S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   10086
 
                           I N  A S S E M B L Y
 
                              March 10, 2020
                                ___________
 
 Introduced  by M. of A. REYES -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the social  services  law  and  the  insurance  law,  in
   relation to coverage for the treatment of asthma
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Paragraph (r) of subdivision 2  of  section  365-a  of  the
 social  services  law, as added by section 32 of part C of chapter 58 of
 the laws of 2008, is amended to read as follows:
   (r) asthma self-management training services for persons OR PARENTS OF
 PERSONS diagnosed with asthma INCLUDING INFORMATION  ON  PROPER  USE  OF
 DEVICES SUCH AS SPACERS, VALVED HOLDING CHAMBERS AND MASKS, AND TRIGGERS
 IN  THE  ENVIRONMENT  WHICH  SHOULD  BE  AVOIDED  OR  MANAGED, when such
 services are ordered by a physician, registered  physician's  assistant,
 registered  nurse  practitioner,  or  licensed midwife and provided by a
 licensed, registered, or certified health care professional,  as  deter-
 mined  by  the  commissioner  of  health,  who is certified as an asthma
 educator by the National  Asthma  Educator  Certification  Board,  or  a
 successor  national  certification  board;  provided,  however, that the
 provisions of this paragraph shall not take effect unless all  necessary
 approvals under federal law and regulation have been obtained to receive
 federal  financial  participation  in  the costs of health care services
 provided pursuant to this paragraph.  Nothing in this paragraph shall be
 construed to modify any licensure, certification or  scope  of  practice
 provision under title eight of the education law.
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 15-b to read as follows:
   (15-B)  (A) EVERY POLICY 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 FOR THE
 TREATMENT OF ASTHMA, AND FOR CHILDREN UNDER NINETEEN YEARS OF AGE  ADDI-
 TIONAL  EQUIPMENT  AND  SUPPLIES  FOR  USE  IN SCHOOL, IF RECOMMENDED OR
 PRESCRIBED BY A PHYSICIAN OR OTHER LICENSED HEALTH CARE PROVIDER LEGALLY
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD14651-01-0

 A. 10086                            2
 
 AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW:   RESCUE
 INHALER  TREATMENTS  AND  NEBULIZERS;  SPACERS, VALVED HOLDING CHAMBERS,
 MASKS AND/OR OTHER SUCH DEVICES USED TO  ASSIST  IN  GETTING  MEDICATION
 INTO  THE  LUNGS.  IN  ADDITION,  THE  COMMISSIONER OF THE DEPARTMENT OF
 HEALTH SHALL PROVIDE AND PERIODICALLY UPDATE BY  RULE  OR  REGULATION  A
 LIST  OF  ADDITIONAL  ASTHMA  EQUIPMENT AND RELATED SUPPLIES SUCH AS ARE
 MEDICALLY NECESSARY FOR THE TREATMENT OF ASTHMA, FOR WHICH  THERE  SHALL
 ALSO  BE  COVERAGE. SUCH POLICIES SHALL ALSO INCLUDE COVERAGE FOR ASTHMA
 SELF-MANAGEMENT  EDUCATION  TO  ENSURE  THAT  PERSONS  WITH  ASTHMA,  OR
 PERSON'S  WHO  HAVE  A CHILD OR CHILDREN WITH ASTHMA, ARE EDUCATED AS TO
 THE PROPER SELF-MANAGEMENT AND TREATMENT OF THEIR  CONDITION,  INCLUDING
 INFORMATION  ON  PROPER  USE  OF DEVICES AND TRIGGERS IN THE ENVIRONMENT
 WHICH SHOULD BE AVOIDED OR MANAGED. SUCH  COVERAGE  FOR  SELF-MANAGEMENT
 EDUCATION  AND  EDUCATION RELATING TO DEVICES SHALL BE LIMITED TO VISITS
 MEDICALLY NECESSARY UPON THE DIAGNOSIS  OF  ASTHMA,  WHERE  A  PHYSICIAN
 DIAGNOSES  A  SIGNIFICANT CHANGE IN THE PATIENT'S SYMPTOMS OR CONDITIONS
 WHICH NECESSITATE CHANGES IN A PATIENT'S SELF-MANAGEMENT, OR WHERE REED-
 UCATION OR REFRESHER EDUCATION  IS  NECESSARY.  SUCH  EDUCATION  MAY  BE
 PROVIDED BY THE PHYSICIAN OR OTHER LICENSED HEALTH CARE PROVIDER LEGALLY
 AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW, OR THEIR
 STAFF,  AS PART OF AN OFFICE VISIT FOR ASTHMA DIAGNOSIS OR TREATMENT, OR
 BY A CERTIFIED ASTHMA NURSE EDUCATOR, UPON THE REFERRAL OF  A  PHYSICIAN
 OR  OTHER  LICENSED HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
 UNDER TITLE EIGHT OF THE EDUCATION LAW. EDUCATION PROVIDED BY THE CERTI-
 FIED ASTHMA NURSE EDUCATOR, MAY BE LIMITED TO  GROUP  SETTINGS  WHEREVER
 PRACTICABLE. COVERAGE FOR SELF-MANAGEMENT EDUCATION AND EDUCATION RELAT-
 ING TO DEVICES SHALL ALSO INCLUDE HOME VISITS WHEN MEDICALLY NECESSARY.
   (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
 AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
 WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
   § 3. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22)  (A)  EVERY  POLICY 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 FOR THE
 TREATMENT OF ASTHMA, AND FOR CHILDREN UNDER NINETEEN YEARS OF AGE  ADDI-
 TIONAL  EQUIPMENT  AND  SUPPLIES  FOR  USE  IN SCHOOL, IF RECOMMENDED OR
 PRESCRIBED BY A PHYSICIAN OR OTHER LICENSED HEALTH CARE PROVIDER LEGALLY
 AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION  LAW:  RESCUE
 INHALER  TREATMENTS  AND  NEBULIZERS;  SPACERS, VALVED HOLDING CHAMBERS,
 MASKS AND/OR OTHER SUCH DEVICES USED TO  ASSIST  IN  GETTING  MEDICATION
 INTO  THE  LUNGS.  IN  ADDITION,  THE  COMMISSIONER OF THE DEPARTMENT OF
 HEALTH SHALL PROVIDE AND PERIODICALLY UPDATE BY  RULE  OR  REGULATION  A
 LIST  OF  ADDITIONAL  ASTHMA  EQUIPMENT AND RELATED SUPPLIES SUCH AS ARE
 MEDICALLY NECESSARY FOR THE TREATMENT OF ASTHMA, FOR WHICH  THERE  SHALL
 ALSO  BE  COVERAGE. SUCH POLICIES SHALL ALSO INCLUDE COVERAGE FOR ASTHMA
 SELF-MANAGEMENT  EDUCATION  TO  ENSURE  THAT  PERSONS  WITH  ASTHMA,  OR
 PERSON'S  WHO  HAVE  A CHILD OR CHILDREN WITH ASTHMA, ARE EDUCATED AS TO
 THE PROPER SELF-MANAGEMENT AND TREATMENT OF THEIR  CONDITION,  INCLUDING
 INFORMATION  ON  PROPER  USE  OF DEVICES AND TRIGGERS IN THE ENVIRONMENT
 WHICH SHOULD BE AVOIDED OR MANAGED. SUCH  COVERAGE  FOR  SELF-MANAGEMENT
 EDUCATION  AND  EDUCATION RELATING TO DEVICES SHALL BE LIMITED TO VISITS
 MEDICALLY NECESSARY UPON THE DIAGNOSIS  OF  ASTHMA,  WHERE  A  PHYSICIAN
 DIAGNOSES  A  SIGNIFICANT CHANGE IN THE PATIENT'S SYMPTOMS OR CONDITIONS
 WHICH NECESSITATE CHANGES IN A PATIENT'S SELF-MANAGEMENT, OR WHERE REED-

 A. 10086                            3
 
 UCATION OR REFRESHER EDUCATION  IS  NECESSARY.  SUCH  EDUCATION  MAY  BE
 PROVIDED BY THE PHYSICIAN OR OTHER LICENSED HEALTH CARE PROVIDER LEGALLY
 AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW, OR THEIR
 STAFF,  AS PART OF AN OFFICE VISIT FOR ASTHMA DIAGNOSIS OR TREATMENT, OR
 BY A CERTIFIED ASTHMA NURSE EDUCATOR, UPON THE REFERRAL OF  A  PHYSICIAN
 OR  OTHER  LICENSED HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
 UNDER TITLE EIGHT OF THE EDUCATION LAW. EDUCATION PROVIDED BY THE CERTI-
 FIED ASTHMA NURSE EDUCATOR, MAY BE LIMITED TO  GROUP  SETTINGS  WHEREVER
 PRACTICABLE. COVERAGE FOR SELF-MANAGEMENT EDUCATION AND EDUCATION RELAT-
 ING TO DEVICES SHALL ALSO INCLUDE HOME VISITS WHEN MEDICALLY NECESSARY.
   (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
 AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
 WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
   §  4. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a law and shall apply to  all
 policies issued, renewed, altered or modified on or after such date.