NY State Senate Bill 2023-S5321

Senate Bill S5321

2023-2024 Legislative Session

Requires the New York state health care quality and cost containment commission to issue a report on coverage for chronic Lyme disease

download bill text pdf

Current 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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to insurance
Mar 01, 2023	referred to insurance

2023-S5321 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §213, Ins L
Versions Introduced in Other Legislative Sessions:: 2015-2016: S7777
2017-2018: S2168
2019-2020: S1345
2021-2022: S3753

2023-S5321 (ACTIVE) - Summary

Requires the New York state health care quality and cost containment commission to issue a report considering the impact on health insurance costs and quality of legislation requiring coverage of long term and chronic Lyme disease and other tick-borne diseases.

2023-S5321 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S5321

SPONSOR: WEIK
 
TITLE OF BILL:

An act to amend the insurance law, in relation to meetings and reports
of the New York state health care quality and cost containment commis-
sion

 
PURPOSE:

To require the New York State Health Care Quality and Cost Containment
Commission to meet each year, and to submit a report on the impact of
providing insurance coverage for Lyme and other tick-borne related
diseases.

 
SUMMARY OF PROVISIONS:

Section 1: Requires the commission to meet on the first Monday after the
first of January of each year to consider any outstanding requests or
duties. Also requires that the commission submits a report to the gover-
nor and legislature which considers the impact on health insurance costs

of requiring coverage of Lyme and other tick-borne diseases by May 1,
2022.

Section 2: Provides the effective date.

 
JUSTIFICATION:

Currently, health insurance companies are not required to cover long
term treatment for those who suffer from chronic Lyme or other related
diseases, and for many New Yorkers, this is devastating.  Those suffer-
ing from chronic Lyme can experience extreme fatigue, nausea,
depression, joint pain and many other symptoms.  Massachusetts, Rhode
Island and Connecticut have recognized the toll these diseases take on
victims by passing legislation, which requires that Lyme disease be
covered by insurance.

This bill is the first major step in establishing a conversation on what
can be done to address this issue in New York and figuring out what a
solution would look like. No individual should be left with the choice
of covering the exorbitant costs needed to combat Lyme disease or sacri-
ficing their quality of life because they cannot afford the necessary
treatment.

 
LEGISLATIVE HISTORY:

2022: S3753 Insurance

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2023-S5321 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5321
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                               March 1, 2023
                                ___________
 
 Introduced  by  Sen.  WEIK  --  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 meetings  and  reports
   of the New York state health care quality and cost containment commis-
   sion

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 213 of the insurance law, as added by section 1  of
 part L of chapter 57 of the laws of 2007, is amended to read as follows:
   § 213. New York state health care quality and cost containment commis-
 sion.  (a)  There  is hereby established within the department a commis-
 sion, to be known as the "New York state health care  quality  and  cost
 containment  commission".  The  commission  shall  consist  of  thirteen
 members appointed by the governor, one of whom shall be the  superinten-
 dent,  one  of whom shall be the commissioner of health, and six of whom
 shall be appointed on the recommendation of the legislative leaders, two
 on the recommendation of the temporary president of the senate,  two  on
 the  recommendation of the speaker of the assembly, one on the recommen-
 dation of the minority leader of the senate, and one on the  recommenda-
 tion  of the minority leader of the assembly. All members shall serve at
 the pleasure of the governor, and vacancies shall be  appointed  in  the
 same  manner  as  original appointments. Members of the commission shall
 serve without compensation, but shall be reimbursed for reasonable trav-
 el expenses. In making appointments  to  the  commission,  the  governor
 shall  ensure  that  the interests of health care consumers, small busi-
 nesses, the medical community and health plans are  represented  on  the
 commission.    THE  COMMISSION  SHALL  BE  REQUIRED TO MEET ON THE FIRST
 MONDAY AFTER THE FIRST OF JANUARY OF  EACH  CALENDAR  YEAR  TO  CONSIDER
 OUTSTANDING REQUESTS OR DUTIES.  ANY VACANCIES SHALL BE DEEMED WAIVED BY
 THE  APPOINTING AUTHORITY FOR THE PURPOSES OF THE FIRST MEETING. NOTHING
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09266-01-3
 S. 5321                             2

 
 IN THIS SECTION SHALL FORFEIT THE RIGHT FOR AN APPOINTMENT AUTHORITY  TO
 FILL VACANCIES WITHIN THEIR STATUTORILY ALLOWED MEMBERS.
   (b)(1) The purpose of the commission shall be to analyze the impact on
 health  insurance  costs and quality of proposed legislation which would
 mandate that health benefits be offered or made available in  individual
 and  group health insurance policies, contracts and comprehensive health
 service plans, including legislation that affects the delivery of health
 benefits or services or the reimbursement of health care providers.
   (2) [The] NOTWITHSTANDING ANY OTHER PROVISION OF  LAW,  THE  governor,
 the  chair of the senate insurance committee and the chair of the assem-
 bly insurance committee may request in writing that the commission eval-
 uate a proposed mandated benefit. Upon receiving  such  a  request,  the
 commission  may,  by a majority vote of its members, undertake an evalu-
 ation of such proposed mandated benefit.
   (3) In evaluating a proposed mandated benefit, the commission shall:
   (A) investigate the current practices of health plans with  regard  to
 the  proposed mandated benefit, and, to the extent possible, self-funded
 health benefit plans;
   (B) investigate the potential premium impact of the proposed  mandated
 benefits  on all segments of the insurance market, as well as the poten-
 tial for avoided costs through early detection and treatment  of  condi-
 tions, or more cost-effective delivery of medical services; and
   (C) analyze the most current medical literature regarding the proposed
 mandated benefit to determine its impact on health care quality.
   (4) In evaluating a proposed mandated benefit, the commission may hold
 one  or more public hearings, and shall strive to obtain independent and
 verifiable information from diverse sources within the healthcare indus-
 try, medical community and among health care consumers  with  regard  to
 the proposed mandated benefit.
   (c)  To assist the commission in its duties, and upon the direction of
 the commission, the superintendent is authorized to enter  into  one  or
 more  contracts  with independent entities and organizations with demon-
 strable expertise in health care quality, finance, utilization and actu-
 arial services. For the purposes of  this  section,  the  superintendent
 shall  not enter into contracts with health plans, entities or organiza-
 tions owned or controlled by health plans, or with significant  business
 relationships with health plans.
   (d)  Upon  completion of its evaluation of a proposed mandated benefit
 pursuant to this section, the commission shall deliver a written  report
 of its findings to the chair of the assembly insurance committee and the
 chair of the senate insurance committee.
   (E)  THE COMMISSION SHALL ISSUE A REPORT TO THE GOVERNOR, THE MAJORITY
 LEADER OF THE SENATE, THE SPEAKER OF THE ASSEMBLY,  THE  CHAIRS  OF  THE
 SENATE  AND  ASSEMBLY  INSURANCE COMMITTEES, AND THE CHAIR OF THE SENATE
 TASK FORCE ON LYME AND TICK-BORNE DISEASES, CONSIDERING  THE  IMPACT  ON
 HEALTH  INSURANCE COSTS AND QUALITY OF LEGISLATION REQUIRING COVERAGE OF
 LONG-TERM AND CHRONIC LYME DISEASE AND OTHER  TICK-BORNE  DISEASES.  THE
 COMMISSION  SHALL  BE  REQUIRED  TO  CONSIDER  ISSUES INCLUDING, BUT NOT
 LIMITED TO, THE SPECIFIC MEDICAL IMPACTS TO PARTICULAR GEOGRAPHIC  AREAS
 IN THE STATE INCLUDING THE HUDSON VALLEY AND LONG ISLAND, BEST PRACTICES
 DEVELOPED  FOR  COVERAGE FOR LONG-TERM AND CHRONIC LYME DISEASE IN OTHER
 STATES, AND THE ASSOCIATED COSTS OF MANDATED  COVERAGE  IN  ADDITION  TO
 PROJECTED  COSTS  OF UNTREATED SYMPTOMS.  THE COMMISSION SHALL DELIVER A
 WRITTEN REPORT OF ITS FINDINGS BY MAY FIRST, TWO THOUSAND TWENTY-FOUR.
   § 2. This act shall take effect immediately.

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