S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2561

                       2009-2010 Regular Sessions

                          I N  A S S E M B L Y

                            January 20, 2009
                               ___________

Introduced by M. of A. GLICK, JOHN, JACOBS, DINOWITZ, WEINSTEIN, EDDING-
  TON  --  Multi-Sponsored  by  --  M.  of A. CYMBROWITZ, GALEF, GREENE,
  O'DONNELL, ORTIZ, PAULIN, SCARBOROUGH -- read once and referred to the
  Committee on Insurance

AN ACT to amend  the  insurance  law,  in  relation  to  requiring  that
  provision  be made for pregnancy termination procedures in every indi-
  vidual or group policy or contract which provides coverage  or  indem-
  nity for hospital, surgical or medical care and which offers maternity
  care coverage

  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 10-a to read as follows:
  (10-A)  (A)  EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL
COVERAGE AND WHICH OFFERS MATERNITY CARE COVERAGE PURSUANT TO  PARAGRAPH
TEN  OF THIS SUBSECTION SHALL ALSO PROVIDE COVERAGE FOR PREGNANCY TERMI-
NATION PROCEDURES WHICH ARE PERFORMED BY A LICENSED PHYSICIAN, UPON  THE
POLICYHOLDER  OR  UPON  HIS  SPOUSE OR UPON A NONSPOUSE WHO IS DEPENDENT
UPON THE POLICYHOLDER, IN ANY  LICENSED  HOSPITAL  OR  MEDICAL  FACILITY
APPROVED  BY  THE  STATE COMMISSIONER OF HEALTH, TO THE SAME EXTENT THAT
COVERAGE IS PROVIDED FOR ILLNESS OR DISEASE UNDER THE POLICY, SUBJECT TO
THE PROVISIONS OF THIS PARAGRAPH.
  (B) PROVISION FOR SUCH COVERAGE SHALL BE  SUBJECT  TO  ANY  GUIDELINES
WHICH  ARE  NOW  OR  HEREAFTER ISSUED BY THE MEDICAL SPECIALTY SOCIETIES
RECOGNIZED BY THE AMERICAN BOARD OF MEDICAL  SPECIALTIES  OF  OBSTETRICS
AND GYNECOLOGY, FOR PREGNANCY TERMINATIONS AND ABORTIONS.
  (C)  SUCH  COVERAGE  SHALL  BE  PROVIDED IN A MANNER WHICH ENSURES THE
CONFIDENTIALITY  AND  PRIVACY  OF  THE  OCCURRENCE  OF  THE   PROCEDURES
PERFORMED TO THE PERSON FOR WHOM COVERAGE IS PROVIDED.
  (D) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04523-01-9
              

A. 2561                             2

WITH  THOSE  ESTABLISHED  FOR  OTHER BENEFITS WITHIN A GIVEN POLICY, BUT
SUCH COVERAGE SHALL NOT BE SUBJECT TO THE REIMBURSEMENT  PERIOD  LIMITA-
TION  OR  MINIMUM  PERIOD OF COVERAGE LIMITATION APPLICABLE TO MATERNITY
CARE COVERAGE.
  (E)  COVERAGE  UNDER  THIS  PARAGRAPH  SHALL NOT RESTRICT OR ELIMINATE
EXISTING COVERAGE PROVIDED BY THE POLICY AND NOTHING IN  THIS  PARAGRAPH
SHALL  BE CONSTRUED TO DENY OR RESTRICT IN ANY WAY ANY EXISTING RIGHT OR
BENEFIT PROVIDED UNDER LAW OR BY CONTRACT.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 5-a to read as follows:
  (5-A) (A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIV-
ERY IN THIS STATE WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL  COVERAGE
AND  WHICH  OFFERS MATERNITY CARE COVERAGE PURSUANT TO PARAGRAPH FIVE OF
THIS SUBSECTION SHALL ALSO PROVIDE COVERAGE  FOR  PREGNANCY  TERMINATION
PROCEDURES  WHICH ARE PERFORMED BY A LICENSED PHYSICIAN, UPON THE POLICY
BENEFICIARY CERTIFICATE HOLDER OR UPON HIS SPOUSE OR  UPON  A  NONSPOUSE
WHO  IS DEPENDENT UPON THE POLICY BENEFICIARY CERTIFICATE HOLDER, IN ANY
LICENSED HOSPITAL OR MEDICAL FACILITY APPROVED BY THE STATE COMMISSIONER
OF HEALTH, TO THE SAME EXTENT THAT COVERAGE IS PROVIDED FOR  ILLNESS  OR
DISEASE UNDER THE POLICY, SUBJECT TO THE PROVISIONS OF THIS PARAGRAPH.
  (B)  PROVISION  FOR  SUCH  COVERAGE SHALL BE SUBJECT TO ANY GUIDELINES
WHICH ARE NOW OR HEREAFTER ISSUED BY  THE  MEDICAL  SPECIALTY  SOCIETIES
RECOGNIZED  BY  THE  AMERICAN BOARD OF MEDICAL SPECIALTIES OF OBSTETRICS
AND GYNECOLOGY, FOR PREGNANCY TERMINATIONS AND ABORTIONS.
  (C) SUCH COVERAGE SHALL BE PROVIDED IN  A  MANNER  WHICH  ENSURES  THE
CONFIDENTIALITY   AND  PRIVACY  OF  THE  OCCURRENCE  OF  THE  PROCEDURES
PERFORMED TO THE PERSON FOR WHOM COVERAGE IS PROVIDED.
  (D) 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,  BUT
SUCH  COVERAGE  SHALL NOT BE SUBJECT TO THE REIMBURSEMENT PERIOD LIMITA-
TION OR MINIMUM PERIOD OF COVERAGE LIMITATION  APPLICABLE  TO  MATERNITY
CARE COVERAGE.
  (E)  COVERAGE  UNDER  THIS  PARAGRAPH  SHALL NOT RESTRICT OR ELIMINATE
EXISTING COVERAGE PROVIDED BY THE POLICY AND NOTHING IN  THIS  PARAGRAPH
SHALL  BE CONSTRUED TO DENY OR RESTRICT IN ANY WAY ANY EXISTING RIGHT OR
BENEFIT PROVIDED UNDER LAW OR BY CONTRACT.
  S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (c-1) to read as follows:
  (C-1)  (A)  EVERY  CONTRACT  ISSUED  BY  A  CORPORATION SUBJECT TO THE
PROVISIONS OF THIS ARTICLE  WHICH  PROVIDES  HOSPITAL  SERVICE,  MEDICAL
EXPENSE  INDEMNITY,  OR  BOTH,  AND WHICH OFFERS MATERNITY CARE COVERAGE
PURSUANT TO SUBSECTION (C) OF THIS SECTION SHALL ALSO  PROVIDE  COVERAGE
FOR  PREGNANCY  TERMINATION PROCEDURES WHICH ARE PERFORMED BY A LICENSED
PHYSICIAN, UPON THE CONTRACT BENEFICIARY CERTIFICATE HOLDER OR UPON  HIS
SPOUSE  OR UPON A NONSPOUSE WHO IS DEPENDENT UPON THE CONTRACT BENEFICI-
ARY CERTIFICATE HOLDER, IN ANY LICENSED  HOSPITAL  OR  MEDICAL  FACILITY
APPROVED  BY  THE  STATE COMMISSIONER OF HEALTH, TO THE SAME EXTENT THAT
COVERAGE IS PROVIDED FOR ILLNESS OR DISEASE UNDER THE CONTRACT,  SUBJECT
TO THE PROVISIONS OF THIS SUBSECTION.
  (B)  PROVISION  FOR  SUCH  COVERAGE SHALL BE SUBJECT TO ANY GUIDELINES
WHICH ARE NOW OR HEREAFTER ISSUED BY  THE  MEDICAL  SPECIALTY  SOCIETIES
RECOGNIZED  BY  THE  AMERICAN BOARD OF MEDICAL SPECIALTIES OF OBSTETRICS
AND GYNECOLOGY, FOR PREGNANCY TERMINATIONS AND ABORTIONS.

A. 2561                             3

  (C) SUCH COVERAGE SHALL BE PROVIDED IN  A  MANNER  WHICH  ENSURES  THE
CONFIDENTIALITY   AND  PRIVACY  OF  THE  OCCURRENCE  OF  THE  PROCEDURES
PERFORMED TO THE PERSON FOR WHOM COVERAGE IS PROVIDED.
  (D) 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 CONTRACT, BUT
SUCH COVERAGE SHALL NOT BE SUBJECT TO THE REIMBURSEMENT  PERIOD  LIMITA-
TION  OR  MINIMUM  PERIOD OF COVERAGE LIMITATION APPLICABLE TO MATERNITY
CARE COVERAGE.
  (E) COVERAGE UNDER THIS SUBSECTION SHALL  NOT  RESTRICT  OR  ELIMINATE
EXISTING   COVERAGE  PROVIDED  BY  THE  CONTRACT  AND  NOTHING  IN  THIS
SUBSECTION SHALL BE CONSTRUED TO DENY OR RESTRICT IN ANY WAY ANY  EXIST-
ING RIGHT OR BENEFIT PROVIDED UNDER LAW OR BY CONTRACT.
  S  4. 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 only apply to
policies and contracts issued, renewed, modified, altered or amended  on
or after such date.