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

                                  2759

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                            January 21, 2009
                               ___________

Introduced  by M. of A. P. RIVERA, McENENY, FIELDS, WEISENBERG, BENEDET-
  TO, ALESSI, V. LOPEZ, CLARK, KOON, PERALTA, J. RIVERA, CAHILL,  BARRA,
  SPANO,  THIELE,  LIFTON,  MAYERSOHN, LATIMER, SCHROEDER -- Multi-Spon-
  sored by -- M. of A. ALFANO, AUBRY, BRADLEY, BRENNAN, CARROZZA, CONTE,
  DIAZ, DUPREY, ESPAILLAT, GABRYSZAK, LUPARDO, MAISEL, MARKEY, McKEVITT,
  MILLER, NOLAN, PEOPLES, REILLY, SAYWARD, SCOZZAFAVA, SEMINERIO,  SWEE-
  NEY,  TOBACCO,  TOWNS,  WALKER, WEINSTEIN -- read once and referred to
  the Committee on Insurance

AN ACT to amend the insurance  law,  in  relation  to  requiring  health
  insurers to provide full coverage for the prevention, early detection,
  diagnosis and treatment of autism spectrum disorder

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

  Section 1.  The insurance law is amended by adding a new  section  342
to read as follows:
  S  342. COVERAGE FOR AUTISM SPECTRUM DISORDER. (A) (1) THERE IS HEREBY
ESTABLISHED WITHIN THE DEPARTMENT AN ADVISORY PANEL ON HEALTH  INSURANCE
COVERAGE  FOR  AUTISM SPECTRUM DISORDER. SUCH PANEL SHALL BE COMPOSED OF
NINE MEMBERS WHO ARE EXPERTS IN HEALTH CARE AND  APPOINTED  AS  FOLLOWS:
SEVEN MEMBERS WHO ARE OFFICERS OR EMPLOYEES OF THE DEPARTMENT OF HEALTH,
OFFICE OF MENTAL HEALTH OR THE OFFICE OF MENTAL RETARDATION AND DEVELOP-
MENTAL  DISABILITIES  SHALL BE APPOINTED BY THE GOVERNOR; AND THE TEMPO-
RARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY SHALL  EACH
APPOINT  A  MEMBER  WHO IS A REPRESENTATIVE OF AN AUTISM ADVOCACY GROUP.
EACH MEMBER SHALL SERVE A TERM OF TWO YEARS. THE GOVERNOR  SHALL  DESIG-
NATE  THE CHAIR OF THE PANEL FROM AMONG HIS OR HER APPOINTEES. VACANCIES
IN THE MEMBERSHIP OF THE PANEL SHALL BE FILLED IN  THE  MANNER  PROVIDED
FOR ORIGINAL APPOINTMENTS.
  (2)  THE  MEMBERS OF THE PANEL SHALL RECEIVE NO COMPENSATION FOR THEIR
SERVICES BUT SHALL  BE  ALLOWED  THEIR  ACTUAL  AND  NECESSARY  EXPENSES
INCURRED IN THE PERFORMANCE OF THEIR DUTIES PURSUANT TO THIS SUBSECTION.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03667-01-9
              

A. 2759                             2

  (3)  THE  ADVISORY PANEL ON HEALTH INSURANCE COVERAGE FOR AUTISM SPEC-
TRUM DISORDER SHALL ANNUALLY, ON OR BEFORE SEPTEMBER FIRST, COMPILE  AND
SUBMIT  TO THE SUPERINTENDENT A LIST OF SUCCESSFUL TREATMENT AND THERAPY
OPTIONS FOR AUTISM SPECTRUM DISORDER THAT WILL BE REQUIRED TO BE COVERED
PURSUANT  TO  PARAGRAPH  TWENTY-FIVE  OF SUBSECTION (I) OF SECTION THREE
THOUSAND TWO HUNDRED SIXTEEN, PARAGRAPH SEVENTEEN OF SUBSECTION  (1)  OF
SECTION  THREE  THOUSAND  TWO  HUNDRED TWENTY-ONE AND SUBSECTION (EE) OF
SECTION FOUR THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
  (4) WITHIN FORTY-FIVE DAYS OF RECEIPT OF EACH LIST SUBMITTED  PURSUANT
TO  PARAGRAPH  THREE OF THIS SUBSECTION, THE SUPERINTENDENT SHALL, ON AN
EMERGENCY BASIS, PROMULGATE AND IMPLEMENT RULES AND REGULATIONS  REQUIR-
ING COVERAGE FOR THE TREATMENT AND THERAPY OPTIONS INCLUDED IN EACH SUCH
LIST.
  (B)  (1)  WITHIN  ONE  HUNDRED  EIGHTY  DAYS  OF THE SUBMISSION OF THE
INITIAL LIST TO  THE  SUPERINTENDENT  PURSUANT  TO  PARAGRAPH  THREE  OF
SUBSECTION (A) OF THIS SECTION, THE DEPARTMENT SHALL ESTABLISH AND OPER-
ATE  AN  AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE. THE HOTLINE SHALL
BE A TOLL-FREE, TWENTY-FOUR HOUR A DAY CONSUMER CALL CENTER FOR FAMILIES
WITH AUTISTIC CHILDREN WHO HAVE COMPLAINTS ABOUT OR QUESTIONS ON  INSUR-
ERS  AND  COVERAGE FOR AUTISM SPECTRUM DISORDER. ALL COMPLAINTS RECEIVED
BY SUCH HOTLINE SHALL BE DOCUMENTED  AND  REFERRED  TO  THE  APPROPRIATE
OFFICIAL IN THE DEPARTMENT FOR CORRECTIVE ACTION.
  (2) THE DEPARTMENT MAY CONTRACT WITH A QUALIFIED NOT-FOR-PROFIT CORPO-
RATION  FOR  THE PROVISION AND OPERATION OF THE HOTLINE REQUIRED BY THIS
SUBSECTION. ANY SUCH CONTRACT SHALL ONLY BE AWARDED AFTER THE DEPARTMENT
HAS CONDUCTED A REQUEST FOR  PROPOSALS  PROCESS.  THE  DEPARTMENT  SHALL
SELECT  A NOT-FOR-PROFIT CORPORATION WHICH HAS THE RESOURCES AND ABILITY
TO OPERATE A STATEWIDE HOTLINE,  AND  IS  STAFFED  BY  EMPLOYEES  AND/OR
VOLUNTEERS WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISORDER.
  (3)  IF  THE  DEPARTMENT  ELECTS  TO ESTABLISH AND OPERATE THE HOTLINE
USING ITS OWN PERSONNEL AND RESOURCES, SUCH HOTLINE SHALL BE STAFFED  BY
OFFICERS  AND EMPLOYEES WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISOR-
DER. UNTIL THE STATE CIVIL SERVICE  COMMISSION  SHALL  HAVE  ESTABLISHED
CIVIL  SERVICE  TITLES  AND  COMPETITIVE  EXAMINATIONS  FOR POSITIONS AS
EMPLOYEES OF THE HOTLINE, THE SUPERINTENDENT IS AUTHORIZED AND  DIRECTED
TO  APPOINT AND EMPLOY SUCH QUALIFIED OFFICERS AND EMPLOYEES AS SHALL BE
NECESSARY TO OPERATE THE AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE.
  (4) THE SUPERINTENDENT IS AUTHORIZED TO PROMULGATE AND  IMPLEMENT  ANY
RULES  AND  REGULATIONS  NECESSARY  TO  CARRY OUT THE PROVISIONS OF THIS
SUBSECTION.
  S 2. 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] INCLUDE FULL coverage for THE
PREVENTION, EARLY DETECTION, diagnosis and treatment of [medical  condi-
tions  otherwise  covered  by the policy solely because the treatment is
provided to diagnose or treat] autism spectrum disorder.   For  purposes
of  this  section,  "autism  spectrum  disorder" means a neurobiological
condition that includes autism, Asperger syndrome, Rett's  syndrome,  or
pervasive developmental disorder.
  S  3.  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

A. 2759                             3

coverage for hospital, surgical, or medical  care  coverage  shall  [not
exclude]  INCLUDE  FULL  coverage  for  THE PREVENTION, EARLY DETECTION,
diagnosis and treatment of [medical conditions otherwise covered by  the
policy  because  the  treatment is provided to diagnose or treat] autism
spectrum disorder.   For purposes  of  this  section,  "autism  spectrum
disorder" means a neurobiological condition that includes autism, Asper-
ger syndrome, Rett's syndrome, or pervasive developmental disorder.
  S 4. 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] INCLUDE
FULL  coverage for THE PREVENTION, EARLY DETECTION, diagnosis and treat-
ment of [medical conditions  otherwise  covered  by  the  policy  solely
because  the treatment is provided to diagnose or treat] autism spectrum
disorder.   For purposes of this  section,  "autism  spectrum  disorder"
means   a  neurobiological  condition  that  includes  autism,  Asperger
syndrome, Rett's syndrome, or pervasive developmental disorder.
  S 5. This act shall take effect on the thirtieth day  after  it  shall
have become a law.