S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7790
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               June 15, 2023
                                ___________
 
 Introduced  by M. of A. SOLAGES -- read once and referred to the Commit-
   tee on Insurance
 
 AN ACT to amend the social  services  law  and  the  insurance  law,  in
   relation to expanding coverage requirements for human donor milk
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (dd) of subdivision 2 of  section  365-a  of  the
 social  services  law,  as added by section 3 of part S of chapter 57 of
 the laws of 2017, is amended to read as follows:
   (dd) pasteurized donor human milk (PDHM), which may include fortifiers
 as medically indicated[,  for  inpatient  use],  for  which  a  licensed
 medical  practitioner has issued an order for an infant who is medically
 or physically unable to receive maternal breast milk or  participate  in
 breast  feeding  or  whose  mother  is medically or physically unable to
 produce maternal breast milk at  all  or  in  sufficient  quantities  or
 participate  in  breast  feeding despite optimal lactation support. Such
 infant shall: (i) have a documented birth weight of less than one  thou-
 sand five hundred grams; or (ii) have a congenital or acquired condition
 that  places  the  infant  at a high risk for development of necrotizing
 enterocolitis; or (iii) have a congenital or acquired condition that may
 benefit from the use of donor breast milk as determined by  the  commis-
 sioner of health or his or her designee.
   §  2.  Paragraph 38 of subsection (i) of section 3216 of the insurance
 law, as added by section 10 of part MM of chapter 57 of the laws of 2018
 and as renumbered by chapter 739 of the laws of 2022, is amended to read
 as follows:
   (38) Every policy that provides coverage  for  hospital,  surgical  or
 medical  care shall provide the following coverage for pasteurized donor
 human milk (PDHM), which may include fortifiers as medically indicated[,
 for inpatient use], for which a licensed medical practitioner has issued
 an order for an infant who is medically or physically unable to  receive

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11129-02-3
              

 A. 7790                             2
 
 maternal breast milk or participate in breast feeding or whose mother is
 medically or physically unable to produce maternal breast milk at all or
 in  sufficient quantities or participate in breast feeding despite opti-
 mal  lactation  support.  Such infant shall: (i) have a documented birth
 weight of less than one thousand five hundred  grams;  or  (ii)  have  a
 congenital  or  acquired condition that places the infant at a high risk
 for development of necrotizing enterocolitis.
   § 3. Paragraph 20 of subsection (l) of section 3221 of  the  insurance
 law,  as  added  by  section  11 of part MM of chapter 57 of the laws of
 2018, is amended to read as follows:
   (20) Every insurer delivering a group or blanket policy or  issuing  a
 group  or blanket policy for delivery in this state that provides cover-
 age for hospital, surgical or medical care shall provide  the  following
 coverage  for  pasteurized  donor  human  milk (PDHM), which may include
 fortifiers as medically indicated[, for  inpatient  use],  for  which  a
 licensed  medical  practitioner has issued an order for an infant who is
 medically or physically  unable  to  receive  maternal  breast  milk  or
 participate in breast feeding or whose mother is medically or physically
 unable  to  produce maternal breast milk at all or in sufficient quanti-
 ties or participate in breast feeding despite optimal lactation support.
 Such infant shall: (i) have a documented birth weight of less  than  one
 thousand  five  hundred  grams;  or  (ii)  have a congenital or acquired
 condition that places the infant at  a  high  risk  for  development  of
 necrotizing enterocolitis.
   § 4. Subsection (oo) of section 4303 of the insurance law, as added by
 section  12  of part MM of chapter 57 of the laws of 2018, is amended to
 read as follows:
   (oo) A medical  expense  indemnity  corporation,  a  hospital  service
 corporation  or  a health service corporation that provides coverage for
 hospital, surgical or medical care shall provide the following  coverage
 for pasteurized donor human milk (PDHM), which may include fortifiers as
 medically  indicated[,  for inpatient use], for which a licensed medical
 practitioner has issued an order for an infant who is medically or phys-
 ically unable to receive maternal breast milk or participate  in  breast
 feeding  or  whose  mother  is medically or physically unable to produce
 maternal breast milk at all or in sufficient quantities  or  participate
 in  breast feeding despite optimal lactation support. Such infant shall:
 (i) have a documented birth  weight  of  less  than  one  thousand  five
 hundred  grams;  or  (ii)  have  a congenital or acquired condition that
 places the infant at a high risk for development of necrotizing  entero-
 colitis.
   §  5. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a law and shall apply to  all
 policies  issued,  renewed,  modified, or altered on or after such date.
 Effectively 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.