senate Bill S36

Requires mandatory health insurance coverage for cerebral palsy

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Sponsor

Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 07 / Jan / 2009
    • REFERRED TO INSURANCE
  • 06 / Jan / 2010
    • REFERRED TO INSURANCE

Summary

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Bill Details

Versions:
S36
Legislative Cycle:
2009-2010
Current Committee:
Senate Insurance
Law Section:
Insurance Law

Sponsor Memo

BILL NUMBER: S36

TITLE OF BILL :
An act to amend the insurance law, in relation to mandatory health
insurance coverage for cerebral palsy


PURPOSE :
To provide that various health insurance policies must include
coverage for treatment for cerebral palsy including coverage for
therapeutic evaluations and various therapies that may be needed by an
individual who has cerebral palsy.

SUMMARY OF PROVISIONS :
This bill would add a new paragraph 25 to subsection (i) of section 32
16 of the insurance law to require coverage for cerebral palsy
including therapeutic evaluations and interventions, such as speech
therapy, occupational therapy, physical therapy, intensive early
intervention and behavioral and educational intervention programs for
individual accident and health insurance policy provisions which
provide hospital, surgical, or medical care coverage. Such coverage
would be subject to annual deductibles and coinsurance payments as are
consistent with those necessary for other benefits within a given
policy.

This bill would also add a new paragraph 17 to subsection (1) of
section 3221 and a new subsection (dd) of section 4303 of the
insurance law to require similar coverage for group blanket accident
and health insurance policies and for contracts issued by a hospital
service corporation or health service corporation which provide
coverage for in-patient hospital care.

JUSTIFICATION :
According to United Cerebral Palsy (UCP), Cerebral Palsy is a term
used to describe a group of chronic conditions affecting body movement
and muscle coordination. While the damage to motor areas in the brain
that disrupt the brain's ability to control movement and posture may
not necessarily worsen, secondary conditions, such as muscle
spasticity, can get better, get worse or stay the same over time. UCP
states that while Cerebral Palsy is not curable, training and therapy
can help improve function.

While some insurance carriers provide coverage for therapy related to
cerebral palsy it is sometimes limited because the underlying
condition is not acute and cannot therefore be fully cured by the
proposed treatment. Individuals with Cerebral Palsy should be able to
continue to receive treatment and therapy that will help to improve
nerve and muscle coordination and prevent or minimize dysfunction.

LEGISLATIVE HISTORY :
2007-2008 Insurance Committee (S.4724).
2005-2006 Insurance Committee (S.1130).
2004 Insurance Committee (S.7006).

FISCAL IMPLICATIONS :
To be determined.

EFFECTIVE DATE :
This act shall take effect on the one hundred twentieth day after it
shall have become a law and shall apply to all policies issued,
renewed, modified, or altered on or after such date.
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