Senate Bill S704A

2017-2018 Legislative Session

Requires mandatory health insurance coverage for prosthetic devices

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Bill Amendments

co-Sponsors

2017-S704 - Details

Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2015-2016: S5943
2019-2020: S5174
2021-2022: S3649
2023-2024: S1315

2017-S704 - Summary

Requires mandatory health insurance coverage for prosthetic devices; requires coverage where the model is determined to be medically necessary for rehabilitative and habilitative purposes.

2017-S704 - Sponsor Memo

2017-S704 - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    704
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                              January 4, 2017
                                ___________
 
 Introduced  by  Sen.  ORTT  --  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  mandatory  health
   insurance coverage for providing prosthetic devices
 
   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 34 to read as follows:
   (34)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
 COMPREHENSIVE TYPE COVERAGE TO A POLICYHOLDER SHALL PROVIDE COVERAGE FOR
 PROSTHETIC DEVICES THAT ARE INTENDED FOR MEDIALLY NECESSARY  REHABILITA-
 TIVE  AND HABILITATIVE PURPOSES AS REQUIRED BY 42 U.S.C. § 18022. COVER-
 AGE SHALL INCLUDE THE  COST  OF  REPAIR  OR  REPLACEMENT  OF  PROSTHETIC
 DEVICES  DUE  TO  NORMAL  WEAR AND TEAR, IF A PROSTHETIC DEVICE HAS BEEN
 OUTGROWN OR NO LONGER FITS PROPERLY, OR WHERE A CHANGE  IN  THE  MEDICAL
 CONDITION  MAKES  REPLACEMENT  NECESSARY. COVERAGE SHALL NOT INCLUDE THE
 COSTS OF REPAIR OR REPLACEMENT OF A PROSTHETIC DEVICE  THAT  IS  COVERED
 UNDER  THE WARRANTY OF THE MANUFACTURE OR WHEN THE REPAIR OR REPLACEMENT
 IS NECESSARY DUE TO MISUSE OR NEGLIGENCE. THE TERM  "PROSTHETIC  DEVICE"
 AS  USED  IN  THIS  PARAGRAPH INCLUDES AN ARTIFICIAL LIMB, BUT SHALL NOT
 INCLUDE SHOES OR  ANY  OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING
 APPAREL,  WHETHER OR NOT SPECIFICALLY CONSTRUCTED. THE TERM "POLICYHOLD-
 ER" AS USED IN THIS PARAGRAPH SHALL MEAN A VETERAN OF THE  ARMED  FORCES
 WHO  RESIDES  IN  THE  STATE OF NEW YORK AND WHOSE MEDICAL NEED FOR SUCH
 PROSTHETIC DEVICE RESULTED FROM AN INJURY SUFFERED WHILE IN ACTIVE  DUTY
 SERVING  IN  THE  ARMED FORCES. 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 ESSENTIAL HEALTH BENEFIT COVERAGE CHOSEN  BY
 THE STATE PURSUANT TO 45 CFR 156.100. NOTHING IN THIS PARAGRAPH SHALL BE
 CONSTRUED  TO  PREVENT  THE  MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

co-Sponsors

2017-S704A (ACTIVE) - Details

Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2015-2016: S5943
2019-2020: S5174
2021-2022: S3649
2023-2024: S1315

2017-S704A (ACTIVE) - Summary

Requires mandatory health insurance coverage for prosthetic devices; requires coverage where the model is determined to be medically necessary for rehabilitative and habilitative purposes.

2017-S704A (ACTIVE) - Sponsor Memo

2017-S704A (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  704--A
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                              January 4, 2017
                                ___________
 
 Introduced  by  Sens. ORTT, CARLUCCI, HAMILTON -- read twice and ordered
   printed, and when printed to be committed to the Committee  on  Insur-
   ance  --  recommitted to the Committee on Insurance in accordance with
   Senate Rule 6, sec. 8 -- committee discharged, bill  amended,  ordered
   reprinted as amended and recommitted to said committee

 AN  ACT  to  amend  the  insurance  law, in relation to mandatory health
   insurance coverage for providing prosthetic devices
 
   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 34 to read as follows:
   (34) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
 COMPREHENSIVE TYPE COVERAGE TO A POLICYHOLDER SHALL PROVIDE COVERAGE FOR
 PROSTHETIC  DEVICES THAT ARE INTENDED FOR MEDIALLY NECESSARY REHABILITA-
 TIVE AND HABILITATIVE PURPOSES AS REQUIRED BY 42 U.S.C. § 18022.  COVER-
 AGE  SHALL  INCLUDE  THE  COST  OF  REPAIR  OR REPLACEMENT OF PROSTHETIC
 DEVICES DUE TO NORMAL WEAR AND TEAR, IF A  PROSTHETIC  DEVICE  HAS  BEEN
 OUTGROWN  OR  NO  LONGER FITS PROPERLY, OR WHERE A CHANGE IN THE MEDICAL
 CONDITION MAKES REPLACEMENT NECESSARY. COVERAGE SHALL  NOT  INCLUDE  THE
 COSTS  OF  REPAIR  OR REPLACEMENT OF A PROSTHETIC DEVICE THAT IS COVERED
 UNDER THE WARRANTY OF THE MANUFACTURE OR WHEN THE REPAIR OR  REPLACEMENT
 IS  NECESSARY  DUE TO MISUSE OR NEGLIGENCE. THE TERM "PROSTHETIC DEVICE"
 AS USED IN THIS PARAGRAPH INCLUDES AN ARTIFICIAL  LIMB,  BUT  SHALL  NOT
 INCLUDE  SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING
 APPAREL, WHETHER OR NOT SPECIFICALLY CONSTRUCTED. THE TERM  "POLICYHOLD-
 ER"  AS  USED IN THIS PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES
 WHO RESIDES IN THE STATE OF NEW YORK AND WHOSE  MEDICAL  NEED  FOR  SUCH
 PROSTHETIC  DEVICE RESULTED FROM AN INJURY SUFFERED WHILE IN ACTIVE DUTY
 SERVING IN THE ARMED FORCES. 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

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