S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6425--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               April 6, 2023
                                ___________
 
 Introduced  by  M.  of  A.  O'DONNELL, PAULIN, LUNSFORD, LAVINE, WEPRIN,
   SIMON, BURDICK, DAVILA, STERN,  SILLITTI,  SIMONE,  SHIMSKY,  DICKENS,
   DeSTEFANO,  LEMONDES,  McDONOUGH,  JACOBSON,  STECK  --  read once and
   referred to the Committee on Insurance -- recommitted to the Committee
   on Insurance in accordance with Assembly Rule 3, sec. 2  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 AN  ACT  to  amend  the  insurance  law, in relation to requiring health
   insurance plans to  provide  coverage  for  epinephrine  auto-injector
   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 39 to read as follows:
   (39)  (A) EVERY INSURER ISSUING A POLICY OF ACCIDENT AND HEALTH INSUR-
 ANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH PROVIDES MAJOR
 MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE  SHALL  INCLUDE  COVERAGE
 FOR,  AT  A  MINIMUM,  TWO MEDICALLY NECESSARY EPINEPHRINE AUTO-INJECTOR
 DEVICES  FOR  THE  EMERGENCY  TREATMENT  OF  LIFE-THREATENING   ALLERGIC
 REACTIONS.  SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COIN-
 SURANCE    AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE
 CONSISTENT WITH THOSE   ESTABLISHED FOR OTHER BENEFITS  WITHIN  A  GIVEN
 POLICY;  PROVIDED    HOWEVER,  THE TOTAL AMOUNT THAT A COVERED PERSON IS
 REQUIRED TO PAY OUT-OF-POCKET FOR SUCH DEVICES SHALL  BE  CAPPED  AT  AN
 AMOUNT  NOT  TO  EXCEED  ONE HUNDRED DOLLARS ANNUALLY REGARDLESS  OF THE
 INSURED'S DEDUCTIBLE, COPAYMENT, COINSURANCE OR ANY  OTHER  COST-SHARING
 REQUIREMENT.  IF UNDER  FEDERAL  LAW,  APPLICATION  OF  THIS REQUIREMENT
 WOULD    RESULT  IN  HEALTH SAVINGS ACCOUNT INELIGIBILITY UNDER  26  USC
 223,   THIS REQUIREMENT   SHALL     APPLY     FOR     HEALTH     SAVINGS
 ACCOUNT-QUALIFIED  HIGH  DEDUCTIBLE  HEALTH  PLANS  WITH  RESPECT TO THE
 DEDUCTIBLE OF SUCH A PLAN AFTER THE ENROLLEE HAS SATISFIED  THE  MINIMUM
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10597-02-4
              

 A. 6425--A                          2
 
 DEDUCTIBLE  UNDER 26  USC  223,  EXCEPT  FOR  WITH  RESPECT TO ITEMS  OR
 SERVICES THAT ARE PREVENTIVE CARE PURSUANT TO 26  USC  223(C)(2)(C),  IN
 WHICH  CASE THE REQUIREMENTS OF THIS PARAGRAPH SHALL APPLY REGARDLESS OF
 WHETHER THE MINIMUM DEDUCTIBLE UNDER 26 USC 223 HAS BEEN SATISFIED.
   (B)  FOR  THE  PURPOSES  OF THIS PARAGRAPH, "EPINEPHRINE AUTO-INJECTOR
 DEVICE" SHALL HAVE THE SAME MEANING AS  PROVIDED  IN  PARAGRAPH  (B)  OF
 SUBDIVISION ONE OF SECTION THREE THOUSAND-C OF THE PUBLIC HEALTH LAW.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23)  (A)  EVERY GROUP OR BLANKET POLICY OF ACCIDENT AND HEALTH INSUR-
 ANCE DELIVERED OR ISSUED FOR  DELIVERY  IN  THIS  STATE  WHICH  PROVIDES
 MEDICAL  COVERAGE  THAT  INCLUDES  COVERAGE  FOR PHYSICIAN SERVICES IN A
 PHYSICIAN'S OFFICE AND EVERY POLICY  WHICH  PROVIDES  MAJOR  MEDICAL  OR
 SIMILAR  COMPREHENSIVE-TYPE    COVERAGE SHALL PROVIDE COVERAGE FOR, AT A
 MINIMUM, TWO MEDICALLY NECESSARY EPINEPHRINE AUTO-INJECTOR  DEVICES  FOR
 THE  EMERGENCY  TREATMENT  OF LIFE-THREATENING ALLERGIC REACTIONS.  SUCH
 COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE AS MAY  BE
 DEEMED  APPROPRIATE  BY  THE  SUPERINTENDENT  AND AS ARE CONSISTENT WITH
 THOSE  ESTABLISHED FOR OTHER BENEFITS WITHIN A  GIVEN  POLICY;  PROVIDED
 HOWEVER,  THE TOTAL AMOUNT THAT A COVERED PERSON IS REQUIRED TO PAY OUT-
 OF-POCKET FOR SUCH DEVICES SHALL BE CAPPED AT AN AMOUNT  NOT  TO  EXCEED
 ONE  HUNDRED  DOLLARS ANNUALLY REGARDLESS   OF THE INSURED'S DEDUCTIBLE,
 COPAYMENT, COINSURANCE OR ANY OTHER COST-SHARING REQUIREMENT.  IF  UNDER
 FEDERAL  LAW,  APPLICATION  OF  THIS REQUIREMENT  WOULD RESULT IN HEALTH
 SAVINGS  ACCOUNT  INELIGIBILITY UNDER 26   USC   223,   THIS REQUIREMENT
 SHALL   APPLY   FOR   HEALTH   SAVINGS ACCOUNT-QUALIFIED HIGH    DEDUCT-
 IBLE   HEALTH   PLANS   WITH   RESPECT TO THE  DEDUCTIBLE OF SUCH A PLAN
 AFTER THE ENROLLEE HAS SATISFIED  THE  MINIMUM DEDUCTIBLE  UNDER 26  USC
 223,  EXCEPT  FOR  WITH  RESPECT TO ITEMS OR  SERVICES THAT ARE  PREVEN-
 TIVE  CARE  PURSUANT TO 26   USC   223(C)(2)(C),   IN   WHICH   CASE THE
 REQUIREMENTS OF THIS PARAGRAPH SHALL APPLY REGARDLESS OF    WHETHER  THE
 MINIMUM DEDUCTIBLE UNDER 26 USC 223 HAS BEEN SATISFIED.
   (B)  FOR  THE  PURPOSES  OF THIS PARAGRAPH, "EPINEPHRINE AUTO-INJECTOR
 DEVICE" SHALL HAVE THE SAME MEANING AS  PROVIDED  IN  PARAGRAPH  (B)  OF
 SUBDIVISION ONE OF SECTION THREE THOUSAND-C OF THE PUBLIC HEALTH LAW.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (vv) to read as follows:
   (VV) (1) EVERY MEDICAL EXPENSE INDEMNITY CORPORATION, HOSPITAL SERVICE
 CORPORATION AND HEALTH SERVICE CORPORATION WHICH PROVIDES MEDICAL COVER-
 AGE THAT INCLUDES COVERAGE  FOR  PHYSICIAN  SERVICES  IN  A  PHYSICIAN'S
 OFFICE  AND EVERY POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMILAR COMPRE-
 HENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE  FOR,  AT  A  MINIMUM,  TWO
 MEDICALLY  NECESSARY EPINEPHRINE AUTO-INJECTOR DEVICES FOR THE EMERGENCY
 TREATMENT OF LIFE-THREATENING ALLERGIC REACTIONS.  SUCH COVERAGE MAY  BE
 SUBJECT  TO  ANNUAL DEDUCTIBLES AND COINSURANCE  AS MAY BE DEEMED APPRO-
 PRIATE BY THE SUPERINTENDENT AND AS ARE  CONSISTENT  WITH  THOSE  ESTAB-
 LISHED  FOR  OTHER BENEFITS WITHIN A GIVEN POLICY; PROVIDED HOWEVER, THE
 TOTAL AMOUNT THAT A COVERED PERSON IS REQUIRED TO PAY OUT-OF-POCKET  FOR
 SUCH  DEVICES  SHALL  BE  CAPPED  AT AN AMOUNT NOT TO EXCEED ONE HUNDRED
 DOLLARS ANNUALLY REGARDLESS   OF THE  INSURED'S  DEDUCTIBLE,  COPAYMENT,
 COINSURANCE  OR  ANY  OTHER COST-SHARING REQUIREMENT.  IF UNDER  FEDERAL
 LAW,  APPLICATION  OF  THIS  REQUIREMENT  WOULD RESULT IN HEALTH SAVINGS
 ACCOUNT INELIGIBILITY UNDER 26   USC   223,   THIS  REQUIREMENT    SHALL
 APPLY     FOR     HEALTH     SAVINGS ACCOUNT-QUALIFIED HIGH   DEDUCTIBLE
 HEALTH  PLANS  WITH  RESPECT TO THE DEDUCTIBLE OF SUCH A PLAN AFTER  THE
 ENROLLEE  HAS SATISFIED   THE   MINIMUM  DEDUCTIBLE  UNDER 26  USC  223,
 A. 6425--A                          3
 
 EXCEPT  FOR  WITH  RESPECT TO ITEMS OR SERVICES THAT ARE PREVENTIVE CARE
 PURSUANT TO 26  USC  223(C)(2)(C), IN WHICH   CASE THE  REQUIREMENTS  OF
 THIS  PARAGRAPH SHALL APPLY REGARDLESS OF WHETHER THE MINIMUM DEDUCTIBLE
 UNDER 26 USC 223 HAS BEEN SATISFIED.
   (2)  FOR  THE  PURPOSES OF THIS SUBSECTION, "EPINEPHRINE AUTO-INJECTOR
 DEVICE" SHALL HAVE THE SAME MEANING AS  PROVIDED  IN  PARAGRAPH  (B)  OF
 SUBDIVISION ONE OF SECTION THREE THOUSAND-C OF THE PUBLIC HEALTH LAW.
   § 4. This act shall take effect January 1, 2026 and shall apply to all
 policies  and contracts issued, renewed, modified, altered or amended on
 or after such date.