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Section 1. Subdivisions 2 and 4 of section 2111 of the public health
law, as added by section 21 of part C of chapter 58 of the laws of 2004,
are amended to read as follows:
2. The department shall establish the criteria by which individuals
will be identified as eligible for enrollment in the demonstration
programs. Persons eligible for enrollment in the disease management
demonstration program shall be limited to individuals who: receive
medical assistance pursuant to title eleven of article five of the
social services law and may be eligible for benefits pursuant to title
18 of the social security act (Medicare); are not enrolled in a Medicaid
managed care plan, including individuals who are not required or not
eligible to participate in Medicaid managed care programs pursuant to
section three hundred sixty-four-j of the social services law; are diag-
nosed with chronic health problems as may be specified by the entity
undertaking the demonstration program, including, but not limited to one
or more of the following: congestive heart failure, chronic obstructive
pulmonary disease, asthma, EMPHYSEMA, CHRONIC BRONCHITIS, OTHER CHRONIC
RESPIRATORY DISEASES, diabetes, ADULT AND CHILDHOOD OBESITY, or other
chronic health conditions as may be specified by the department; or have
experienced or are likely to experience one or more hospitalizations or
are otherwise expected to incur excessive costs and high utilization of
health care services.
4. The demonstration program shall offer evidence-based services and
interventions designed to ensure that the enrollees receive high quali-
ty, preventative and cost-effective care, aimed at reducing the necessi-
ty for hospitalization or emergency room care or at reducing lengths of
stay when hospitalization is necessary. The demonstration program may
include screening of eligible enrollees, developing an individualized
care management plan for each enrollee and implementing that plan.
Disease management demonstration programs that utilize information tech-
nology systems that allow for continuous application of evidence-based
guidelines to medical assistance claims data and other available data to
identify specific instances in which clinical interventions are justi-
fied and communicate indicated interventions to physicians, health care
providers and/or patients, and monitor physician and health care provid-
er response to such interventions, shall have the enrollees, or groups
of enrollees, approved by the department for participation. The services
provided by the demonstration program as part of the care management
plan may include, but are not limited to, case management, social work,
individualized health counselors, multi-behavioral goals plans, claims
data management, health and self-care education, drug therapy management
and oversight, personal emergency response systems and other monitoring
technologies, SYSTEMATIC CHRONIC HEALTH CONDITIONS IDENTIFIED FOR MONI-
TORING, telehealth services and similar services designed to improve the
quality and cost-effectiveness of health care services.
S 2. This act shall take effect immediately.
PART B
Section 1. Section 2599-b of the public health law, as amended by
section 88 of part B of chapter 58 of the laws of 2005, is amended to
read as follows:
S 2599-b. Program development. 1. The program shall be designed to
prevent and reduce the incidence and prevalence of obesity in children
and adolescents, especially among populations with high rates of obesity
and obesity-related health complications including, but not limited to,
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diabetes, heart disease, cancer, osteoarthritis, asthma, EMPHYSEMA,
CHRONIC BRONCHITIS, OTHER CHRONIC RESPIRATORY DISEASES and other condi-
tions. The program shall use recommendations and goals of the United
States departments of agriculture and health and human services, the
surgeon general and centers for disease control AND PREVENTION in devel-
oping and implementing guidelines for nutrition education and physical
activity projects as part of obesity prevention efforts. The content and
implementation of the program shall stress the benefits of choosing a
balanced, healthful diet from the many options available to consumers,
without specifically targeting the elimination of any particular food
group, food product or food-related industry.
2. The childhood obesity prevention program shall include, but not be
limited to:
(a) developing media health promotion campaigns targeted to children
and adolescents and their parents and caregivers that emphasize increas-
ing consumption of low-calorie, high-nutrient foods, decreasing consump-
tion of high-calorie, low-nutrient foods and increasing physical activ-
ity designed to prevent or reduce obesity;
(b) establishing school-based childhood obesity prevention nutrition
education and physical activity programs including programs described in
section twenty-five hundred ninety-nine-c of this article, as well as
other programs with linkages to physical and health education courses,
and which utilize the school health index of the National Center for
Chronic Disease Prevention and Health Promotion or other recognized
school health assessment PURSUANT TO ARTICLE NINETEEN OF THE EDUCATION
LAW;
(c) establishing community-based childhood obesity prevention nutri-
tion education and physical activity programs including programs which
involve parents and caregivers, and which encourage communities, fami-
lies, child care and other settings to provide safe and adequate space
and time for physical activity and encourage a healthy diet, AND CAN BE
IN COORDINATION WITH COUNTY COOPERATIVE EXTENSION PROGRAMS ESTABLISHED
PURSUANT TO SECTION TWO HUNDRED TWENTY-FOUR-B OF THE COUNTY LAW;
(d) coordinating with the state education department, department of
agriculture and markets, office of parks, recreation and historic pres-
ervation, office of temporary and disability assistance, office of chil-
dren and family services and other federal, state and local agencies to
incorporate strategies to prevent and reduce childhood obesity into
government food assistance, health, education and recreation programs;
(e) sponsoring periodic conferences or meetings to bring together
experts in nutrition, exercise, public health, mental health, education,
parenting, media, food marketing, food security, agriculture, community
planning and other disciplines to examine societal-based solutions to
the problem of childhood obesity and issue guidelines and recommenda-
tions for New York state policy and programs;
(f) developing training programs for medical and other health profes-
sionals to teach practical skills in nutrition and exercise education to
children and their parents and caregivers; [and]
(g) developing screening programs in coordination with health care
providers and institutions including but not limited to day care centers
and schools for overweight and obesity for children aged two through
eighteen years, using body mass index (BMI) appropriate for age and
gender, and notification, in a manner protecting the confidentiality of
such children and their families, of parents of BMI status, and explana-
tion of the consequences of such status, including recommended actions
parents may need to take and information about resources and referrals
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available to families to enhance nutrition and physical activity to
reduce and prevent obesity[.]; AND
(H) COORDINATING WITH THE EDUCATION DEPARTMENT, OFFICE OF TEMPORARY
AND DISABILITY ASSISTANCE, OFFICE OF CHILDREN AND FAMILY SERVICES AND
OTHER FEDERAL, STATE AND LOCAL AGENCIES TO INCORPORATE STRATEGIES TO
CURTAIL THE INCIDENCE OF ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC
RESPIRATORY DISEASES TO ENABLE ADULTS AND CHILDREN TO SAFELY INCREASE
PHYSICAL ACTIVITY TO HELP CURB THE INCIDENCE OF OBESITY.
3. The department, IN COOPERATION WITH THE EDUCATION DEPARTMENT, shall
periodically collect and analyze information from schools, health and
nutrition programs and other sources to determine the prevalence of
childhood obesity in New York state, and to evaluate, to the extent
possible, the effectiveness of the childhood obesity prevention program.
S 2. The opening paragraph of section 2599-c of the public health law,
as amended by section 88 of part B of chapter 58 of the laws of 2005, is
amended to read as follows:
The commissioner, IN COOPERATION WITH THE COMMISSIONERS OF EDUCATION
AND AGRICULTURE AND MARKETS, AND COUNTY BOARDS OF COOPERATIVE EXTENSION,
shall encourage the establishment of school-based childhood obesity
prevention and physical activity programs that promote:
S 3. This act shall take effect immediately.
PART C
Section 1. Paragraphs (a), (b) and (c) of subdivision 1 of section
2411 of the public health law, as amended by chapter 219 of the laws of
1997, are amended to read as follows:
(a) Survey state agencies, boards, programs and other state govern-
mental entities to assess what, if any, relevant data has been or is
being collected which may be of use to researchers engaged in breast,
prostate or testicular cancer research, OR ADULT AND CHILDHOOD OBESITY,
ASTHMA, CHRONIC BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE
RESEARCH;
(b) Consistent with the survey conducted pursuant to paragraph (a) of
this subdivision, compile a list of data collected by state agencies
which may be of assistance to researchers engaged in breast, prostate or
testicular cancer research as established in section twenty-four hundred
twelve of this title, AND ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC
BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE RESEARCH;
(c) Consult with the Centers for Disease Control and Prevention, the
National Institutes of Health, the Federal Agency For Health Care Policy
and Research, the National Academy of Sciences and other organizations
or entities which may be involved in cancer research to solicit both
information regarding breast, prostate and testicular cancer research
projects, AND ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC BRONCHITIS OR
OTHER CHRONIC RESPIRATORY DISEASE RESEARCH PROJECTS that are currently
being conducted and recommendations for future research projects;
S 2. Subdivision 1 of section 2500 of the public health law, as
amended by chapter 822 of the laws of 1987, is amended to read as
follows:
1. The commissioner shall act in an advisory and supervisory capacity,
in matters pertaining to the safeguarding of motherhood, the prevention
of maternal, perinatal, infant and child mortality, the prevention of
diseases, low birth weight, CHILDHOOD OBESITY, and defects of childhood
and the promotion of maternal, prenatal and child health, including care
in hospitals, and shall administer such services bearing on the health
A. 9186 5
of mothers and children for which funds are or shall hereafter be made
available.
S 3. This act shall take effect immediately.
PART D
Section 1. Section 2505-a of the public health law, as added by chap-
ter 292 of the laws of 2009, is amended to read as follows:
S 2505-a. Rights of breastfeeding mothers. 1. The principles enunci-
ated in subdivision three of this section are declared to be the public
policy of the state and a copy of such statement of rights shall be
posted conspicuously in a public place in each maternal health care
facility AND CHILD DAY CARE FACILITY. For purposes of this section,
"maternal health care provider" means a physician, midwife, or other
authorized practitioner attending a pregnant woman; and "maternal health
care facility" includes hospitals and freestanding birthing centers
providing perinatal services in accordance with article twenty-eight of
this chapter and applicable regulations.
2. The commissioner shall make available to every maternal health care
provider [and], maternal health care facility AND CHILD DAY CARE FACILI-
TY, on the health department's website for the purpose of health care
facilities to include such rights in the maternity information leaflet
as described in section twenty-eight hundred three-j of this chapter, a
copy of the statement of rights provided in subdivision three of this
section in the top six languages other than English spoken in the state
according to the latest available data from the U.S. Bureau of Census,
and shall adopt any rules and regulations necessary to ensure that such
patients are treated in accordance with the provisions of such state-
ment.
3. The statement of rights shall consist of the following:
"Breastfeeding Mothers' Bill of Rights"
Choosing the way you will feed your new baby is one of the important
decisions you will make in preparing for your infant's arrival. Doctors
agree that for most women breastfeeding is the safest and most healthy
choice. It is your right to be informed about the benefits of breast-
feeding and have your health care provider [and], maternal health care
facility AND CHILD DAY CARE FACILITY encourage and support breastfeed-
ing. You have the right to make your own choice about breastfeeding.
Whether you choose to breastfeed or not you have the following basic
rights regardless of your race, creed, national origin, sexual orien-
tation, gender identity or expression, or source of payment for your
health care. Maternal health care facilities have a responsibility to
ensure that you understand these rights. They must provide this informa-
tion clearly for you and must provide an interpreter if necessary. These
rights may only be limited in cases where your health or the health of
your baby requires it. If any of the following things are not medically
right for you or your baby, you should be fully informed of the facts
and be consulted.
(1) Before You Deliver, if you attend prenatal childbirth education
classes provided by the maternal health care facility and all hospital
clinics and diagnostic and treatment centers providing prenatal services
in accordance with article 28 of the public health law you must receive
the breastfeeding mothers' bill of rights. Each maternal health care
facility shall provide the maternity information leaflet, including the
Breastfeeding Mothers' Bill of Rights, in accordance with section twen-
ty-eight hundred three-i of this chapter to each patient or to the
A. 9186 6
appointed personal representative at the time of prebooking or time of
admission to a maternal health care facility. Each maternal health care
provider shall give a copy of the Breastfeeding Mothers' Bill of Rights
to each patient at or prior to the medically appropriate time.
You have the right to complete information about the benefits of
breastfeeding for yourself and your baby. This will help you make an
informed choice on how to feed your baby.
You have the right to receive information that is free of commercial
interests and includes:
* How breastfeeding benefits you and your baby nutritionally,
medically and emotionally;
* How to prepare yourself for breastfeeding;
* How to understand some of the problems you may face and how to solve
them.
(2) In The Maternal Health Care Facility:
* You have the right to have your baby stay with you right after birth
whether you deliver vaginally or by cesarean section. You have the right
to begin breastfeeding within one hour after birth.
* You have the right to have someone trained to help you in breast-
feeding give you information and help you when you need it.
* You have the right to have your baby not receive any bottle feeding
or pacifiers.
* You have the right to know about and refuse any drugs that may dry
up your milk.
* You have the right to have your baby in your room with you 24 hours
a day.
* You have the right to breastfeed your baby at any time day or night.
* You have the right to know if your doctor or your baby's pediatri-
cian is advising against breastfeeding before any feeding decisions are
made.
* You have the right to have a sign on your baby's crib clearly stat-
ing that your baby is breastfeeding and that no bottle feeding of any
type is to be offered.
* You have the right to receive full information about how you are
doing with breastfeeding and get help on how to improve.
* You have the right to breastfeed your baby in the neonatal intensive
care unit. If nursing is not possible, every attempt will be made to
have your baby receive your pumped or expressed milk.
* If you, or your baby, are re-hospitalized in a maternal care facili-
ty after the initial delivery stay, the hospital will make every effort
to continue to support breastfeeding, to provide hospital grade electric
pumps and rooming in facilities.
* You have the right to have help from someone specially trained in
breastfeeding support and expressing breast milk if your baby has
special needs.
* You have the right to have a family member or friend receive breast-
feeding information from a staff member if you request it.
(3) When You Leave The Maternal Health Care Facility:
* You have the right to printed breastfeeding information free of
commercial material.
* You have the right, unless specifically requested by you, and avail-
able at the facility, to be discharged from the facility without
discharge packs containing infant formula, or formula coupons unless
ordered by your baby's health care provider.
A. 9186 7
* You have the right to get information about breastfeeding resources
in your community including information on availability of breastfeeding
consultants, support groups and breast pumps.
* You have the right to have the facility give you information to help
choose a medical provider for your baby and understand the importance of
a follow-up appointment.
* You have the right to receive information about safely collecting
and storing your breast milk.
* You have the right to breastfeed your baby in any location, public
or private, where you are otherwise authorized to be. Complaints can be
directed to the New York State Division of Human Rights.
* YOU HAVE A RIGHT TO BREASTFEED YOUR BABY AT YOUR PLACE OF EMPLOYMENT
OR CHILD DAY CARE CENTER IN AN ENVIRONMENT THAT DOES NOT DISCOURAGE
BREASTFEEDING OR THE PROVISION OF BREAST MILK.
All the above are your rights. If the maternal health care facility
does not honor these rights you can seek help by contacting the New York
state department of health or by contacting the hospital complaint
hotline or via email.
4. The commissioner shall make regulations reasonably necessary to
implement this section.
S 2. Section 2505 of the public health law, as added by chapter 479 of
the laws of 1980, is amended to read as follows:
S 2505. Human breast milk; collection, storage and distribution;
general powers of the commissioner. The commissioner is hereby
empowered to:
(a) adopt regulations and guidelines including, but not limited to
donor standards, methods of collection, and standards for storage, and
distribution of human breast milk;
(b) conduct educational activities to inform the public and health
care providers of the availability of human breast milk for infants
determined to require such milk and to inform potential donors of the
opportunities for proper donation;
(c) CONDUCT EDUCATIONAL ACTIVITIES TO ENCOURAGE AND FACILITATE EMPLOY-
ERS AND CHILD DAY CARE CENTERS TO ESTABLISH ENVIRONMENTS THAT DO NOT
DISCOURAGE BREASTFEEDING AND THE PROVISION OF BREAST MILK. SUCH ENVIRON-
MENTS MAY INCLUDE SANITARY LOCATIONS FOR BREASTFEEDING AND REFRIGERATORS
TO ASSIST IN BREASTFEEDING AND FEEDING BABIES WITH EXPRESSED BREAST
MILK; AND
(D) establish rules and regulations to effectuate the provisions of
this section.
S 3. Subdivision 2 of section 2515 of the public health law, as added
by section 20 of part A of chapter 58 of the laws of 2008, is amended to
read as follows:
2. "Services for eligible adolescents" means those services, including
but not limited to: vocational and educational counseling, job skills
training, family life and parenting education, life skills development,
coordination, case management, primary preventive health care, PREGNANCY
AND CHILD NUTRITION COUNSELING FOR EXPECTANT MOTHERS TO CURB THE INCI-
DENCE OF CHILDHOOD OBESITY, family planning, social and recreational
programs, child care, outreach and advocacy, follow-up on service utili-
zation, crisis intervention, and efforts to stimulate community interest
and involvement.
S 4. Paragraph (c) of subdivision 2 of section 2515-a of the public
health law, as added by section 20 of part A of chapter 58 of the laws
of 2008, is amended to read as follows:
A. 9186 8
(c) serve a geographic area where the incidence of infant mortality,
LOW BIRTH WEIGHT INFANTS, CHILDHOOD OBESITY and the prevalence of low-
income families are high and where the availability or accessibility of
services for eligible adolescents is low;
S 5. Subdivision (b) of section 2522 of the public health law, as
amended by chapter 484 of the laws of 2009, is amended and a new subdi-
vision (e-1) is added to read as follows:
(b) promotion of community awareness of the benefits TO THE MOTHER AND
CHILD of preconception health and early and continuous prenatal care;
(E-1) HEALTH AND NUTRITIONAL EDUCATION AND SERVICES FOR BOTH PARENTS,
REGARDING CHILDHOOD AND ADULT OBESITY AND ASTHMA, AND THE PREVENTION OR
MITIGATION THEREOF;
S 6. This act shall take effect immediately.
PART E
Section 1. Section 901 of the education law, as amended by chapter 477
of the laws of 2004, subdivision 1 as amended by section 57 of part A-1
of chapter 58 of the laws of 2006, is amended to read as follows:
S 901. School health services to be provided. 1. School health
services, as defined in subdivision two of this section, shall be
provided by each school district for all students attending the public
schools in this state, except in the city school district of the city of
New York, as provided in this article. School health services shall
include the services of a registered professional nurse, if one is
employed, and shall also include such services as may be rendered as
provided in this article in examining students for the existence of
disease or disability, OR MAY INCLUDE SERVICES RELATED TO EXAMINING FOR
CHILDHOOD OBESITY BASED UPON THE CALCULATION OF EACH STUDENT'S BODY MASS
INDEX AND WEIGHT STATUS CATEGORY PURSUANT TO SECTION NINE HUNDRED FOUR
OF THIS ARTICLE, and in testing the eyes and ears of such students.
2. School health services for the purposes of this article shall mean
the several procedures, including, but not limited to, medical examina-
tions, dental inspection and/or screening, scoliosis screening, vision
screening [and], audiometer tests, AND CHILDHOOD OBESITY AS MEASURED BY
BODY MASS INDEX AND WEIGHT STATUS CATEGORY, designed to determine the
health status of the child; to inform parents or other persons in
parental relation to the child, pupils and teachers of the individual
child's health condition subject to federal and state confidentiality
laws; to guide parents, children and teachers in procedures for prevent-
ing and correcting defects [and], diseases AND CHILDHOOD OBESITY CONDI-
TIONS; to instruct the school personnel in procedures to take in case of
accident or illness; to survey and make necessary recommendations
concerning the health and safety aspects of school facilities and the
provision of health information.
S 2. Subdivisions 4 and 5 of section 918 of the education law, as
added by chapter 493 of the laws of 2004, are amended to read as
follows:
4. The committee is encouraged to study AND MAKE RECOMMENDATIONS ON
all facets of the current nutritional policies of the district includ-
ing, but not limited to, the goals of the district to promote health and
proper nutrition, REDUCE THE INCIDENCE OF CHILDHOOD OBESITY, vending
machine sales, menu criteria, educational curriculum teaching healthy
nutrition, AND educational information provided to parents or guardians
regarding healthy nutrition and the health risks associated with obesi-
ty, ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC RESPIRATORY DISEASES.
A. 9186 9
PROVIDED, FURTHER, THE COMMITTEE MAY PROVIDE INFORMATION TO PERSONS IN
PARENTAL RELATION ON opportunities offered to parents or guardians to
encourage healthier eating habits to students, and the education
provided to teachers and other staff as to the importance of healthy
nutrition AND ABOUT THE DANGERS OF CHILDHOOD OBESITY. In addition the
committee shall consider recommendations and practices of other
districts and nutrition studies.
5. The committee is encouraged to report periodically to the district
regarding practices that will educate teachers, parents or guardians and
children about healthy nutrition and raise awareness of the dangers of
CHILDHOOD obesity, ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC RESPIR-
ATORY DISEASES. The committee is encouraged also to provide any parent
teacher associations in the district with such findings and recommenda-
tions.
S 3. This act shall take effect two years after it shall have become a
law.
PART F
Section 1. Section 813 of the education law, as added by chapter 296
of the laws of 1994, is amended to read as follows:
S 813. School lunch period; scheduling. Each school shall schedule a
reasonable time DURING EACH SCHOOL DAY for each full day pupil attending
pre-kindergarten through grade twelve WITH AMPLE TIME to consume lunch
AND TO ENGAGE IN PHYSICAL EXERCISE OR RECREATION.
S 2. This act shall take effect immediately.
PART G
Section 1. Section 3231 of the insurance law, as added by chapter 501
of the laws of 1992, is amended by adding a new subsection (c-1) to read
as follows:
(C-1) SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT, AN INSURER OR
HEALTH MAINTENANCE ORGANIZATION ISSUING AN INDIVIDUAL OR GROUP HEALTH
INSURANCE POLICY PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY
APPROPRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS
APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S
ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELL-
NESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK
POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE-
ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE-
QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL
WELL-BEING OF ITS PARTICIPANTS:
(1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
(2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
A. 9186 10
PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
ARTICLE; AND
(3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
APPROVED WELLNESS PROGRAM.
S 2. Subsections (b) and (c) of section 3239 of the insurance law, as
added by chapter 592 of the laws of 2008, paragraphs 6 and 7 of
subsection (b) and subparagraphs (C) and (D) of paragraph 2 of
subsection (c) as amended, and paragraph 8 of subsection (b) and subpar-
agraphs (E) and (F) of paragraph 2 of subsection (c) as added by chapter
519 of the laws of 2013, are amended to read as follows:
(b) A wellness program may include, but is not limited to, the follow-
ing programs or services:
(1) the use of a health risk assessment tool;
(2) a smoking cessation program;
(3) a weight management program;
(4) a stress AND/OR HYPERTENSION management program;
(5) a worker injury prevention program;
(6) a nutrition education program;
(7) health or fitness incentive programs; [and]
(8) a coordinated weight management, nutrition, stress management and
physical fitness program to combat the high incidence of adult and
childhood obesity, asthma and other chronic respiratory conditions[.];
(9) A SUBSTANCE OR ALCOHOL ABUSE CESSATION PROGRAM; AND
(10) A PROGRAM TO MANAGE AND COPE WITH CHRONIC PAIN.
(c)(1) A wellness program may use rewards and incentives for partic-
ipation provided that where the group health insurance policy or
subscriber contract is required to be community-rated, the rewards and
incentives shall not include a discounted premium rate or a rebate or
refund of premium, EXCEPT AS PROVIDED IN SECTION THREE THOUSAND TWO
HUNDRED THIRTY-ONE OF THIS ARTICLE, OR SECTION FOUR THOUSAND TWO HUNDRED
THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED SEVENTEEN OR FOUR THOUSAND
THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, OR SECTION FORTY-FOUR HUNDRED
FIVE OF THE PUBLIC HEALTH LAW.
(2) Permissible rewards and incentives MAY include:
(A) full or partial reimbursement of the cost of participating in
smoking cessation [or], weight management, STRESS AND/OR HYPERTENSION,
WORKER INJURY PREVENTION, NUTRITION EDUCATION, SUBSTANCE OR ALCOHOL
ABUSE CESSATION, OR CHRONIC PAIN MANAGEMENT AND COPING programs;
(B) full or partial reimbursement of the cost of membership in a
health club or fitness center;
(C) the waiver or reduction of copayments, coinsurance and deductibles
for preventive services covered under the group policy or subscriber
contract;
(D) monetary rewards in the form of gift cards or gift certificates,
so long as the recipient of the reward is encouraged to use the reward
for a product or a service that promotes good health, such as healthy
cook books, over the counter vitamins or exercise equipment;
(E) full or partial reimbursement of the cost of participating in a
stress management program or activity; and
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(F) full or partial reimbursement of the cost of participating in a
health or fitness program.
(3) Where the reward involves a group member's meeting a specified
standard based on a health condition, the wellness program must meet the
requirements of 45 CFR Part 146.
(4) A reward or incentive which involves a discounted premium rate or
a rebate or refund of premium shall be based on actuarial demonstration
that the wellness program can reasonably be expected to result in the
overall good health and well being of the group AS PROVIDED IN SECTION
THREE THOUSAND TWO HUNDRED THIRTY-ONE OF THIS ARTICLE, SECTIONS FOUR
THOUSAND TWO HUNDRED THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED SEVENTEEN
AND FOUR THOUSAND THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, AND SECTION
FORTY-FOUR HUNDRED FIVE OF THE PUBLIC HEALTH LAW.
S 3. Subsection (h) of section 4235 of the insurance law is amended by
adding a new paragraph 5 to read as follows:
(5) EACH INSURER DOING BUSINESS IN THIS STATE, WHEN FILING WITH THE
SUPERINTENDENT ITS SCHEDULES OF PREMIUM RATES, RULES AND CLASSIFICATION
OF RISKS FOR USE IN CONNECTION WITH THE ISSUANCE OF ITS POLICIES OF
GROUP ACCIDENT, GROUP HEALTH OR GROUP ACCIDENT AND HEALTH INSURANCE, MAY
PROVIDE FOR AN ACTUARIALLY APPROPRIATE REDUCTION IN PREMIUM RATES OR
OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOUR-
AGE AN ENROLLEE'S OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELL-
NESS PROGRAM. A QUALIFIED WELLNESS PROGRAM CAN BE A RISK MANAGEMENT
SYSTEM THAT IDENTIFIES AT-RISK POPULATIONS OR ANY OTHER SYSTEMATIC
PROGRAM OR COURSE OF MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND
MENTAL FITNESS, HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE THE
CONDITIONS OF ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINI-
MIZES ADVERSE HEALTH CONSEQUENCES DUE TO LIFESTYLE. SUCH A WELLNESS
PROGRAM MAY HAVE SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE
PHYSICAL HEALTH AND MENTAL WELL-BEING OF ITS PARTICIPANTS:
(A) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
(B) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
CHAPTER; AND
(C) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
APPROVED WELLNESS PROGRAM.
S 4. Section 4317 of the insurance law is amended by adding a new
subsection (c-1) to read as follows:
(C-1) SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT, AN INSURER OR
HEALTH MAINTENANCE ORGANIZATION ISSUING AN INDIVIDUAL OR GROUP HEALTH
INSURANCE CONTRACT PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARI-
A. 9186 12
ALLY APPROPRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR
ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S
OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A
QUALIFIED WELLNESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTI-
FIES AT-RISK POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF
MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS,
HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF
ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE
HEALTH CONSEQUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE
SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND
MENTAL WELL-BEING OF ITS PARTICIPANTS:
(1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
(2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
CHAPTER; AND
(3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
APPROVED WELLNESS PROGRAM.
S 5. Subsection (m) of section 4326 of the insurance law is amended by
adding a new paragraph 4 to read as follows:
(4) APPROVAL OF THE SUPERINTENDENT, AN INSURER OR HEALTH MAINTENANCE
ORGANIZATION ISSUING A CONTRACT FOR QUALIFYING SMALL EMPLOYERS OR INDI-
VIDUALS PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY APPRO-
PRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS
APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S
ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELL-
NESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK
POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE-
ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE-
QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL
WELL-BEING OF ITS PARTICIPANTS:
(1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
A. 9186 13
(2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
CHAPTER; AND
(3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
APPROVED WELLNESS PROGRAM.
S 6. Section 4405 of the public health law is amended by adding a new
subdivision 5-a to read as follows:
5-A. SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT OF FINANCIAL
SERVICES, THE POSSIBLE PROVIDING OF AN ACTUARIALLY APPROPRIATE REDUCTION
IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE
SUPERINTENDENT OF FINANCIAL SERVICES TO ENCOURAGE AN ENROLLEE'S ACTIVE
PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELLNESS
PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK POPU-
LATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE-
ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE-
QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL
WELL-BEING OF ITS PARTICIPANTS:
(1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
(2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THE
INSURANCE LAW; AND
(3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC OUTCOMES AS A
RESULT OF AN ENROLLEE'S ADHERENCE TO THE APPROVED WELLNESS PROGRAM;
S 7. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided that, effective immediately any
rules and regulations necessary to implement the provisions of this act
on its effective date are authorized and directed to be added, amended
and/or repealed on or before such date.
S 2. Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by any court of
A. 9186 14
competent jurisdiction to be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall be confined in
its operation to the clause, sentence, paragraph, subdivision, section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would have been enacted even if such
invalid provisions had not been included herein.
S 3. This act shall take effect immediately provided, however, that
the applicable effective date of Parts A through G of this act shall be
as specifically set forth in the last section of such Parts.