NY State Senate Bill 2019-S7373

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 22, 2020	referred to insurance

2019-S7373 (ACTIVE) - Details

See Assembly Version of this Bill:: A3086
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: A770
2011-2012: A497
2013-2014: A1103
2015-2016: A1178
2017-2018: A2212
2021-2022: A4120
2023-2024: A4395

2019-S7373 (ACTIVE) - Summary

Relates to mandatory health insurance coverage for providing prosthetic devices.

2019-S7373 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S7373

SPONSOR: METZGER
 
TITLE OF BILL:

An act to amend the insurance law, in relation to mandatory health
insurance coverage for providing prosthetic devices

 
PURPOSE OR GENERAL IDEA OF BILL:

To provide mandatory coverage for prosthetic devises for children who
periodically need to have these devices altered or replaced due to
normal physical growth, for adults whose conditions change and to
account for updated technology, repair and replacement.

 
SUMMARY OF SPECIFIC PROVISIONS:

In order to mandate coverage by health insurance providers for prosthet-
ic devices:

Section 1 of the bill amends Subsection (i) of Section 3216 of the

Insurance Law by adding a new paragraph 35

Section 2 of the bill amends Subsection (1) of Section 3221 of the
Insurance Law by adding a new paragraph 21

Section 3 of the bill amends Section 4303 of the Insurance Law by adding
a new subsection (ss)

 
JUSTIFICATION:

Though not as common as in adults, children, even infants may need a
prosthetic device due to the loss of a limb. The overwhelming experience
for a child of losing a limb does not need to be compounded by a long
battle to pay for treatment. This legislation will provide coverage to
children and adults for prosthetic devices and to replace or change
these devices as needed to account for natural growth and repairs of
such devices.

 
LEGISLATIVE HISTORY:

2017-18: S.2080 (Bonacic) - referred to insurance
2015-16: S.1708-C (Bonacic)- referred to insurance
2013-14: S.3951-A (Bonacic)- referred to insurance
2009-10: S.2893 (Bonacic)- referred to insurance
2007-08: S.1672 (Bonacic)- referred to insurance
2005-06: 5.599 (Bonacic)- referred to insurance

 
FISCAL IMPLICATIONS:

None to the state.

 
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law and shall apply to policies and contracts issued, renewed,
modified, altered or amended on or after such effective date.

2019-S7373 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7373
 
                             I N  S E N A T E
 
                             January 22, 2020
                                ___________
 
 Introduced  by  Sen. METZGER -- 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 36 to read as follows:
   (36)  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 OF 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.
   § 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
 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 OF 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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD01454-03-0

 S. 7373                             2

   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (ss) to read as follows:
   (SS)  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 SUBSECTION INCLUDES AN ARTIFICIAL LIMB AND ALL  OF  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.
   § 4. This act shall take effect on the ninetieth day  after  it  shall
 have  become  a  law  and  shall apply to policies and contracts issued,
 renewed, modified, altered or amended on or after such effective date.

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Senate Bill S7373

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

2019-S7373 (ACTIVE) - Details

2019-S7373 (ACTIVE) - Summary

2019-S7373 (ACTIVE) - Sponsor Memo

2019-S7373 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S7373

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Sponsored By

Jen Metzger

Archive: Last Bill Status - In Senate Committee Insurance Committee

2019-S7373 (ACTIVE) - Details

2019-S7373 (ACTIVE) - Summary

2019-S7373 (ACTIVE) - Sponsor Memo

2019-S7373 (ACTIVE) - Bill Text download pdf

Comments