S T A T E   O F   N E W   Y O R K
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                                  3351

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            January 25, 2011
                               ___________

Introduced  by  M. of A. CYMBROWITZ, GALEF, COLTON -- Multi-Sponsored by
  -- M. of A. HOOPER, MAYERSOHN, TOWNS -- read once and referred to  the
  Committee on Insurance

AN  ACT  to amend the insurance law, in relation to requiring individual
  and group or blanket accident or health insurance policies and  hospi-
  tal  service  corporations,  health  service corporations, and medical
  indemnity corporations, which provide hospital,  surgical  or  medical
  coverage  to  include  coverage for the purchase of cranial prostheses
  when prescribed as medically necessary

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

  Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
amended by adding a new paragraph 28 to read as follows:
  (28) (A) EVERY INDIVIDUAL POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMI-
LAR COMPREHENSIVE-TYPE COVERAGE SHALL INCLUDE COVERAGE FOR THE  PURCHASE
OF CRANIAL PROSTHESES WORN FOR PERMANENT OR TEMPORARY HAIR LOSS SUFFERED
AS  A  RESULT  OF  ACCIDENT, INJURY OR DISEASE, OR THE TREATMENT OF SUCH
CONDITIONS, PROVIDED THAT  THE  TREATING  PHYSICIAN  OR  OTHER  LICENSED
HEALTH  CARE  PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT
OF THE EDUCATION LAW ISSUES A WRITTEN ORDER FOR SUCH PURCHASE TO SIGNIFY
HIS OR HER OPINION THAT SUCH PURCHASE IS MEDICALLY NECESSARY TO  PROMOTE
THE  PATIENT'S  PHYSICAL  OR  PSYCHOLOGICAL WELL-BEING OR TO PROMOTE THE
HEALING PROCESS.
  (B) SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND  COIN-
SURANCE  AS DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSIST-
ENT WITH THOSE REQUIRED FOR OTHER  BENEFITS  UNDER  THE  POLICY.    SUCH
COVERAGE MAY BE LIMITED TO ONE CRANIAL PROSTHESIS PER COVERED PERSON FOR
THE LIFETIME OF THE POLICY.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 17 to read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07755-01-1

              

A. 3351                             2

  (17) (A) EVERY GROUP OR BLANKET POLICY WHICH PROVIDES MAJOR MEDICAL OR
SIMILAR  COMPREHENSIVE-TYPE  COVERAGE  SHALL  INCLUDE  COVERAGE  FOR THE
PURCHASE OF CRANIAL PROSTHESES WORN FOR PERMANENT OR TEMPORARY HAIR LOSS
SUFFERED AS A RESULT OF ACCIDENT, INJURY OR DISEASE, OR THE TREATMENT OF
SUCH  CONDITIONS, PROVIDED THAT THE TREATING PHYSICIAN OR OTHER LICENSED
HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER  TITLE  EIGHT
OF THE EDUCATION LAW ISSUES A WRITTEN ORDER FOR SUCH PURCHASE TO SIGNIFY
HIS  OR HER OPINION THAT SUCH PURCHASE IS MEDICALLY NECESSARY TO PROMOTE
THE PATIENT'S PHYSICAL OR PSYCHOLOGICAL WELL-BEING  OR  TO  PROMOTE  THE
HEALING PROCESS.
  (B)  SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND COIN-
SURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE  CONSIST-
ENT  WITH  THOSE  REQUIRED  FOR  OTHER BENEFITS UNDER THE POLICY.   SUCH
COVERAGE MAY BE LIMITED TO ONE CRANIAL PROSTHESIS PER COVERED PERSON FOR
THE LIFETIME OF THE POLICY.
  S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (hh) to read as follows:
  (HH)(1)  EVERY  CONTRACT  ISSUED  BY  A  CORPORATION  SUBJECT  TO  THE
PROVISIONS OF THIS ARTICLE  WHICH  PROVIDES  MAJOR  MEDICAL  OR  SIMILAR
COMPREHENSIVE-TYPE  COVERAGE, SHALL INCLUDE COVERAGE FOR THE PURCHASE OF
CRANIAL PROSTHESES WORN FOR PERMANENT OR TEMPORARY HAIR LOSS SUFFERED AS
A RESULT OF ACCIDENT, INJURY OR DISEASE, OR THE TREATMENT OF SUCH CONDI-
TIONS, PROVIDED THAT THE TREATING PHYSICIAN  OR  OTHER  LICENSED  HEALTH
CARE  PROVIDER  LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE
EDUCATION LAW ISSUES A WRITTEN ORDER FOR SUCH PURCHASE TO SIGNIFY HIS OR
HER OPINION THAT SUCH PURCHASE IS MEDICALLY  NECESSARY  TO  PROMOTE  THE
PATIENT'S PHYSICAL OR PSYCHOLOGICAL WELL-BEING OR TO PROMOTE THE HEALING
PROCESS.
  (2)  SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND COIN-
SURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE  CONSIST-
ENT  WITH  THOSE  REQUIRED  FOR  OTHER BENEFITS UNDER THE POLICY.   SUCH
COVERAGE MAY BE LIMITED TO ONE CRANIAL PROSTHESIS PER COVERED PERSON FOR
THE LIFETIME OF THE POLICY.
  S 4. This act shall take effect on the ninetieth day  after  it  shall
have  become  a  law and shall apply according to its terms to all poli-
cies, contracts and certificates issued, renewed, modified,  altered  or
amended on or after such date.