S T A T E   O F   N E W   Y O R K
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                                  2609

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 25, 2009
                               ___________

Introduced  by Sen. FLANAGAN -- 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 coverage and  benefits
  of accident and health insurance policies for podiatric care

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

  Section 1. Paragraph 2 of subsection (i) of section 3216 of the insur-
ance law is amended to read as follows:
  (2) If a policy provides for reimbursement for any podiatrical service
within the lawful scope  of  practice  of  a  licensed  podiatrist,  the
insured  shall  be  entitled  to THE SAME reimbursement for such service
whether it is performed by a physician or licensed podiatrist.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 15 to read as follows:
  (15) EVERY POLICY WHICH  PROVIDES  COVERAGE  FOR  PODIATRIC  CARE,  AS
DEFINED IN  SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED BY
A  DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE
OF THE EDUCATION LAW, MAY BE SUBJECT TO REASONABLE  DEDUCTIBLE,  CO-PAY-
MENT  AND  CO-INSURANCE  AMOUNTS,  REASONABLE  FEE OR BENEFIT LIMITS AND
REASONABLE UTILIZATION REVIEW, PROVIDED THAT ANY  SUCH  AMOUNTS,  LIMITS
AND  REVIEW:  (A)  SHALL  NOT  FUNCTION  TO DIRECT TREATMENT IN A MANNER
DISCRIMINATIVE AGAINST PODIATRIC CARE; AND (B) INDIVIDUALLY AND  COLLEC-
TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THAT SAME POLI-
CY  TO  CARE  OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS IN  THE
DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR  CONDITIONS,
DISORDERS  OR  INJURIES. NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED AS
IMPEDING OR PREVENTING EITHER THE PROVISION  OR  COVERAGE  OF  PODIATRIC
CARE  AND  SERVICES  BY  DULY    LICENSED DOCTORS OF PODIATRY WITHIN THE
LAWFUL SCOPE OF PODIATRIC CARE IN HOSPITAL  FACILITIES  ON  A  STAFF  OR
EMPLOYEE BASIS.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06543-01-9

              

S. 2609                             2

  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (ff) to read as follows:
  (FF)  EVERY  CONTRACT  ISSUED  BY  A  HEALTH  SERVICE CORPORATION OR A
MEDICAL EXPENSE INDEMNITY CORPORATION THAT INCLUDES COVERAGE FOR  PHYSI-
CIAN  SERVICES  IN  A PHYSICIAN'S OFFICE, THAT PROVIDES MAJOR MEDICAL OR
SIMILAR COMPREHENSIVE-TYPE COVERAGE, AND COVERAGE FOR PODIATRIC CARE  AS
DEFINED  IN SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED BY
A DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED  FORTY-ONE
OF  THE  EDUCATION LAW, MAY BE SUBJECT TO REASONABLE DEDUCTIBLE, CO-PAY-
MENT AND CO-INSURANCE AMOUNTS, REASONABLE  FEE  OR  BENEFIT  LIMITS  AND
REASONABLE  UTILIZATION  REVIEW,  PROVIDED THAT ANY SUCH AMOUNTS, LIMITS
AND REVIEW:  (1) SHALL NOT FUNCTION TO  DIRECT  TREATMENT  IN  A  MANNER
DISCRIMINATIVE  AGAINST PODIATRIC CARE; AND (2) INDIVIDUALLY AND COLLEC-
TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THE SAME POLICY
TO CARE OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS IN THE  DIAG-
NOSIS,  TREATMENT  AND  MANAGEMENT  OF  THE  SAME OR SIMILAR CONDITIONS,
DISORDERS OR INJURIES. NOTHING IN THIS SUBSECTION SHALL BE CONSTRUED  AS
IMPEDING  OR  PREVENTING  EITHER THE PROVISIONS OR COVERAGE OF PODIATRIC
CARE AND SERVICES BY DULY LICENSED DOCTORS OF PODIATRY WITHIN THE LAWFUL
SCOPE OF PODIATRIC CARE IN HOSPITAL FACILITIES ON A  STAFF  OR  EMPLOYEE
BASIS.
  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
policies  and contracts issued, renewed, modified, altered or amended on
or after such effective date.