NY State Senate Bill 2021-S4801

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 05, 2022	referred to insurance
Feb 12, 2021	referred to insurance

2021-S4801 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2013-2014: S5390
2015-2016: S2574, S5350
2017-2018: S2875
2019-2020: S4259
2023-2024: S6039

2021-S4801 (ACTIVE) - Summary

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

2021-S4801 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S4801

SPONSOR: PARKER
 
TITLE OF BILL:

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

 
PURPOSE OR GENERAL IDEA OF THE BILL:

TO ENSURE THAT COVERAGE FOR REHABILITATIVE AND HABILITATIVE SERVICES,
INCLUDING PROSTHETIC DEVICES, ARE AVAILABLE TO MILITARY VETERANS RESID-
ING IN NYS.

 
SUMMARY OF SPECIFIC PROVISIONS:

THIS BILL WOULD REQUIRE THAT HEALTH INSURERS THAT PROVIDE MEDICAL,
MAJOR, MEDICAL, OR SIMILAR COMPREHENSIVE TYPE COVERAGE AND COVER DURABLE
MEDICAL EQUIPMENT INCLUDE COVERAGE FOR PROSTHETIC DEVICES FOR VETERANS
OF THE ARMED FORCES WHO ARE RESIDENTS OF NEW YORK ON PARITY WITH THE
COVERAGE FOR DURABLE MEDICAL, EQUIPMENT.

 
JUSTIFICATION:

TWO RECENT WARS INVOLVING THE UNITED STATES, IRAQ AND AFGHANISTAN HAS
LEFT OVER 600 MILITARY MEN AND WOMEN AS AMPUTEES WITH LIFE-LONG INJU-
RIES. EACH YEAR 185,000 AMPUTATIONS OCCUR IN THE US AND THERE ARE NEARLY
2 MILLION PEOPLE LIVING WITH LIMB LOSS IN THE US. IMPROVING ACCESS TO
QUALITY AND UPDATED PROSTHETIC DEVICES WILL IMPROVE THE QUALITY OF LIFE
OF VETERANS AND OTHER AMPUTEES, WHILE HELPING TO REDUCE OTHER MEDICAL
COSTS RELATED TO LACK OF MOBILITY AND ASSOCIATED PHYSICAL AND EMOTIONAL
HEALTH.

ACCORDING TO THE VETERANS HEALTH ADMINISTRATION, APPROXIMATELY 6 PERCENT
OF WOUNDED SERVICE MEMBERS RETURNING FROM IRAQ ARE INDIVIDUALS WITH
AMPUTATIONS. AS A SOCIETY, WE OWE THESE VETERANS THE BEST OF OUR EFFORTS
TO HELP THEM LIVE IMPROVED LIVES AFTER THEIR SACRIFICE FOR OUR NATION.

 
PRIOR LEGISLATIVE HISTORY:

2019-20: 5.4259 - REFERRED TO INSURANCE

2017-18: 5.2875 - REFERRED TO INSURANCE

2015-16: 5.2574A - AMEND AND RECOMMIT TO INSURANCE

2013-14: 5.5390C/A.6820C - REFERRED TO INSURANCE/PASSED ASSEMBLY

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENT:

NONE

 
EFFECTIVE DATE:
THIS ACT SHALL TAKE EFFECT MAY 1, 2023.

2021-S4801 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4801
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             February 12, 2021
                                ___________
 
 Introduced  by  Sen.  PARKER -- 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 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 AND PROVIDES COVERAGE  FOR  DURABLE  MEDICAL
 EQUIPMENT  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC  DEVICES  THAT  ARE
 INTENDED  FOR  MEDICALLY  NECESSARY  REHABILITATIVE   AND   HABILITATIVE
 PURPOSES  AS  REQUIRED  BY  42  U.S.C. § 18022 THAT IS EQUIVALENT TO THE
 COVERAGE PROVIDED FOR DURABLE MEDICAL EQUIPMENT.  COVERAGE SHALL NOT  BE
 DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC DEVICE
 IS THE MOST APPROPRIATE MODEL THAT ADEQUATELY MEETS THE MEDICAL NEEDS OF
 THE  POLICY  HOLDER.  THE TERM "PROSTHETIC DEVICE" AS USED IN THIS PARA-
 GRAPH INCLUDES AN ARTIFICIAL LIMB 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  PARA-
 GRAPH  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 SERVING 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  AND PROVIDES COVERAGE FOR DURABLE MEDICAL
 EQUIPMENT  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC  DEVICES  THAT  ARE
 INTENDED   FOR   MEDICALLY  NECESSARY  REHABILITATIVE  AND  HABILITATIVE
 PURPOSES AS REQUIRED BY 42 U.S.C. § 18022  THAT  IS  EQUIVALENT  TO  THE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD09205-01-1

 S. 4801                             2
 
 COVERAGE  PROVIDED FOR DURABLE MEDICAL EQUIPMENT.  COVERAGE SHALL NOT BE
 DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC DEVICE
 IS THE MOST APPROPRIATE MODEL THAT ADEQUATELY MEETS THE MEDICAL NEEDS OF
 THE  POLICY  HOLDER.  THE TERM "PROSTHETIC DEVICE" AS USED IN THIS PARA-
 GRAPH INCLUDES AN ARTIFICIAL LIMB 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  PARA-
 GRAPH  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 SERVING IN THE ARMED
 FORCES.
   § 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 AND PROVIDES COVERAGE  FOR  DURABLE  MEDICAL
 EQUIPMENT  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC  DEVICES  THAT  ARE
 INTENDED  FOR  MEDICALLY  NECESSARY  REHABILITATIVE   AND   HABILITATIVE
 PURPOSES  AS  REQUIRED  BY  42  U.S.C. § 18022 THAT IS EQUIVALENT TO THE
 COVERAGE PROVIDED FOR DURABLE MEDICAL EQUIPMENT.  COVERAGE SHALL NOT  BE
 DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC DEVICE
 IS THE MOST APPROPRIATE MODEL THAT ADEQUATELY MEETS THE MEDICAL NEEDS OF
 THE  POLICY  HOLDER.    THE  TERM  "PROSTHETIC  DEVICE"  AS USED IN THIS
 SUBSECTION INCLUDES AN ARTIFICIAL LIMB 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
 SUBSECTION 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  SERVING  IN
 THE ARMED FORCES.
   §  4.  This  act  shall take effect May 1, 2023 and shall apply to all
 policies and contracts issued, renewed, altered, or amended on or  after
 such effective date.

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Senate Bill S4801

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

2021-S4801 (ACTIVE) - Details

2021-S4801 (ACTIVE) - Summary

2021-S4801 (ACTIVE) - Sponsor Memo

2021-S4801 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S4801

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Sponsored By

Kevin S. Parker

Archive: Last Bill Status - In Senate Committee Insurance Committee

2021-S4801 (ACTIVE) - Details

2021-S4801 (ACTIVE) - Summary

2021-S4801 (ACTIVE) - Sponsor Memo

2021-S4801 (ACTIVE) - Bill Text download pdf

Comments