S T A T E O F N E W Y O R K
________________________________________________________________________
5223
2009-2010 Regular Sessions
I N A S S E M B L Y
February 11, 2009
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Introduced by M. of A. ESPAILLAT, PERALTA, ROBINSON -- Multi-Sponsored
by -- M. of A. ALFANO, BARRA, BOYLAND, DIAZ, HOOPER -- read once and
referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring certain
health and casualty insurers to provide coverage for prenatal ultra-
sounds
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 DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE
WHICH PROVIDES MEDICAL COVERAGE THAT INCLUDES COVERAGE FOR PHYSICIAN
SERVICES IN A PHYSICIAN'S OFFICE AND EVERY POLICY WHICH PROVIDES MAJOR
MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE
FOR PRENATAL MATERNITY CARE. SUCH PRENATAL MATERNITY CARE SHALL INCLUDE
THE ADMINISTRATION AND INTERPRETATION OF AT LEAST ONE ULTRASOUND
(THREE-DIMENSIONAL SONOGRAM) OF THE PREGNANCY.
(B) 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.
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 MEDICAL COVERAGE THAT INCLUDES COVERAGE
FOR PHYSICIAN SERVICES IN A PHYSICIAN'S OFFICE, AND EVERY GROUP OR BLAN-
KET POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE
COVERAGE SHALL PROVIDE COVERAGE FOR PRENATAL MATERNITY CARE. SUCH PRENA-
TAL MATERNITY CARE SHALL INCLUDE THE ADMINISTRATION AND INTERPRETATION
OF AT LEAST ONE ULTRASOUND (THREE-DIMENSIONAL SONOGRAM) OF THE PREGNAN-
CY.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09101-01-9
A. 5223 2
(B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSU-
RANCE, AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE
CONSISTENT WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN
POLICY.
S 3. Section 4303 of the insurance law is amended by adding a new
subsection (c-1) to read as follows:
(C-1) (1) EVERY CONTRACT ISSUED BY A CORPORATION SUBJECT TO THE
PROVISIONS OF THIS ARTICLE WHICH PROVIDES HOSPITAL SERVICE, MEDICAL
EXPENSE INDEMNITY OR BOTH SHALL PROVIDE COVERAGE FOR PRENATAL MATERNITY
CARE. SUCH PRENATAL MATERNITY CARE SHALL INCLUDE THE ADMINISTRATION AND
INTERPRETATION OF AT LEAST ONE ULTRASOUND (THREE-DIMENSIONAL SONOGRAM)
OF THE PREGNANCY.
(2) SUCH COVERAGE SHALL BE MADE AVAILABLE AT THE INCEPTION OF ALL NEW
CONTRACTS AND, WITH RESPECT TO ALL OTHER CONTRACTS, AT ANY ANNIVERSARY
DATE SUBJECT TO EVIDENCE OF INSURABILITY. SUCH COVERAGE MAY BE SUBJECT
TO ANNUAL DEDUCTIBLES AND COINSURANCE AS MAY BE DEEMED APPROPRIATE BY
THE SUPERINTENDENT.
S 4. This act shall take effect on the first of September next
succeeding the date on which it shall have become a law, and shall apply
to insurance coverage issued, renewed or delivered on or after such
date.