S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7577--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                               June 8, 2023
                                ___________
 
 Introduced by Sens. BRESLIN, GALLIVAN, GOUNARDES, HARCKHAM -- read twice
   and ordered printed, and when printed to be committed to the Committee
   on  Rules  --  recommitted to the Committee on Insurance in accordance
   with Senate Rule 6, sec. 8  --  committee  discharged,  bill  amended,
   ordered reprinted as amended and recommitted to said committee

 AN ACT to amend the insurance law, in relation to addressing non-covered
   dental services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 4224 of the insurance law is amended  by  adding  a
 new subsection (g) to read as follows:
   (G)(1) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SECTION, NO INSURER
 AUTHORIZED  TO  DO BUSINESS IN THIS STATE SHALL INCLUDE A PROVISION IN A
 CONTRACT OR  PARTICIPATING  PROVIDER  AGREEMENT  WITH  A  DENTIST  WHICH
 REQUIRES,  DIRECTLY  OR INDIRECTLY, THAT A PARTICIPATING DENTIST PROVIDE
 SERVICES TO AN INSURED AT A FEE SET BY, OR  AT  A  FEE  SUBJECT  TO  THE
 APPROVAL OF, THE INSURER UNLESS THE DENTAL SERVICES ARE COVERED SERVICES
 UNDER THE INSURED'S DENTAL PLAN.
   (2)  FOR  PURPOSES  OF  THIS SUBSECTION, "COVERED SERVICES" SHALL MEAN
 DENTAL SERVICES FOR WHICH REIMBURSEMENT IS AVAILABLE UNDER AN  INSURED'S
 DENTAL  PLAN OR FOR WHICH A REIMBURSEMENT WOULD BE AVAILABLE BUT FOR THE
 APPLICATION OF CONTRACTUAL LIMITATIONS SUCH AS DEDUCTIBLES,  COPAYMENTS,
 COINSURANCE,  WAITING  PERIODS,  ANNUAL  OR LIFETIME MAXIMUMS, FREQUENCY
 LIMITATIONS, ALTERNATIVE BENEFIT PAYMENTS, OR ANY OTHER LIMITATION.
   § 2. Subsection (s) of section 4303 of the insurance law, as added  by
 chapter 293 of the laws of 1992, is amended to read as follows:
   [(s)](S-1)(1)  Notwithstanding any provision of a contract issued by a
 medical expense indemnity corporation, a dental expense indemnity corpo-
 ration or health service  corporation,  every  contract  which  provides
 coverage for care provided through licensed health professionals who can
 bill  for services shall provide the same coverage and reimbursement for
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11752-05-4
              

 S. 7577--A                          2
 
 such service provided pursuant to a clinical practice  plan  established
 pursuant  to  subdivision  fourteen  of  section  two hundred six of the
 public health law.
   (2)  NOTWITHSTANDING  ANY  OTHER PROVISION OF THIS SECTION, NO MEDICAL
 EXPENSE INDEMNITY CORPORATION, DENTAL EXPENSE INDEMNITY  CORPORATION  OR
 HEALTH SERVICE CORPORATION AUTHORIZED TO DO BUSINESS IN THIS STATE SHALL
 INCLUDE  A  PROVISION  IN A CONTRACT OR PARTICIPATING PROVIDER AGREEMENT
 WITH A DENTIST WHICH REQUIRES, DIRECTLY OR INDIRECTLY,  THAT  A  PARTIC-
 IPATING  DENTIST PROVIDE SERVICES TO AN INSURED AT A FEE SET BY, OR AT A
 FEE SUBJECT TO THE APPROVAL OF, THE MEDICAL EXPENSE    INDEMNITY  CORPO-
 RATION,  DENTAL  EXPENSE  INDEMNITY CORPORATION OR HEALTH SERVICE CORPO-
 RATION UNLESS  THE  DENTAL  SERVICES  ARE  COVERED  SERVICES  UNDER  THE
 INSURED'S DENTAL PLAN.
   (3)  FOR  PURPOSES  OF  THIS SUBSECTION, "COVERED SERVICES" SHALL MEAN
 DENTAL SERVICES FOR WHICH REIMBURSEMENT IS AVAILABLE UNDER AN  INSURED'S
 DENTAL  PLAN OR FOR WHICH A REIMBURSEMENT WOULD BE AVAILABLE BUT FOR THE
 APPLICATION OF CONTRACTUAL LIMITATIONS SUCH AS DEDUCTIBLES,  COPAYMENTS,
 COINSURANCE,  WAITING  PERIODS,  ANNUAL  OR LIFETIME MAXIMUMS, FREQUENCY
 LIMITATIONS, ALTERNATIVE BENEFIT PAYMENTS, OR ANY OTHER LIMITATION.
   § 3. This act shall take effect January 1, 2025 and shall apply to all
 insurance contracts issued or entered into on or after such date.