NY State Senate Bill 2019-S8526

Senate Bill S8526

2019-2020 Legislative Session

Requires the provision of additional insurance coverage for pre-term labor hospitalizations, monitoring and counseling

download bill text pdf

Archive: Last Bill Status - In Senate Committee Rules 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
Jun 08, 2020	referred to rules

2019-S8526 (ACTIVE) - Details

See Assembly Version of this Bill:: A10314
Current Committee:: Senate Rules
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2021-2022: A7492
2023-2024: A1096

2019-S8526 (ACTIVE) - Summary

Requires insurance policies to provide coverage for pre-term labor hospitalizations, home visits to monitor pre-term labor patients and counseling.

2019-S8526 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S8526

SPONSOR: MONTGOMERY
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring insurance
policies to provide coverage for pre-term labor hospitalizations, home
visits to monitor pre-term labor patients and counseling

 
PURPOSE OR GENERAL IDEA OF BILL:

The purpose of this bill is to have healthcare services provided to
expectant mothers in pre-term labor covered by insurance carriers.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends item (i) of subparagraph (A) of paragraph 10 of
subsection (i) of section 3216 of the insurance law as amended by chap-
ter 238 of the laws of 2010 to include two new subparagraphs

(C)and (D). Adding expectant mothers in pre-term labor. Subparagraph

(C) includes provision for part-time or intermittent home nursing care
by or under the supervision of registered professional nurse to monitor
expectant mothers diagnosed by physicians as having experienced pre-term
labor; and for administration of Makena

(17-alpha hydroxyprogesterone). Subparagraph (D) includes provision for
visit with a physician, psychiatrist or psychologist or licensed clin-
ical social worker to provide services for treatment of mental, nervous
or emotional disorders and ailments for assistance with emotional issues
experienced by expectant mothers and the family for expectant mothers
who: lost a fetus through miscarriage or stillbirth; lost a child within
a month of birth; or diagnosed as having experienced pre-term labor.

Section 2 amends item (i) of subparagraph (A) of paragraph 5 of
subsection (k) of section 3221 of the insurance law as amended by chap-
ter 238 of the laws of 2010 to include two new subparagraphs

(C)and (D). Adding expectant mothers in pre-term labor. Subparagraph

(C) includes provision for part-time or intermittent home nursing care
by or under the supervision of registered professional nurse to monitor
expectant mothers diagnosed by physicians as having experienced pre-term
labor; and for administration of Makena

(17-alpha hydroxyprogesterone). Subparagraph (D) includes provision for
visit with a physician, psychiatrist or psychologist or licensed clin-
ical social worker to provide services for treatment of mental, nervous
or emotional disorders and ailments for assistance with emotional issues
experienced by expectant mothers and the family for expectant mothers
who: lost a fetus through miscarriage or stillbirth; lost a child within
a month of birth; or diagnosed as having experienced pre-term labor.

Section 3 amends subparagraph (A) of paragraph 1 of subsection (c) of
section 4303 the insurance law as amended by chapter 238 of the laws of
2010 to include two new paragraphs 3 and 4. Adding expectant mothers in
pre-term labor. Paragraph 3 includes provision for part-time or inter-
mittent home nursing care by or under the supervision of registered
professional nurse to monitor expectant mothers diagnosed by physicians
as having experienced pre-term labor; and for administration of Makena
(17-alpha hydroxyprogesterone)".  Paragraph 4 includes provision for
visit with a physician, psychiatrist or psychologist or licensed clin-
ical social worker to provide services for treatment of mental, nervous
or emotional disorders and ailments for assistance with emotional issues
experienced by expectant mothers and the family for expectant mothers
who: lost a fetus through miscarriage or stillbirth; lost a child within
a month of birth; or diagnosed as having experienced pre-term labor.

Section 4 This act shall take effect on the sixtieth day after it shall
have become a law. Effective immediately the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of
this act on its effective date are authorized to be made and completed
on or before such date.

 
JUSTIFICATION:

In October of 2016, Assemblymember Rodneyse Bichotte, pregnant at 22
weeks, entered the New York Presbyterian/Columbia University Medical
Hospital after discovering she was dilating at 3cm. Hunched over the
hospital desk in emotional pain, awaiting to see the Doctor in the exam-
ination room, she was soon to be notified of the worst news an expectant
mother can receive - both she and her unborn baby were in an incredibly
fatal and high risk situation. Knowing the risks associated with Assem-
blymember Bichotte's condition, the Doctors at New York Presbyterian
Columbia University Hospital discharged and forcefully released her
citing "hospital policy". They claimed they could not intervene before
23 weeks and refused her a bed for monitoring at the hospital. She was,
therefore, denied the safe care of medical professionals to herself and
her unborn child. Several days later, Assemblymember Rodneyse Bichotte
was admitted to Wyckoff Heights Medical Center and delivered her still-
born son, Jonah Bichotte Cowan.

Pre-term labor, a proxy of pre-term birth, accounts for 17% of all
infant deaths in America and devastates the growth of premature babies,
making them especially vulnerable to the environment. One in 10 families
across the country and New York State will face the same unfortunate
narrative of a high-risk pregnancy and mistreatment at the hands of
medical professionals. At such a sensitive stage in a woman's pregnancy,
health coverage for needed services should not be a factor.

This bill ensures that the care and treatment provided to expectant
mothers are covered by insurance carriers, and that they and their fami-
ly have access to services that assist with emotional issues experience
by the expectant mother.

 
PRIOR LEGISLATIVE HISTORY:

New Bill

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None

 
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become a law. Effective immediately the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of
this act on its effective date are authorized to be made and completed
on or before such date.

2019-S8526 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8526
 
                             I N  S E N A T E
 
                               June 8, 2020
                                ___________
 
 Introduced  by  Sen.  MONTGOMERY  -- read twice and ordered printed, and
   when printed to be committed to the Committee on Rules
 
 AN ACT to amend the insurance law, in relation  to  requiring  insurance
   policies to provide coverage for pre-term labor hospitalizations, home
   visits to monitor pre-term labor patients and counseling
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Item (i) of subparagraph (A) of paragraph 10 of subsection
 (i) of section 3216 of the insurance law, as amended by chapter  238  of
 the  laws  of 2010, is amended and two new subparagraphs (C) and (D) are
 added to read as follows:
   (i) Every policy which provides hospital, surgical or medical coverage
 shall provide coverage for maternity care, including hospital,  surgical
 or  medical  care  to the same extent that hospital, surgical or medical
 coverage is provided for illness  or  disease  under  the  policy.  Such
 maternity  care  coverage,  other  than  coverage  for perinatal compli-
 cations, shall include inpatient hospital coverage FOR EXPECTANT MOTHERS
 IN PRE-TERM LABOR,  INPATIENT  HOSPITAL  COVERAGE  for  mother  and  for
 newborn for at least forty-eight hours after childbirth for any delivery
 other  than a caesarean section, and for at least ninety-six hours after
 a caesarean section. Such coverage for maternity care shall include  the
 services  of a midwife licensed pursuant to article one hundred forty of
 the education law, practicing consistent with section sixty-nine hundred
 fifty-one of the education law and affiliated or practicing in  conjunc-
 tion  with  a  facility licensed pursuant to article twenty-eight of the
 public health law, but no insurer shall be required to pay for  duplica-
 tive routine services actually provided by both a licensed midwife and a
 physician.
   (C)  COVERAGE  PROVIDED  UNDER  THIS SUBSECTION FOR CARE AND TREATMENT
 DURING PREGNANCY SHALL INCLUDE PROVISION FOR PART-TIME  OR  INTERMITTENT
 HOME  NURSING  CARE  BY OR UNDER THE SUPERVISION OF A REGISTERED PROFES-
 SIONAL NURSE TO MONITOR EXPECTANT MOTHERS WHO HAVE BEEN DIAGNOSED  BY  A
 PHYSICIAN  AS  HAVING  EXPERIENCED  PRE-TERM LABOR, AND FOR THE ADMINIS-
 TRATION OF MAKENA (17-ALPHA HYDROXYPROGESTERONE) BY SUCH NURSE. AS  USED
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD16189-01-0

 S. 8526                             2
 
 IN  THIS  SUBSECTION, "PRE-TERM LABOR" MEANS THE COMMENCEMENT OF REGULAR
 CONTRACTIONS OF THE UTERUS CAUSING PALPABLE CHANGES IN THE  CERVIX  THAT
 START BETWEEN TWENTY WEEKS AND THIRTY-SIX WEEKS AND SIX DAYS OF PREGNAN-
 CY, INCLUDING, BUT NOT LIMITED TO, EFFACEMENT AND DILATION.
   (D)  COVERAGE  PROVIDED  UNDER  THIS SUBSECTION FOR CARE AND TREATMENT
 DURING PREGNANCY SHALL INCLUDE PROVISIONS FOR VISITS WITH  A  PHYSICIAN,
 PSYCHIATRIST OR PSYCHOLOGIST OR A LICENSED CLINICAL SOCIAL WORKER WITHIN
 THE  LAWFUL  SCOPE  OF  HIS  OR HER PRACTICE WHO PROVIDES PSYCHIATRIC OR
 PSYCHOLOGICAL SERVICES OR FOR THE DIAGNOSIS  AND  TREATMENT  OF  MENTAL,
 NERVOUS   OR  EMOTIONAL  DISORDERS  AND  AILMENTS  FOR  ASSISTANCE  WITH
 EMOTIONAL ISSUES EXPERIENCED BY AN EXPECTANT MOTHER AND THE FAMILY OF AN
 EXPECTANT MOTHER WHO HAS:
   (I) LOST A FETUS THROUGH MISCARRIAGE OR STILLBIRTH;
   (II) LOST A CHILD WITHIN A MONTH AFTER THE BIRTH OF THE CHILD; OR
   (III) BEEN DIAGNOSED BY A PHYSICIAN  AS  HAVING  EXPERIENCED  PRE-TERM
 LABOR.
   §  2. Item (i) of subparagraph (A) of paragraph 5 of subsection (k) of
 section 3221 of the insurance law, as amended by chapter 238 of the laws
 of 2010, is amended and two new subparagraphs (C) and (D) are  added  to
 read as follows:
   (i)  Every group or blanket policy delivered or issued for delivery in
 this state which provides hospital, surgical or medical  coverage  shall
 include  coverage  for  maternity  care, including hospital, surgical or
 medical care to the same extent that coverage is provided for illness or
 disease under the policy.  Such  maternity  care  coverage,  other  than
 coverage  for  perinatal complications, shall include inpatient hospital
 coverage FOR EXPECTANT MOTHERS IN  PRE-TERM  LABOR,  INPATIENT  HOSPITAL
 COVERAGE  for  mother  and  newborn for at least forty-eight hours after
 childbirth for any delivery other than a caesarean section, and  for  at
 least  ninety-six  hours  after  a  caesarean section. Such coverage for
 maternity care shall include the services of a midwife licensed pursuant
 to article one hundred forty of the education law, practicing consistent
 with section sixty-nine hundred  fifty-one  of  the  education  law  and
 affiliated  or practicing in conjunction with a facility licensed pursu-
 ant to article twenty-eight of the public health  law,  but  no  insurer
 shall  be  required  to  pay  for  duplicative routine services actually
 provided by both a licensed midwife and a physician.
   (C) COVERAGE PROVIDED UNDER THIS SUBSECTION  FOR  CARE  AND  TREATMENT
 DURING  PREGNANCY  SHALL INCLUDE PROVISION FOR PART-TIME OR INTERMITTENT
 HOME NURSING CARE BY OR UNDER THE SUPERVISION OF  A  REGISTERED  PROFES-
 SIONAL  NURSE  TO MONITOR EXPECTANT MOTHERS WHO HAVE BEEN DIAGNOSED BY A
 PHYSICIAN AS HAVING EXPERIENCED PRE-TERM LABOR,  AND  FOR  THE  ADMINIS-
 TRATION  OF MAKENA (17-ALPHA HYDROXYPROGESTERONE) BY SUCH NURSE. AS USED
 IN THIS SUBSECTION, "PRE-TERM LABOR" MEANS THE COMMENCEMENT  OF  REGULAR
 CONTRACTIONS  OF  THE UTERUS CAUSING PALPABLE CHANGES IN THE CERVIX THAT
 START BETWEEN TWENTY WEEKS AND THIRTY-SIX WEEKS AND SIX DAYS OF PREGNAN-
 CY, INCLUDING, BUT NOT LIMITED TO, EFFACEMENT AND DILATION.
   (D) COVERAGE PROVIDED UNDER THIS SUBSECTION  FOR  CARE  AND  TREATMENT
 DURING  PREGNANCY  SHALL INCLUDE PROVISIONS FOR VISITS WITH A PHYSICIAN,
 PSYCHIATRIST OR PSYCHOLOGIST OR A LICENSED CLINICAL SOCIAL WORKER WITHIN
 THE LAWFUL SCOPE OF HIS OR HER  PRACTICE  WHO  PROVIDES  PSYCHIATRIC  OR
 PSYCHOLOGICAL  SERVICES  OR  FOR  THE DIAGNOSIS AND TREATMENT OF MENTAL,
 NERVOUS  OR  EMOTIONAL  DISORDERS  AND  AILMENTS  FOR  ASSISTANCE   WITH
 EMOTIONAL ISSUES EXPERIENCED BY AN EXPECTANT MOTHER AND THE FAMILY OF AN
 EXPECTANT MOTHER WHO HAS:
   (I) LOST A FETUS THROUGH MISCARRIAGE OR STILLBIRTH;

 S. 8526                             3
 
   (II) LOST A CHILD WITHIN A MONTH AFTER THE BIRTH OF THE CHILD; OR
   (III)  BEEN  DIAGNOSED  BY  A PHYSICIAN AS HAVING EXPERIENCED PRE-TERM
 LABOR.
   § 3. Subparagraph (A) of paragraph 1 of subsection (c) of section 4303
 of the insurance law, as amended by chapter 238 of the laws of 2010,  is
 amended and two new paragraphs 3 and 4 are added to read as follows:
   (A)  Every  contract issued by a corporation subject to the provisions
 of this article which provides hospital service, medical expense  indem-
 nity  or both shall provide coverage for maternity care including hospi-
 tal, surgical or medical care to the same extent that hospital  service,
 medical  expense  indemnity  or both are provided for illness or disease
 under the contract. Such maternity care coverage,  other  than  coverage
 for  perinatal  complications, shall include inpatient hospital coverage
 FOR EXPECTANT MOTHERS IN PRE-TERM LABOR, INPATIENT HOSPITAL COVERAGE for
 mother and for newborn for at least forty-eight hours  after  childbirth
 for  any delivery other than a caesarean section, and for at least nine-
 ty-six hours following a caesarean section. Such coverage for  maternity
 care  shall include the services of a midwife licensed pursuant to arti-
 cle one hundred forty of the education law, practicing  consistent  with
 section sixty-nine hundred fifty-one of the education law and affiliated
 or  practicing in conjunction with a facility licensed pursuant to arti-
 cle twenty-eight of the public health  law,  but  no  insurer  shall  be
 required  to  pay  for duplicative routine services actually provided by
 both a licensed midwife and a physician.
   (3) COVERAGE PROVIDED UNDER THIS SUBSECTION  FOR  CARE  AND  TREATMENT
 DURING  PREGNANCY  SHALL INCLUDE PROVISION FOR PART-TIME OR INTERMITTENT
 HOME NURSING CARE BY OR UNDER THE SUPERVISION OF  A  REGISTERED  PROFES-
 SIONAL  NURSE  TO MONITOR EXPECTANT MOTHERS WHO HAVE BEEN DIAGNOSED BY A
 PHYSICIAN AS HAVING EXPERIENCED PRE-TERM LABOR,  AND  FOR  THE  ADMINIS-
 TRATION  OF MAKENA (17-ALPHA HYDROXYPROGESTERONE) BY SUCH NURSE. AS USED
 IN THIS SUBSECTION, "PRE-TERM LABOR" MEANS THE COMMENCEMENT  OF  REGULAR
 CONTRACTIONS  OF  THE UTERUS CAUSING PALPABLE CHANGES IN THE CERVIX THAT
 START BETWEEN TWENTY WEEKS AND THIRTY-SIX WEEKS AND SIX DAYS OF PREGNAN-
 CY, INCLUDING, BUT NOT LIMITED TO, EFFACEMENT AND DILATION.
   (4) COVERAGE PROVIDED UNDER THIS SUBSECTION  FOR  CARE  AND  TREATMENT
 DURING  PREGNANCY  SHALL INCLUDE PROVISIONS FOR VISITS WITH A PHYSICIAN,
 PSYCHIATRIST OR PSYCHOLOGIST OR A LICENSED CLINICAL SOCIAL WORKER WITHIN
 THE LAWFUL SCOPE OF HIS OR HER  PRACTICE  WHO  PROVIDES  PSYCHIATRIC  OR
 PSYCHOLOGICAL  SERVICES  OR  FOR  THE DIAGNOSIS AND TREATMENT OF MENTAL,
 NERVOUS  OR  EMOTIONAL  DISORDERS  AND  AILMENTS  FOR  ASSISTANCE   WITH
 EMOTIONAL ISSUES EXPERIENCED BY AN EXPECTANT MOTHER AND THE FAMILY OF AN
 EXPECTANT MOTHER WHO HAS:
   (A) LOST A FETUS THROUGH MISCARRIAGE OR STILLBIRTH;
   (B) LOST A CHILD WITHIN A MONTH AFTER THE BIRTH OF THE CHILD; OR
   (C)  BEEN  DIAGNOSED  BY  A  PHYSICIAN  AS HAVING EXPERIENCED PRE-TERM
 LABOR.
   § 4. This act shall take effect on the sixtieth  day  after  it  shall
 have become a law.  Effective immediately the addition, amendment and/or
 repeal  of  any  rule  or regulation necessary for the implementation of
 this act on its effective date are authorized to be made  and  completed
 on or before such date.

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