Senate Bill S4490

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

                                 4490--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 24, 2009
                               ___________

Introduced  by Sens. DUANE, OPPENHEIMER -- read twice and ordered print-
  ed, and when printed to be committed to the Committee on Insurance  --
  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 reimbursement for
  nurse practitioners

  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 27 to read as follows:
  (27) EVERY POLICY WHICH PROVIDES COVERAGE FOR PHYSICIAN SERVICES IN  A
PHYSICIAN'S  OFFICE,  AND  EVERY  POLICY WHICH PROVIDES MAJOR MEDICAL OR
SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE THE SAME COVERAGE  FOR
SUCH  SERVICES  WHEN PERFORMED BY A NURSE PRACTITIONER WITHIN THE LAWFUL
SCOPE OF HIS OR HER PRACTICE AND CONSISTENT WITH ANY APPLICABLE  WRITTEN
PRACTICE  AGREEMENT,  WHO  IS  CERTIFIED PURSUANT TO ARTICLE ONE HUNDRED
THIRTY-NINE OF THE EDUCATION LAW. SUCH COVERAGE MAY BE SUBJECT TO ANNUAL
DEDUCTIBLES AND COINSURANCE AS MAY BE  DEEMED  APPROPRIATE  AND  AS  ARE
CONSISTENT WITH OTHER BENEFITS COVERED UNDER THE POLICY.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 16 to read as follows:
  (16)  EVERY POLICY WHICH PROVIDES COVERAGE FOR PHYSICIAN SERVICES IN A
PHYSICIAN'S OFFICE, AND EVERY POLICY WHICH  PROVIDES  MAJOR  MEDICAL  OR
SIMILAR  COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE THE SAME COVERAGE FOR
SUCH SERVICES WHEN PERFORMED BY A NURSE PRACTITIONER WITHIN  THE  LAWFUL
SCOPE  OF HIS OR HER PRACTICE AND CONSISTENT WITH ANY APPLICABLE WRITTEN
PRACTICE AGREEMENTS, WHO IS CERTIFIED PURSUANT TO  ARTICLE  ONE  HUNDRED
THIRTY-NINE OF THE EDUCATION LAW. SUCH COVERAGE MAY BE SUBJECT TO ANNUAL
DEDUCTIBLES  AND  COINSURANCE  AS  MAY  BE DEEMED APPROPRIATE AND AS ARE
CONSISTENT WITH OTHER BENEFITS COVERED UNDER THE POLICY.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00776-03-0
              

S. 4490--A                          2

  S 3. Subparagraphs (G) and (H) of paragraph 4  of  subsection  (f)  of
section  4235  of the insurance law, as relettered by chapter 456 of the
laws of 1993, are amended and a new subparagraph (I) is added to read as
follows:
  (G)  psychiatric  or  psychological  services or for the diagnosis and
treatment of mental, nervous, or emotional disorders or ailments, howev-
er defined in such policy, a subscriber to such policy shall be entitled
to reimbursement for such psychiatric or psychological services or diag-
nosis or treatment whether performed by a physician, psychiatrist  or  a
certified  and  registered  psychologist  when the services rendered are
within the lawful scope of their practice, and when such policy  or  any
certificate  issued thereunder is delivered or issued for delivery with-
out this state by an authorized insurer,  covered  persons  residing  in
this  state  shall  be  entitled to reimbursement for such diagnosis and
treatment by a physician, psychiatrist or  a  certified  and  registered
psychologist as hereinabove provided; [and]
  (H)  any  service  which  is  within the lawful scope of practice of a
licensed chiropractor, a subscriber to such policy shall be entitled  to
reimbursement  for  such  service  when  such  service is performed by a
licensed chiropractor[.]; AND
  (I) ANY SERVICE WHICH IS WITHIN THE LAWFUL  SCOPE  OF  PRACTICE  OF  A
CERTIFIED NURSE PRACTITIONER, A SUBSCRIBER TO SUCH POLICY SHALL BE ENTI-
TLED TO REIMBURSEMENT FOR SUCH SERVICE WHEN SAID SERVICE IS PERFORMED BY
A CERTIFIED NURSE PRACTITIONER.
  S  4.  Section  4303  of  the insurance law is amended by adding a new
subsection (gg) to read as follows:
  (GG) EVERY CONTRACT ISSUED  BY  A  HEALTH  SERVICE  CORPORATION  OR  A
MEDICAL EXPENSE INDEMNITY CORPORATION WHICH PROVIDES COVERAGE FOR PHYSI-
CIAN SERVICES IN A PHYSICIAN'S OFFICE, AND EVERY CONTRACT WHICH PROVIDES
MAJOR  MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE, SHALL PROVIDE THE
SAME COVERAGE FOR SUCH SERVICES WHEN PERFORMED BY A  NURSE  PRACTITIONER
WITHIN  THE  LAWFUL SCOPE OF HIS OR HER PRACTICE AND CONSISTENT WITH ANY
APPLICABLE WRITTEN PRACTICE AGREEMENTS, WHO  IS  CERTIFIED  PURSUANT  TO
ARTICLE  ONE HUNDRED THIRTY-NINE OF THE EDUCATION LAW. SUCH COVERAGE MAY
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE AS MAY BE DEEMED APPRO-
PRIATE AND AS ARE CONSISTENT WITH OTHER BENEFITS COVERED UNDER THE POLI-
CY.
  S 5. This act shall take effect on the one hundred eightieth day after
it shall have become a law and shall apply to all policies and contracts
issued, renewed, modified, altered or amended on or after such date.