Senate Bill S4097

2011-2012 Legislative Session

Requires that accident and health insurance policies shall provide coverage for screening, diagnosis and treatment of autism spectrum disorder

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Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2011-S4097 (ACTIVE) - Details

See Assembly Version of this Bill:
A5365
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §2500-j, Pub Health L
Versions Introduced in 2009-2010 Legislative Session:
S7000, A10372

2011-S4097 (ACTIVE) - Summary

Requires that individual accident and health insurance policies shall provide coverage for screening, diagnosis and treatment of autism spectrum disorder.

2011-S4097 (ACTIVE) - Sponsor Memo

2011-S4097 (ACTIVE) - Bill Text download pdf

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

                                  4097

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             March 17, 2011
                               ___________

Introduced  by  Sen.  DUANE  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Insurance

AN ACT to amend the insurance law and the public health law, in relation
  to coverage for the screening, diagnosis and treatment of autism spec-
  trum disorder

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

  Section  1.  Paragraph  25  of  subsection  (i) of section 3216 of the
insurance law, as added by chapter 557 of the laws of 2006,  is  amended
to read as follows:
  (25)  Every  policy which provides coverage for hospital, surgical, or
medical care coverage shall  [not  exclude]  PROVIDE  coverage  for  THE
SCREENING,  diagnosis  and  treatment  of  [medical conditions otherwise
covered by the policy solely because the treatment is provided to  diag-
nose  or  treat]  autism spectrum disorder IN ACCORDANCE WITH THIS PARA-
GRAPH AND SHALL NOT EXCLUDE COVERAGE FOR THE TREATMENT OF MEDICAL CONDI-
TIONS  OTHERWISE  COVERED  BY  THE  POLICY  BECAUSE  THE  INDIVIDUAL  IS
DIAGNOSED  WITH  AN  AUTISM  SPECTRUM  DISORDER.    SUCH COVERAGE MAY BE
SUBJECT TO ANNUAL DEDUCTIBLES, COPAYMENTS  AND  COINSURANCE  AS  MAY  BE
DEEMED  APPROPRIATE  BY  THE SUPERINTENDENT AND SHALL BE CONSISTENT WITH
THOSE IMPOSED ON OTHER BENEFITS UNDER THE POLICY. THIS  PARAGRAPH  SHALL
NOT  BE  CONSTRUED AS LIMITING THE BENEFITS THAT ARE OTHERWISE AVAILABLE
TO AN INDIVIDUAL UNDER THE POLICY. COVERAGE MAY BE SUBJECT  TO  UTILIZA-
TION  REVIEW  OF  HEALTH  CARE SERVICES, INCLUDING THE REVIEW OF MEDICAL
NECESSITY, CASE MANAGEMENT, AND OTHER MANAGED CARE PROVISIONS.
  (A) For purposes of this [section] PARAGRAPH, "autism spectrum  disor-
der"  means  a GROUP OF neurobiological [condition that includes autism,
Asperger syndrome, Rett's syndrome, or pervasive developmental disorder]
CONDITIONS DEFINED IN THE DIAGNOSTIC AND STATISTICAL  MANUAL  OF  MENTAL
DISORDERS  IV  REVISED,  OR  ITS  SUCCESSOR,  AS PERVASIVE DEVELOPMENTAL
DISORDERS.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05243-01-1
              

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