S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1682--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2023
                                ___________
 
 Introduced  by  M. of A. WOERNER, SIMON, DICKENS, THIELE, CRUZ, GUNTHER,
   SEAWRIGHT, GLICK, REYES -- Multi-Sponsored by -- M. of  A.  SAYEGH  --
   read  once  and  referred  to  the Committee on Insurance -- committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee

 AN ACT to amend the insurance law, in relation to prohibiting the exclu-
   sion of coverage based upon gender indication on claim forms
 
   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 39 to read as follows:
   (39) EVERY POLICY THAT PROVIDES COVERAGE  FOR  HOSPITAL,  SURGICAL  OR
 MEDICAL  CARE  SHALL  NOT  EXCLUDE COVERAGE FOR SCREENING, DIAGNOSIS AND
 TREATMENT OF MEDICAL CONDITIONS, OR SERVICES OTHERWISE  COVERED  BY  THE
 POLICY  SOLELY  ON THE BASIS OF THE GENDER INDICATED ON A CLAIM FORM, OR
 THAT THE GENDER  INDICATED  ON  A  CLAIM  FORM  IS  DIFFERENT  FROM  THE
 INSURED'S  SEX  ASSIGNED  AT BIRTH OR GENDER OTHERWISE RECORDED, OR THAT
 THE INSURED IS NOT OF THE GENDER TO WHOM A SERVICE IS PROVIDED.  NOTHING
 HEREIN  SHALL  LIMIT  THE  INSURER'S  ABILITY  TO TAKE REASONABLE STEPS,
 INCLUDING REQUESTING ADDITIONAL INFORMATION, TO  DETERMINE  WHETHER  THE
 INSURED  IS ELIGIBLE FOR THE SERVICES, TO REVIEW THE CLAIM FOR POTENTIAL
 FRAUD, OR TO REVIEW THE CLAIM FOR CLINICAL APPROPRIATENESS.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22) EVERY POLICY THAT PROVIDES COVERAGE  FOR  HOSPITAL,  SURGICAL  OR
 MEDICAL  CARE  SHALL  NOT  EXCLUDE COVERAGE FOR SCREENING, DIAGNOSIS AND
 TREATMENT OF MEDICAL CONDITIONS, OR SERVICES OTHERWISE  COVERED  BY  THE
 POLICY  SOLELY  ON THE BASIS OF THE GENDER INDICATED ON A CLAIM FORM, OR
 THAT THE GENDER  INDICATED  ON  A  CLAIM  FORM  IS  DIFFERENT  FROM  THE
 INSURED'S  SEX  ASSIGNED  AT BIRTH OR GENDER OTHERWISE RECORDED, OR THAT
 THE INSURED IS NOT OF THE GENDER TO WHOM A SERVICE IS PROVIDED.  NOTHING
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04905-03-3
              

 A. 1682--A                          2
 
 HEREIN  SHALL  LIMIT  THE  INSURER'S  ABILITY  TO TAKE REASONABLE STEPS,
 INCLUDING REQUESTING ADDITIONAL INFORMATION, TO  DETERMINE  WHETHER  THE
 INSURED  IS ELIGIBLE FOR THE SERVICES, TO REVIEW THE CLAIM FOR POTENTIAL
 FRAUD, OR TO REVIEW THE CLAIM FOR CLINICAL APPROPRIATENESS.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (vv) to read as follows:
   (VV) EVERY CONTRACT THAT PROVIDES COVERAGE FOR HOSPITAL,  SURGICAL  OR
 MEDICAL  CARE  SHALL  NOT  EXCLUDE COVERAGE FOR SCREENING, DIAGNOSIS AND
 TREATMENT OF MEDICAL CONDITIONS, OR SERVICES OTHERWISE  COVERED  BY  THE
 CONTRACT SOLELY ON THE BASIS OF THE GENDER INDICATED ON A CLAIM FORM, OR
 THAT  THE  GENDER  INDICATED  ON  A  CLAIM  FORM  IS  DIFFERENT FROM THE
 INSURED'S SEX ASSIGNED AT BIRTH OR GENDER OTHERWISE  RECORDED,  OR  THAT
 THE  INSURED IS NOT OF THE GENDER TO WHOM A SERVICE IS PROVIDED. NOTHING
 HEREIN SHALL LIMIT THE  INSURER'S  ABILITY  TO  TAKE  REASONABLE  STEPS,
 INCLUDING  REQUESTING  ADDITIONAL  INFORMATION, TO DETERMINE WHETHER THE
 INSURED IS ELIGIBLE FOR THE SERVICES, TO REVIEW THE CLAIM FOR  POTENTIAL
 FRAUD, OR TO REVIEW THE CLAIM FOR CLINICAL APPROPRIATENESS.
   §  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  apply  to
 policies  and contracts issued, renewed, modified, altered or amended on
 or after such effective date.