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

                                  3730

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            January 26, 2011
                               ___________

Introduced by M. of A. WEPRIN, HOYT, GUNTHER -- Multi-Sponsored by -- M.
  of  A.  COLTON,  GALEF,  HOOPER, LATIMER, MAYERSOHN, McENENY, MILLMAN,
  PERRY, WEISENBERG -- read once and referred to the Committee on Insur-
  ance

AN ACT to amend the insurance law, in relation to coverage and  benefits
  of accident and health insurance policies for podiatric care

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 2 of subsection (i) of section 3216 of the insur-
ance law is amended to read as follows:
  (2) If a policy provides for reimbursement for any podiatrical service
within the lawful scope  of  practice  of  a  licensed  podiatrist,  the
insured  shall  be  entitled  to THE SAME reimbursement for such service
whether it is performed by a physician or licensed podiatrist.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 17 to read as follows:
  (17) EVERY POLICY WHICH  PROVIDES  COVERAGE  FOR  PODIATRIC  CARE,  AS
DEFINED IN  SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED BY
A  DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE
OF THE EDUCATION LAW, MAY BE SUBJECT TO REASONABLE  DEDUCTIBLE,  CO-PAY-
MENT  AND  CO-INSURANCE  AMOUNTS,  REASONABLE  FEE OR BENEFIT LIMITS AND
REASONABLE UTILIZATION REVIEW, PROVIDED THAT ANY  SUCH  AMOUNTS,  LIMITS
AND  REVIEW:  (A)  SHALL  NOT  FUNCTION  TO DIRECT TREATMENT IN A MANNER
DISCRIMINATIVE AGAINST PODIATRIC CARE; AND (B) INDIVIDUALLY AND  COLLEC-
TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THAT SAME POLI-
CY  TO  CARE  OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS IN  THE
DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR  CONDITIONS,
DISORDERS  OR  INJURIES. NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED AS
IMPEDING OR PREVENTING EITHER THE PROVISION  OR  COVERAGE  OF  PODIATRIC
CARE  AND  SERVICES  BY  DULY    LICENSED DOCTORS OF PODIATRY WITHIN THE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05102-01-1

              

A. 3730                             2

LAWFUL SCOPE OF PODIATRIC CARE IN HOSPITAL  FACILITIES  ON  A  STAFF  OR
EMPLOYEE BASIS.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (hh) to read as follows:
  (HH) EVERY CONTRACT ISSUED  BY  A  HEALTH  SERVICE  CORPORATION  OR  A
MEDICAL  EXPENSE INDEMNITY CORPORATION THAT INCLUDES COVERAGE FOR PHYSI-
CIAN SERVICES IN A PHYSICIAN'S OFFICE, THAT PROVIDES  MAJOR  MEDICAL  OR
SIMILAR  COMPREHENSIVE-TYPE COVERAGE, AND COVERAGE FOR PODIATRIC CARE AS
DEFINED IN SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED  BY
A  DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE
OF THE EDUCATION LAW, MAY BE SUBJECT TO REASONABLE  DEDUCTIBLE,  CO-PAY-
MENT  AND  CO-INSURANCE  AMOUNTS,  REASONABLE  FEE OR BENEFIT LIMITS AND
REASONABLE UTILIZATION REVIEW, PROVIDED THAT ANY  SUCH  AMOUNTS,  LIMITS
AND  REVIEW:    (1)  SHALL  NOT FUNCTION TO DIRECT TREATMENT IN A MANNER
DISCRIMINATIVE AGAINST PODIATRIC CARE; AND (2) INDIVIDUALLY AND  COLLEC-
TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THE SAME POLICY
TO  CARE OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS IN THE DIAG-
NOSIS, TREATMENT AND MANAGEMENT  OF  THE  SAME  OR  SIMILAR  CONDITIONS,
DISORDERS  OR INJURIES. NOTHING IN THIS SUBSECTION SHALL BE CONSTRUED AS
IMPEDING OR PREVENTING EITHER THE PROVISIONS OR  COVERAGE  OF  PODIATRIC
CARE AND SERVICES BY DULY LICENSED DOCTORS OF PODIATRY WITHIN THE LAWFUL
SCOPE  OF  PODIATRIC  CARE IN HOSPITAL FACILITIES ON A STAFF OR EMPLOYEE
BASIS.
  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 apply to
policies and contracts issued, renewed, modified, altered or amended  on
or after such effective date.