S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5272
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 12, 2021
                                ___________
 
 Introduced  by M. of A. SOLAGES, THIELE -- read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance  law,  in  relation  to  requiring  health
   insurance  policies to include coverage for doula services as required
   coverage for maternity care

   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 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 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 DOULA AND 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.
   § 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 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD06563-01-1

 A. 5272                             2
 
 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 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 DOULA AND THE SERVICES OF
 A  midwife  licensed pursuant to article one hundred forty of the educa-
 tion 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 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.
   § 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 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  mother  and for newborn for at least forty-eight hours after child-
 birth for any delivery other than a caesarean section, and for at  least
 ninety-six hours following a caesarean section. Such coverage for mater-
 nity  care  shall  include the services of a DOULA AND 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 pursuant 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.
   § 4. This act shall take effect on the one hundred eightieth day after
 it shall have become a law and shall apply to all policies and contracts
 issued,  renewed,  modified,  altered  or amended on or after such date.
 Effective immediately the addition, amendment 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.