coverage, families often pay as much as they can
out-of-pocket for services that can cost upwards of $50,000 per year.
In the process, many risk their homes and the education's of their
unaffected children _ essentially mortgaging their futures. This bill
would expedite diagnosis and treatment by providing insurance parity
for autism sufferers by requiring equitable coverage of the disorder
by insurance companies for individuals 21 years or younger.

 LEGISLATIVE HISTORY :
New Bill.

 FISCAL IMPLICATIONS :
None.

 EFFECTIVE DATE :
The first of January after it shall have become law.

2009-S2366A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2366--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 19, 2009
                               ___________

Introduced  by Sens. FUSCHILLO, C. JOHNSON, ADAMS, ADDABBO, ALESI, BONA-
  CIC, DeFRANCISCO, DIAZ, DILAN, FARLEY, FLANAGAN, FOLEY, GOLDEN,  GRIF-
  FO,  HANNON,  HASSELL-THOMPSON,  HUNTLEY,  O. JOHNSON,  KLEIN, KRUGER,
  LANZA, LARKIN, LAVALLE, LIBOUS, LITTLE, MARCELLINO, MAZIARZ, McDONALD,
  MONSERRATE, MONTGOMERY, MORAHAN, NOZZOLIO, ONORATO, OPPENHEIMER, PADA-
  VAN, PARKER, PERKINS, RANZENHOFER, ROBACH, SALAND, SAMPSON, SCHNEIDER-
  MAN, SERRANO, SKELOS, SQUADRON, STACHOWSKI, STAVISKY, STEWART-COUSINS,
  VALESKY, VOLKER, WINNER, YOUNG -- read twice and ordered printed,  and
  when  printed to be committed to the Committee on Insurance -- commit-
  tee discharged, bill amended, ordered reprinted as amended and  recom-
  mitted to said committee

AN ACT to amend the insurance law, in relation to autism spectrum disor-
  ders

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 25 of subsection  (i)  of  section  3216  of  the
insurance  law,  as added by chapter 557 of the laws of 2006, is amended
to read as follows:
  (25) Every policy which provides coverage for hospital,  surgical,  or
medical  care  coverage  shall  not  exclude  coverage for diagnosis and
treatment of medical conditions otherwise covered by the  policy  solely
because  the  treatment is provided to diagnose or treat autism spectrum
disorder. IN INDIVIDUALS TWENTY-ONE YEARS OF AGE OR LESS, THERE SHALL BE
NO LIMITS ON THE NUMBER OF VISITS AN INDIVIDUAL MAY MAKE  TO  AN  AUTISM
PROVIDER.  COVERAGE  UNDER  THIS SUBSECTION MAY BE SUBJECT TO COPAYMENT,
DEDUCTIBLE AND COINSURANCE PROVISIONS OF A HEALTH  INSURANCE  POLICY  TO
THE  EXTENT  THAT  OTHER MEDICAL SERVICE COVERED BY THE HEALTH INSURANCE
POLICY ARE SUBJECT TO SUCH PROVISIONS.  THIS  SUBSECTION  SHALL  NOT  BE
CONSTRUED  AS  LIMITING THE BENEFITS THAT ARE AVAILABLE TO AN INDIVIDUAL
UNDER A HEALTH INSURANCE POLICY. COVERAGE FOR APPLIED BEHAVIOR  ANALYSIS
THERAPY  MAY  BE  SUBJECT  TO  A  MAXIMUM BENEFIT OF THIRTY-SIX THOUSAND

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06364-14-9

S. 2366--A                          2

DOLLARS. AFTER DECEMBER THIRTY-FIRST, TWO THOUSAND  ELEVEN,  THE  SUPER-
INTENDENT  SHALL,  ON  AN  ANNUAL  BASIS, ADJUST THE MAXIMUM BENEFIT FOR
INFLATION USING THE MEDICAL CARE COMPONENT OF THE UNITED STATES  DEPART-
MENT  OF  LABOR CONSUMER PRICE INDEX FOR ALL URBAN CONSUMERS. THE SUPER-
INTENDENT SHALL SUBMIT THE  ADJUSTED  MAXIMUM  BENEFIT  FOR  PUBLICATION
ANNUALLY  NO  LATER  THAN  APRIL  FIRST  OF EACH CALENDAR YEAR, AND SUCH
PUBLISHED ADJUSTED MAXIMUM BENEFIT SHALL BE APPLICABLE IN THE  FOLLOWING
CALENDAR  YEAR  TO  HEALTH  INSURANCE  POLICIES SUBJECT TO THIS SECTION.
PAYMENTS MADE BY AN INSURER ON BEHALF OF A COVERED  INDIVIDUAL  FOR  ANY
CARE,  TREATMENT,  INTERVENTION,  SERVICE  OR  ITEM UNRELATED TO APPLIED
BEHAVIOR ANALYSIS SHALL NOT  BE  APPLIED  TOWARDS  ANY  MAXIMUM  BENEFIT
ESTABLISHED  PURSUANT TO THIS PARAGRAPH.  EXCEPT FOR INPATIENT SERVICES,
IF AN INDIVIDUAL IS RECEIVING TREATMENT FOR AUTISM  SPECTRUM  DISORDERS,
AN  INSURER  SHALL  HAVE THE RIGHT TO REQUEST A REVIEW OF SUCH TREATMENT
NOT MORE THAN ONCE EVERY TWELVE MONTHS UNLESS SUCH INSURER AND THE INDI-
VIDUAL'S LICENSED PHYSICIAN OR LICENSED PSYCHOLOGIST AGREE THAT  A  MORE
FREQUENT  REVIEW IS NECESSARY. THE COST OF OBTAINING ANY REVIEW SHALL BE
BORNE BY THE INSURER.
  (A) For purposes of this section[,]:
  (I) "autism spectrum disorder" means a neurobiological condition  that
includes  [autism,  Asperger  syndrome,  Rett's  syndrome,  or] AUTISTIC
DISORDER, ASPERGER'S DISORDER, RETT'S DISORDER, RETT'S DISORDER,  CHILD-
HOOD  DISINTEGRATIVE  DISORDER, AND ANY pervasive developmental disorder
NOT OTHERWISE SPECIFIED.
  (II) "APPLIED BEHAVIOR ANALYSIS" MEANS THE DESIGN, IMPLEMENTATION, AND
EVALUATION OF ENVIRONMENTAL MODIFICATIONS, USING BEHAVIORAL STIMULI  AND
CONSEQUENCES,  TO  PRODUCE  SOCIALLY  SIGNIFICANT  IMPROVEMENT  IN HUMAN
BEHAVIOR, INCLUDING THE USE  OF  DIRECT  OBSERVATION,  MEASUREMENT,  AND
FUNCTIONAL  ANALYSIS  OF THE RELATIONSHIP BETWEEN ENVIRONMENT AND BEHAV-
IOR.
  (III) "AUTISM SERVICES PROVIDER" MEANS ANY PERSON,  ENTITY,  OR  GROUP
THAT PROVIDES TREATMENT OF AUTISM SPECTRUM DISORDERS.
  (IV)  "DIAGNOSIS  OF AUTISM SPECTRUM DISORDERS" MEANS MEDICALLY NECES-
SARY ASSESSMENT, EVALUATIONS, OR TESTS TO DIAGNOSE WHETHER AN INDIVIDUAL
HAS ONE OF THE AUTISM SPECTRUM DISORDERS.
  (V) "EVIDENCE-BASED RESEARCH" MEANS RESEARCH  THAT  APPLIES  RIGOROUS,
SYSTEMATIC,  AND OBJECTIVE PROCEDURES TO OBTAIN VALID KNOWLEDGE RELEVANT
TO AUTISM SPECTRUM DISORDERS.
  (VI) "HABILITATIVE OR REHABILITATIVE CARE" MEANS  PROFESSIONAL,  COUN-
SELING,  AND GUIDANCE SERVICES AND TREATMENT PROGRAMS, INCLUDING APPLIED
BEHAVIOR ANALYSIS, THAT ARE NECESSARY TO DEVELOP, MAINTAIN, AND RESTORE,
TO THE MAXIMUM EXTENT PRACTICABLE, THE FUNCTIONING OF AN INDIVIDUAL.
  (VII) "MEDICALLY NECESSARY" MEANS ANY CARE,  TREATMENT,  INTERVENTION,
SERVICE,  OR ITEM THAT IS PRESCRIBED, PROVIDED, OR ORDERED BY A LICENSED
PHYSICIAN OR A LICENSED PSYCHOLOGIST IN ACCORDANCE WITH ACCEPTED  STAND-
ARDS  OF PRACTICE AND THAT WILL, OR IS REASONABLY EXPECTED TO, DO ANY OF
THE FOLLOWING:
  (1) PREVENT THE ONSET OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY;
  (2) REDUCE  OR  AMELIORATE  THE  PHYSICAL,  MENTAL,  OR  DEVELOPMENTAL
EFFECTS OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY; OR
  (3)  ASSIST  TO  ACHIEVE  OR  MAINTAIN  MAXIMUM FUNCTIONAL CAPACITY IN
PERFORMING DAILY ACTIVITIES, TAKING INTO  ACCOUNT  BOTH  THE  FUNCTIONAL
CAPACITY OF THE INDIVIDUAL AND THE FUNCTIONAL CAPACITIES THAT ARE APPRO-
PRIATE FOR INDIVIDUALS OF THE SAME AGE.

S. 2366--A                          3

  (VIII)  "PHARMACY  CARE"  MEANS  MEDICATIONS  PRESCRIBED BY A LICENSED
PHYSICIAN AND ANY HEALTH-RELATED SERVICES DEEMED MEDICALLY NECESSARY  TO
DETERMINE THE NEED OR EFFECTIVENESS OF THE MEDICATIONS.
  (IX) "PSYCHIATRIC CARE" MEANS DIRECT OR CONSULTATIVE SERVICES PROVIDED
BY  A PSYCHIATRIST LICENSED IN THE STATE IN WHICH THE PSYCHIATRIST PRAC-
TICES.
  (X)  "PSYCHOLOGICAL  CARE"  MEANS  DIRECT  OR  CONSULTATIVE   SERVICES
PROVIDED  BY  A PSYCHOLOGIST LICENSED IN THE STATE IN WHICH THE PSYCHOL-
OGIST PRACTICES.
  (XI) "THERAPEUTIC CARE" MEANS SERVICES PROVIDED BY LICENSED OR  CERTI-
FIED SPEECH THERAPISTS, OCCUPATIONAL THERAPISTS, OR PHYSICAL THERAPISTS.
  (XII)  "TREATMENT  FOR  AUTISM  SPECTRUM  DISORDERS"  WILL INCLUDE THE
FOLLOWING CARE PRESCRIBED, PROVIDED, OR ORDERED FOR AN INDIVIDUAL  DIAG-
NOSED  WITH ONE OF THE AUTISM SPECTRUM DISORDERS BY A LICENSED PHYSICIAN
OR A LICENSED PSYCHOLOGIST WHO  DETERMINES  THE  CARE  TO  BE  MEDICALLY
NECESSARY:
  (1) HABILITATIVE OR REHABILITATIVE CARE;
  (2) PHARMACY CARE;
  (3) PSYCHIATRIC CARE;
  (4) PSYCHOLOGICAL CARE;
  (5) THERAPEUTIC CARE; AND
  (6)  ANY  CARE  FOR INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS THAT IS
DETERMINED BY THE STATE HEALTH DEPARTMENT, BASED UPON ITS REVIEW OF BEST
PRACTICES OR EVIDENCE-BASED RESEARCH, TO BE MEDICALLY NECESSARY AND THAT
IS PUBLISHED IN THE REGISTER FOR RULEMAKING BY STATE AGENCIES. ANY  SUCH
CARE,  TREATMENT, INTERVENTION, SERVICE, OR ITEM THAT WAS NOT PREVIOUSLY
COVERED WILL BE INCLUDED  IN  ANY  HEALTH  INSURANCE  POLICY  DELIVERED,
EXECUTED,  ISSUED,  AMENDED, ADJUSTED, OR RENEWED ON OR AFTER SIXTY DAYS
FOLLOWING THE DATE OF ITS PUBLICATION IN THE STATE REGISTER.
  (B) THIS PARAGRAPH SHALL NOT BE CONSTRUED TO AFFECT ANY OBLIGATION  TO
PROVIDE SERVICES TO AN INDIVIDUAL UNDER AN INDIVIDUALIZED FAMILY SERVICE
PLAN,  AN  INDIVIDUALIZED EDUCATION PROGRAM OR AN INDIVIDUALIZED SERVICE
PLAN.
  S 2. Paragraph 17 of subsection (l) of section 3221 of  the  insurance
law,  as added by chapter 557 of the laws of 2006, is amended to read as
follows:
  (17) A group or blanket accident or health insurance policy or issuing
a group or blanket policy for delivery  in  this  state  which  provides
coverage  for  hospital,  surgical,  or  medical care coverage shall not
exclude coverage for  diagnosis  and  treatment  of  medical  conditions
otherwise  covered  by  the  policy because the treatment is provided to
diagnose or treat autism spectrum disorder.  IN  INDIVIDUALS  TWENTY-ONE
YEARS  OF  AGE OR LESS, THERE SHALL BE NO LIMITS ON THE NUMBER OF VISITS
AN INDIVIDUAL MAY MAKE  TO  AN  AUTISM  PROVIDER.  COVERAGE  UNDER  THIS
SUBSECTION  MAY  BE  SUBJECT  TO  COPAYMENT,  DEDUCTIBLE AND COINSURANCE
PROVISIONS OF A HEALTH INSURANCE POLICY TO THE EXTENT THAT OTHER MEDICAL
SERVICE COVERED BY THE HEALTH  INSURANCE  POLICY  ARE  SUBJECT  TO  SUCH
PROVISIONS. THIS SUBSECTION SHALL NOT BE CONSTRUED AS LIMITING THE BENE-
FITS  THAT ARE AVAILABLE TO AN INDIVIDUAL UNDER A HEALTH INSURANCE POLI-
CY. COVERAGE SHALL BE SUBJECT TO A MAXIMUM BENEFIT OF  THIRTY-SIX  THOU-
SAND  DOLLARS.  AFTER  DECEMBER  THIRTY-FIRST,  TWO THOUSAND ELEVEN, THE
SUPERINTENDENT SHALL, ON AN ANNUAL BASIS, ADJUST THE MAXIMUM BENEFIT FOR
INFLATION USING THE MEDICAL CARE COMPONENT OF THE UNITED STATES  DEPART-
MENT  OF  LABOR CONSUMER PRICE INDEX FOR ALL URBAN CONSUMERS. THE SUPER-
INTENDENT SHALL SUBMIT THE  ADJUSTED  MAXIMUM  BENEFIT  FOR  PUBLICATION
ANNUALLY  NO  LATER  THAN  APRIL  FIRST  OF EACH CALENDAR YEAR, AND SUCH

S. 2366--A                          4

PUBLISHED ADJUSTED MAXIMUM BENEFIT SHALL BE APPLICABLE IN THE  FOLLOWING
CALENDAR  YEAR  TO  HEALTH  INSURANCE  POLICIES SUBJECT TO THIS SECTION.
PAYMENTS MADE BY AN INSURER ON BEHALF OF A COVERED  INDIVIDUAL  FOR  ANY
CARE,  TREATMENT,  INTERVENTION,  SERVICE  OR  ITEM UNRELATED TO APPLIED
BEHAVIOR ANALYSIS SHALL NOT  BE  APPLIED  TOWARDS  ANY  MAXIMUM  BENEFIT
ESTABLISHED  PURSUANT  TO THIS PARAGRAPH. EXCEPT FOR INPATIENT SERVICES,
IF AN INDIVIDUAL IS RECEIVING TREATMENT FOR AUTISM  SPECTRUM  DISORDERS,
AN  INSURER  SHALL  HAVE THE RIGHT TO REQUEST A REVIEW OF SUCH TREATMENT
NOT MORE THAN ONCE EVERY TWELVE MONTHS UNLESS SUCH INSURER AND THE INDI-
VIDUAL'S LICENSED PHYSICIAN OR LICENSED PSYCHOLOGIST AGREE THAT  A  MORE
FREQUENT  REVIEW IS NECESSARY. THE COST OF OBTAINING ANY REVIEW SHALL BE
BORNE BY THE INSURER.
  (A) For purposes of this section[,]:
  (I) "autism spectrum disorder" means a neurobiological condition  that
includes  [autism,  Asperger  syndrome,  Rett's  syndrome,  or] AUTISTIC
DISORDER, ASPERGER'S DISORDER, RETT'S DISORDER, CHILDHOOD DISINTEGRATIVE
DISORDER, AND ANY pervasive developmental disorder NOT OTHERWISE  SPECI-
FIED.
  (II) "APPLIED BEHAVIOR ANALYSIS" MEANS THE DESIGN, IMPLEMENTATION, AND
EVALUATION  OF ENVIRONMENTAL MODIFICATIONS, USING BEHAVIORAL STIMULI AND
CONSEQUENCES, TO  PRODUCE  SOCIALLY  SIGNIFICANT  IMPROVEMENT  IN  HUMAN
BEHAVIOR,  INCLUDING  THE  USE  OF  DIRECT OBSERVATION, MEASUREMENT, AND
FUNCTIONAL ANALYSIS OF THE RELATIONSHIP BETWEEN ENVIRONMENT  AND  BEHAV-
IOR.
  (III)  "AUTISM  SERVICES  PROVIDER" MEANS ANY PERSON, ENTITY, OR GROUP
THAT PROVIDES TREATMENT OF AUTISM SPECTRUM DISORDERS.
  (IV) "DIAGNOSIS OF AUTISM SPECTRUM DISORDERS" MEANS  MEDICALLY  NECES-
SARY ASSESSMENT, EVALUATIONS, OR TESTS TO DIAGNOSE WHETHER AN INDIVIDUAL
HAS ONE OF THE AUTISM SPECTRUM DISORDERS.
  (V)  "EVIDENCE-BASED  RESEARCH"  MEANS RESEARCH THAT APPLIES RIGOROUS,
SYSTEMATIC, AND OBJECTIVE PROCEDURES TO OBTAIN VALID KNOWLEDGE  RELEVANT
TO AUTISM SPECTRUM DISORDERS.
  (VI)  "HABILITATIVE  OR REHABILITATIVE CARE" MEANS PROFESSIONAL, COUN-
SELING, AND GUIDANCE SERVICES AND TREATMENT PROGRAMS, INCLUDING  APPLIED
BEHAVIOR ANALYSIS, THAT ARE NECESSARY TO DEVELOP, MAINTAIN, AND RESTORE,
TO THE MAXIMUM EXTENT PRACTICABLE, THE FUNCTIONING OF AN INDIVIDUAL.
  (VII)  "MEDICALLY  NECESSARY" MEANS ANY CARE, TREATMENT, INTERVENTION,
SERVICE, OR ITEM THAT IS PRESCRIBED, PROVIDED, OR ORDERED BY A  LICENSED
PHYSICIAN  OR A LICENSED PSYCHOLOGIST IN ACCORDANCE WITH ACCEPTED STAND-
ARDS OF PRACTICE AND THAT WILL, OR IS REASONABLY EXPECTED TO, DO ANY  OF
THE FOLLOWING:
  (1) PREVENT THE ONSET OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY;
  (2)  REDUCE  OR  AMELIORATE  THE  PHYSICAL,  MENTAL,  OR DEVELOPMENTAL
EFFECTS OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY; OR
  (3) ASSIST TO ACHIEVE  OR  MAINTAIN  MAXIMUM  FUNCTIONAL  CAPACITY  IN
PERFORMING  DAILY  ACTIVITIES,  TAKING  INTO ACCOUNT BOTH THE FUNCTIONAL
CAPACITY OF THE INDIVIDUAL AND THE FUNCTIONAL CAPACITIES THAT ARE APPRO-
PRIATE FOR INDIVIDUALS OF THE SAME AGE.
  (VIII) "PHARMACY CARE" MEANS  MEDICATIONS  PRESCRIBED  BY  A  LICENSED
PHYSICIAN  AND ANY HEALTH-RELATED SERVICES DEEMED MEDICALLY NECESSARY TO
DETERMINE THE NEED OR EFFECTIVENESS OF THE MEDICATIONS.
  (IX) "PSYCHIATRIC CARE" MEANS DIRECT OR CONSULTATIVE SERVICES PROVIDED
BY A PSYCHIATRIST LICENSED IN THE STATE IN WHICH THE PSYCHIATRIST  PRAC-
TICES.

S. 2366--A                          5

  (X)   "PSYCHOLOGICAL  CARE"  MEANS  DIRECT  OR  CONSULTATIVE  SERVICES
PROVIDED BY A PSYCHOLOGIST LICENSED IN THE STATE IN WHICH  THE  PSYCHOL-
OGIST PRACTICES.
  (XI)  "THERAPEUTIC CARE" MEANS SERVICES PROVIDED BY LICENSED OR CERTI-
FIED SPEECH THERAPISTS, OCCUPATIONAL THERAPISTS, OR PHYSICAL THERAPISTS.
  (XII) "TREATMENT FOR  AUTISM  SPECTRUM  DISORDERS"  WILL  INCLUDE  THE
FOLLOWING  CARE PRESCRIBED, PROVIDED, OR ORDERED FOR AN INDIVIDUAL DIAG-
NOSED WITH ONE OF THE AUTISM SPECTRUM DISORDERS BY A LICENSED  PHYSICIAN
OR  A  LICENSED  PSYCHOLOGIST  WHO  DETERMINES  THE CARE TO BE MEDICALLY
NECESSARY:
  (1) HABILITATIVE OR REHABILITATIVE CARE;
  (2) PHARMACY CARE;
  (3) PSYCHIATRIC CARE;
  (4) PSYCHOLOGICAL CARE;
  (5) THERAPEUTIC CARE; AND
  (6) ANY CARE FOR INDIVIDUALS WITH AUTISM SPECTRUM  DISORDERS  THAT  IS
DETERMINED BY THE STATE HEALTH DEPARTMENT, BASED UPON ITS REVIEW OF BEST
PRACTICES OR EVIDENCE-BASED RESEARCH, TO BE MEDICALLY NECESSARY AND THAT
IS  PUBLISHED  IN THE GAZETTE FOR RULEMAKING BY STATE AGENCIES. ANY SUCH
CARE, TREATMENT, INTERVENTION, SERVICE, OR ITEM THAT WAS NOT  PREVIOUSLY
COVERED  WILL  BE  INCLUDED  IN  ANY  HEALTH INSURANCE POLICY DELIVERED,
EXECUTED, ISSUED, AMENDED, ADJUSTED, OR RENEWED ON OR AFTER  SIXTY  DAYS
FOLLOWING THE DATE OF ITS PUBLICATION IN THE STATE REGISTER.
  (B)  THIS PARAGRAPH SHALL NOT BE CONSTRUED TO AFFECT ANY OBLIGATION TO
PROVIDE SERVICES TO AN INDIVIDUAL UNDER AN INDIVIDUALIZED FAMILY SERVICE
PLAN, AN INDIVIDUALIZED EDUCATION PROGRAM OR AN  INDIVIDUALIZED  SERVICE
PLAN.
  S 3. Subsection (ee) of section 4303 of the insurance law, as added by
chapter 557 of the laws of 2006, is amended to read as follows:
  (ee)  A  medical  expense  indemnity  corporation,  a hospital service
corporation or a health service corporation which provides coverage  for
hospital,  surgical, or medical care coverage shall not exclude coverage
for diagnosis and treatment of medical conditions otherwise  covered  by
the policy solely because the treatment is provided to diagnose or treat
autism  spectrum  disorder.  IN  INDIVIDUALS  TWENTY-ONE YEARS OF AGE OR
LESS, THERE SHALL BE NO LIMITS ON THE NUMBER OF VISITS AN INDIVIDUAL MAY
MAKE TO AN AUTISM  PROVIDER.  COVERAGE  UNDER  THIS  SUBSECTION  MAY  BE
SUBJECT  TO COPAYMENT, DEDUCTIBLE AND COINSURANCE PROVISIONS OF A HEALTH
INSURANCE POLICY TO THE EXTENT THAT OTHER MEDICAL  SERVICES  COVERED  BY
THE  HEALTH  INSURANCE  POLICY  ARE  SUBJECT  TO  SUCH  PROVISIONS. THIS
SUBSECTION SHALL NOT BE CONSTRUED AS  LIMITING  THE  BENEFITS  THAT  ARE
AVAILABLE  TO  AN  INDIVIDUAL  UNDER A HEALTH INSURANCE POLICY. COVERAGE
SHALL BE SUBJECT TO A MAXIMUM BENEFIT OF  THIRTY-SIX  THOUSAND  DOLLARS.
AFTER  DECEMBER  THIRTY-FIRST,  TWO  THOUSAND ELEVEN, THE SUPERINTENDENT
SHALL, ON AN ANNUAL BASIS, ADJUST  THE  MAXIMUM  BENEFIT  FOR  INFLATION
USING  THE  MEDICAL  CARE  COMPONENT  OF THE UNITED STATES DEPARTMENT OF
LABOR CONSUMER PRICE INDEX FOR ALL URBAN CONSUMERS.  THE  SUPERINTENDENT
SHALL  SUBMIT  THE  ADJUSTED MAXIMUM BENEFIT FOR PUBLICATION ANNUALLY NO
LATER THAN APRIL  FIRST  OF  EACH  CALENDAR  YEAR,  AND  SUCH  PUBLISHED
ADJUSTED  MAXIMUM  BENEFIT SHALL BE APPLICABLE IN THE FOLLOWING CALENDAR
YEAR TO HEALTH INSURANCE POLICIES SUBJECT TO THIS SUBSECTION.   PAYMENTS
MADE  BY  AN  INSURER  ON  BEHALF  OF A COVERED INDIVIDUAL FOR ANY CARE,
TREATMENT, INTERVENTION, SERVICE OR ITEM UNRELATED TO  APPLIED  BEHAVIOR
ANALYSIS  SHALL  NOT  BE APPLIED TOWARDS ANY MAXIMUM BENEFIT ESTABLISHED
PURSUANT TO THIS SECTION. EXCEPT FOR INPATIENT SERVICES, IF AN  INDIVID-
UAL  IS  RECEIVING  TREATMENT  FOR AUTISM SPECTRUM DISORDERS, AN INSURER

S. 2366--A                          6

SHALL HAVE THE RIGHT TO REQUEST A REVIEW OF SUCH TREATMENT NOT MORE THAN
ONCE EVERY TWELVE  MONTHS  UNLESS  SUCH  INSURER  AND  THE  INDIVIDUAL'S
LICENSED  PHYSICIAN  OR LICENSED PSYCHOLOGIST AGREE THAT A MORE FREQUENT
REVIEW  IS NECESSARY. THE COST OF OBTAINING ANY REVIEW SHALL BE BORNE BY
THE INSURER.
  (A) For purposes of this section[,]:
  (I) "autism spectrum disorder" means a neurobiological condition  that
includes  [autism,  Asperger  syndrome,  Rett's  syndrome,  or] AUTISTIC
DISORDER, ASPERGER'S DISORDER, RETT'S DISORDER, CHILDHOOD DISINTEGRATIVE
DISORDER, AND ANY pervasive developmental disorder.
  (II) "APPLIED BEHAVIOR ANALYSIS" MEANS THE DESIGN, IMPLEMENTATION, AND
EVALUATION OF ENVIRONMENTAL MODIFICATIONS, USING BEHAVIORAL STIMULI  AND
CONSEQUENCES,  TO  PRODUCE  SOCIALLY  SIGNIFICANT  IMPROVEMENT  IN HUMAN
BEHAVIOR, INCLUDING THE USE  OF  DIRECT  OBSERVATION,  MEASUREMENT,  AND
FUNCTIONAL  ANALYSIS  OF THE RELATIONSHIP BETWEEN ENVIRONMENT AND BEHAV-
IOR.
  (III) "AUTISM SERVICES PROVIDER" MEANS ANY PERSON,  ENTITY,  OR  GROUP
THAT PROVIDES TREATMENT OF AUTISM SPECTRUM DISORDERS.
  (IV)  "DIAGNOSIS  OF AUTISM SPECTRUM DISORDERS" MEANS MEDICALLY NECES-
SARY ASSESSMENT, EVALUATIONS, OR TESTS TO DIAGNOSE WHETHER AN INDIVIDUAL
HAS ONE OF THE AUTISM SPECTRUM DISORDERS.
  (V) "EVIDENCE-BASED RESEARCH" MEANS RESEARCH  THAT  APPLIES  RIGOROUS,
SYSTEMATIC,  AND OBJECTIVE PROCEDURES TO OBTAIN VALID KNOWLEDGE RELEVANT
TO AUTISM SPECTRUM DISORDERS.
  (VI) "HABILITATIVE OR REHABILITATIVE CARE" MEANS  PROFESSIONAL,  COUN-
SELING,  AND GUIDANCE SERVICES AND TREATMENT PROGRAMS, INCLUDING APPLIED
BEHAVIOR ANALYSIS, THAT ARE NECESSARY TO DEVELOP, MAINTAIN, AND RESTORE,
TO THE MAXIMUM EXTENT PRACTICABLE, THE FUNCTIONING OF AN INDIVIDUAL.
  (VII) "MEDICALLY NECESSARY" MEANS ANY CARE,  TREATMENT,  INTERVENTION,
SERVICE,  OR ITEM THAT IS PRESCRIBED, PROVIDED, OR ORDERED BY A LICENSED
PHYSICIAN OR A LICENSED PSYCHOLOGIST IN ACCORDANCE WITH ACCEPTED  STAND-
ARDS  OF PRACTICE AND THAT WILL, OR IS REASONABLY EXPECTED TO, DO ANY OF
THE FOLLOWING:
  (1) PREVENT THE ONSET OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY;
  (2) REDUCE  OR  AMELIORATE  THE  PHYSICAL,  MENTAL,  OR  DEVELOPMENTAL
EFFECTS OF AN ILLNESS, CONDITION, INJURY, OR DISABILITY; OR
  (3)  ASSIST  TO  ACHIEVE  OR  MAINTAIN  MAXIMUM FUNCTIONAL CAPACITY IN
PERFORMING DAILY ACTIVITIES, TAKING INTO  ACCOUNT  BOTH  THE  FUNCTIONAL
CAPACITY OF THE INDIVIDUAL AND THE FUNCTIONAL CAPACITIES THAT ARE APPRO-
PRIATE FOR INDIVIDUALS OF THE SAME AGE.
  (VIII)  "PHARMACY  CARE"  MEANS  MEDICATIONS  PRESCRIBED BY A LICENSED
PHYSICIAN AND ANY HEALTH-RELATED SERVICES DEEMED MEDICALLY NECESSARY  TO
DETERMINE THE NEED OR EFFECTIVENESS OF THE MEDICATIONS.
  (IX) "PSYCHIATRIC CARE" MEANS DIRECT OR CONSULTATIVE SERVICES PROVIDED
BY  A PSYCHIATRIST LICENSED IN THE STATE IN WHICH THE PSYCHIATRIST PRAC-
TICES.
  (X)  "PSYCHOLOGICAL  CARE"  MEANS  DIRECT  OR  CONSULTATIVE   SERVICES
PROVIDED  BY  A PSYCHOLOGIST LICENSED IN THE STATE IN WHICH THE PSYCHOL-
OGIST PRACTICES.
  (XI) "THERAPEUTIC CARE" MEANS SERVICES PROVIDED BY LICENSED OR  CERTI-
FIED SPEECH THERAPISTS, OCCUPATIONAL THERAPISTS, OR PHYSICAL THERAPISTS.
  (XII)  "TREATMENT  FOR  AUTISM  SPECTRUM  DISORDERS"  WILL INCLUDE THE
FOLLOWING CARE PRESCRIBED, PROVIDED, OR ORDERED FOR AN INDIVIDUAL  DIAG-
NOSED  WITH ONE OF THE AUTISM SPECTRUM DISORDERS BY A LICENSED PHYSICIAN
OR A LICENSED PSYCHOLOGIST WHO  DETERMINES  THE  CARE  TO  BE  MEDICALLY
NECESSARY:

S. 2366--A                          7

  (1) HABILITATIVE OR REHABILITATIVE CARE;
  (2) PHARMACY CARE;
  (3) PSYCHIATRIC CARE;
  (4) PSYCHOLOGICAL CARE;
  (5) THERAPEUTIC CARE; AND
  (6)  ANY  CARE  FOR INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS THAT IS
DETERMINED BY THE STATE HEALTH DEPARTMENT, BASED UPON ITS REVIEW OF BEST
PRACTICES OR EVIDENCE-BASED RESEARCH, TO BE MEDICALLY NECESSARY AND THAT
IS PUBLISHED IN THE GAZETTE FOR RULEMAKING BY STATE AGENCIES.  ANY  SUCH
CARE,  TREATMENT, INTERVENTION, SERVICE, OR ITEM THAT WAS NOT PREVIOUSLY
COVERED WILL BE INCLUDED  IN  ANY  HEALTH  INSURANCE  POLICY  DELIVERED,
EXECUTED,  ISSUED,  AMENDED, ADJUSTED, OR RENEWED ON OR AFTER SIXTY DAYS
FOLLOWING THE DATE OF ITS PUBLICATION IN THE STATE REGISTER.
  (B) THIS SUBSECTION SHALL NOT BE CONSTRUED TO AFFECT ANY OBLIGATION TO
PROVIDE SERVICES TO AN INDIVIDUAL UNDER AN INDIVIDUALIZED FAMILY SERVICE
PLAN, AN INDIVIDUALIZED EDUCATION PROGRAM OR AN  INDIVIDUALIZED  SERVICE
PLAN.
  S 4.  This act shall take effect on the first of January next succeed-
ing  the date on which it shall have become a law and shall apply to all
policies and contracts issued, renewed, modified, altered or amended  on
or after the effective date; provided, however, that any rules and regu-
lations necessary for the implementation of this act shall be promulgat-
ed on or before such effective date.

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Senate Bill S2366

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

2009-S2366 - Details

2009-S2366 - Summary

2009-S2366 - Sponsor Memo

2009-S2366 - Bill Text download pdf

co-Sponsors

2009-S2366A (ACTIVE) - Details

2009-S2366A (ACTIVE) - Summary

2009-S2366A (ACTIVE) - Sponsor Memo

2009-S2366A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S2366

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Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

2009-S2366 - Details

2009-S2366 - Summary

2009-S2366 - Sponsor Memo

2009-S2366 - Bill Text download pdf

co-Sponsors

2009-S2366A (ACTIVE) - Details

2009-S2366A (ACTIVE) - Summary

2009-S2366A (ACTIVE) - Sponsor Memo

2009-S2366A (ACTIVE) - Bill Text download pdf

Comments