S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1096
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 13, 2023
                                ___________
 
 Introduced  by  M.  of  A.  BICHOTTE HERMELYN, SILLITTI, STIRPE, COLTON,
   CRUZ, JACKSON -- read once and referred to the Committee on Insurance
 
 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-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01144-01-3
              

 A. 1096                             2
 
 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;
   (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
 A. 1096                             3
 
 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.
   § 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.