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

                                  4707

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 14, 2011
                               ___________

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  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:
  (17) (A) EVERY GROUP OR BLANKET POLICY WHICH PROVIDES MAJOR MEDICAL OR
SIMILAR COMPREHENSIVE-TYPE  COVERAGE  SHALL  INCLUDE  COVERAGE  FOR  THE

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

S. 4707                             2

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.