Assembly Bill A6286

2019-2020 Legislative Session

Requires mandatory health insurance coverage for prosthetic devices

download bill text pdf

Sponsored By

Archive: Last Bill Status - Stricken

  • 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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2019-A6286 (ACTIVE) - Details

Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2013-2014: A6820
2015-2016: A7549, A7545
2017-2018: A6304

2019-A6286 (ACTIVE) - Summary

Requires mandatory health insurance coverage for certain individuals with prosthetic limbs; requires coverage where the model is determined to adequately meet the medical needs of the policy holder.

2019-A6286 (ACTIVE) - Bill Text download pdf 

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6286
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 4, 2019
                                ___________
 
 Introduced  by  M.  of A. CRESPO, RAIA, RIVERA, PALMESANO -- Multi-Spon-
   sored by -- M. of A. ARROYO, DAVILA, JOYNER, LAVINE, PICHARDO,  RODRI-
   GUEZ -- read once and referred to the Committee on Insurance
 
 AN  ACT  to  amend  the  insurance  law, in relation to mandatory health
   insurance coverage for 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 35 to read as follows:
   (35) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
 COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
 DEVICES, INCLUDING REPAIRS  AND  REPLACEMENTS,  THAT  ARE  INTENDED  FOR
 MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
 BY  42  U.S.C.    §  18022. AS SUCH, PROSTHETIC DEVICE COVERAGE SHALL BE
 SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED  APPROPRIATE  BY
 THE  SUPERINTENDENT  IN  AMOUNTS  NO GREATER THAN OTHER ESSENTIAL HEALTH
 BENEFITS COVERED BY THE POLICY. THE TERM "PROSTHETIC DEVICE" AS USED  IN
 THIS  PARAGRAPH  INCLUDES  AN ARTIFICIAL LIMB AND ALL THE COMPONENTS AND
 RELATED SERVICES THAT COMPRISE PROSTHETIC CARE  BUT  SHALL  NOT  INCLUDE
 SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING APPAREL,
 WHETHER OR NOT SPECIALLY CONSTRUCTED.  THE TERM "POLICY HOLDER" 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 IN THE LINE OF DUTY WHILE SERV-
 ING IN THE ARMED FORCES.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 21 to read as follows:
   (21) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
 COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
 DEVICES, INCLUDING REPAIRS  AND  REPLACEMENTS,  THAT  ARE  INTENDED  FOR
 MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

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