S T A T E O F N E W Y O R K
________________________________________________________________________
7893
I N S E N A T E
June 17, 2014
___________
Introduced by Sen. VALESKY -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
AN ACT to amend the insurance law, in relation to authorizing insurance
coverage for equipment and supplies used for the treatment of ostomies
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph 30 of subsection (i) of section 3216 of the
insurance law, as added by a chapter of the laws of 2014, amending the
insurance law relating to authorizing insurance coverage for equipment
and supplies used for the treatment of ostomies, as proposed in legisla-
tive bills numbers S.5937-A and A.8137-A, is amended to read as follows:
(30) Every policy which provides medical coverage that includes cover-
age for physician services in a physician's office and every policy
which provides major medical or similar comprehensive-type coverage
shall include coverage for [the following] equipment and supplies used
for the treatment of ostomies, if [recommended or] prescribed by a
physician or other licensed health care provider legally authorized to
prescribe under title eight of the education law[: flanges, collection
bags, clamps, irrigation devices, sanitizing products, ostomy rings and
ostomy belts. In addition, the commissioner of the department of health
shall provide and periodically update by rule or regulation a list of
additional ostomy equipment and related supplies such as are medically
necessary for the treatment of ostomies for which there shall also be
coverage]. SUCH COVERAGE SHALL BE SUBJECT TO ANNUAL DEDUCTIBLES AND
COINSURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT. THE COVERAGE
REQUIRED BY THIS PARAGRAPH SHALL BE IDENTICAL TO, AND SHALL NOT ENHANCE
OR INCREASE THE COVERAGE REQUIRED AS PART OF ESSENTIAL HEALTH BENEFITS
AS REQUIRED PURSUANT TO SECTION 2707 (A) OF THE PUBLIC HEALTH SERVICES
ACT 42 U.S.C. 300 GG-6(A).
S 2. Paragraph 19 of subsection (k) of section 3221 of the insurance
law, as added by a chapter of the laws of 2014, amending the insurance
law relating to authorizing insurance coverage for equipment and
supplies used for the treatment of ostomies, as proposed in legislative
bills numbers S. 5937-A and A. 8137-A, is amended to read as follows:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD15635-01-4
S. 7893 2
(19) Every group or blanket accident and health insurance policy
[issued] DELIVERED or issued for delivery in this state which provides
medical coverage that includes coverage for physician services in a
physician's office and every policy which provides major medical or
similar comprehensive-type coverage shall include coverage for [the
following] equipment and supplies used for the treatment of ostomies, if
[recommended or] prescribed by a physician or other licensed health care
provider legally authorized to prescribe under title eight of the educa-
tion law[: flanges, collection bags, clamps, irrigation devices, sani-
tizing products, ostomy rings and ostomy belts. In addition, the commis-
sioner of the department of health shall provide and periodically update
by rule or regulation a list of additional ostomy equipment and related
supplies such as are medically necessary for the treatment of ostomies
for which there shall also be coverage]. SUCH COVERAGE SHALL BE SUBJECT
TO ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED APPROPRIATE BY THE
SUPERINTENDENT. THE COVERAGE REQUIRED BY THIS PARAGRAPH SHALL BE IDEN-
TICAL TO, AND SHALL NOT ENHANCE OR INCREASE THE COVERAGE REQUIRED AS
PART OF ESSENTIAL HEALTH BENEFITS AS REQUIRED PURSUANT TO SECTION 2707
(A) OF THE PUBLIC HEALTH SERVICES ACT 42 U.S.C. 300 GG-6(A).
S 3. Subsection (u-1) of section 4303 of the insurance law, as added
by a chapter of the laws of 2014, amending the insurance law relating to
authorizing insurance coverage for equipment and supplies used for the
treatment of ostomies, as proposed in legislative bills numbers S.
5937-A and A. 8137-A, is amended to read as follows:
(u-1) A medical expense indemnity corporation or a health service
corporation which provides medical coverage that includes coverage for
physician services in a physician's office and every policy which
provides major medical or similar comprehensive-type coverage shall
include coverage for [the following] equipment and supplies used for the
treatment of ostomies, if [recommended or] prescribed by a physician or
other licensed health care provider legally authorized to prescribe
under title eight of the education law[: flanges, collection bags,
clamps, irrigation devices, sanitizing products, ostomy rings and ostomy
belts. In addition, the commissioner of the department of health shall
provide and periodically update by rule or regulation a list of addi-
tional ostomy equipment and related supplies such as are medically
necessary for the treatment of ostomies for which there shall also be
coverage]. SUCH COVERAGE SHALL BE SUBJECT TO ANNUAL DEDUCTIBLES AND
COINSURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT. THE COVERAGE
REQUIRED BY THIS SUBSECTION SHALL BE IDENTICAL TO, AND SHALL NOT ENHANCE
OR INCREASE THE COVERAGE REQUIRED AS PART OF ESSENTIAL HEALTH BENEFITS
AS REQUIRED PURSUANT TO SECTION 2707(A) OF THE PUBLIC HEALTH SERVICES
ACT 42 U.S.C. 300 GG-6(A).
S 4. This act shall take effect on the same date and in the same
manner as a chapter of the laws of 2014, amending the insurance law
relating to authorizing insurance coverage for equipment and supplies
used for the treatment of ostomies, as proposed in legislative bills
numbers S. 5937-A and A. 8137-A, takes effect.