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Assembly Bill A497

2011-2012 Legislative Session

Relates to mandatory health insurance coverage for providing prosthetic devices

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Archive: Last Bill Status - In Assembly Committee

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2011-A497 (ACTIVE) - Details

Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd ยงยง3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A770
2013-2014: A1103
2015-2016: A1178
2017-2018: A2212
2019-2020: A3086
2021-2022: A4120
2023-2024: A4395

2011-A497 (ACTIVE) - Summary

Relates to mandatory health insurance coverage for providing prosthetic devices equal to or above Medicare's standard of coverage; includes the repair or replacement of a prosthetic device required to be worn or used by a policy holder; coverage includes expenses for assessment, evaluation, treatment, management, and follow-up care.

2011-A497 (ACTIVE) - Bill Text download pdf 

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

                                   497

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 5, 2011
                               ___________

Introduced  by  M.  of  A.  GUNTHER,  PHEFFER, ORTIZ, ROSENTHAL, WRIGHT,
  JAFFEE, JACOBS, PERRY, CLARK, HOOPER, KELLNER, SPANO, CALHOUN,  McKEV-
  ITT,  DINOWITZ  --  Multi-Sponsored  by -- M. of A. ABBATE, BENEDETTO,
  BING, CONTE, COOK, CROUCH, CUSICK, GALEF, GIGLIO, GOTTFRIED,  LANCMAN,
  LATIMER, MAGNARELLI, MAISEL, McENENY, J. MILLER, PAULIN, RAIA, REILLY,
  J. RIVERA,  SCHROEDER,  SWEENEY,  THIELE,  WEISENBERG -- read once and
  referred to the Committee on Insurance

AN ACT to amend the insurance  law,  in  relation  to  mandatory  health
  insurance coverage for providing prosthetic devices

  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 28 to read as follows:
  (28)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE  EQUAL  TO  OR  ABOVE
MEDICARE'S  STANDARD  OF  COVERAGE  FOR PROSTHETIC DEVICES.   THIS SHALL
INCLUDE COVERAGE NOT ONLY FOR  THE  PROVISION  OF  A  PROSTHETIC  DEVICE
REQUIRED  TO  BE  WORN OR USED BY A POLICY HOLDER BUT ALSO THE REPAIR OR
REPLACEMENT OF A PROSTHETIC DEVICE REQUIRED TO BE  WORN  OR  USED  BY  A
POLICY  HOLDER.  COVERAGE  SHALL INCLUDE EXPENSES FOR ASSESSMENT, EVALU-
ATION, TREATMENT, MANAGEMENT, AND FOLLOW-UP CARE. COVERAGE SHALL NOT  BE
DENIED  ON  THE  GROUND THAT IT IS FOR COSMETIC PURPOSES OR IS NOT FOR A
FUNCTIONAL DEFECT OR IMPAIRMENT. THE TERM "PROSTHETIC DEVICE" AS USED IN
THIS SECTION INCLUDES AN ARTIFICIAL LIMB OR ARTIFICIAL EYE BUT SHALL NOT
INCLUDE SHOES OR  ANY  OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING
APPAREL, WHETHER OR NOT SPECIALLY CONSTRUCTED.
  S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 18 to read as follows:
  (18)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE TYPE COVERAGE SHALL INCLUDE COVERAGE  EQUAL  TO  OR  ABOVE

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

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