S T A T E O F N E W Y O R K
________________________________________________________________________
4206--A
2011-2012 Regular Sessions
I N A S S E M B L Y
February 2, 2011
___________
Introduced by M. of A. P. RIVERA, McENENY, V. LOPEZ, CAHILL, LIFTON,
WEISENBERG, CLARK, BENEDETTO, J. RIVERA, THIELE, LATIMER, TITONE,
CAMARA, MAISEL, JAFFEE, GUNTHER, LANCMAN, CASTRO, BARRON, TITUS --
Multi-Sponsored by -- M. of A. ARROYO, AUBRY, BOYLAND, BRENNAN,
BURLING, CASTELLI, COLTON, CONTE, COOK, CURRAN, DUPREY, GABRYSZAK,
GIGLIO, HIKIND, JEFFRIES, KATZ, LUPARDO, MALLIOTAKIS, MARKEY, McDO-
NOUGH, McKEVITT, McLAUGHLIN, J. MILLER, M. MILLER, MILLMAN, MONTESANO,
NOLAN, PEOPLES-STOKES, REILLY, N. RIVERA, ROBINSON, SALADINO, SAYWARD,
SCHIMEL, STEVENSON, SWEENEY, TOBACCO, WEINSTEIN, ZEBROWSKI -- read
once and referred to the Committee on Insurance -- recommitted to the
Committee on Health in accordance with Assembly Rule 3, sec. 2 --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee
AN ACT to amend the insurance law, in relation to establishing an advi-
sory panel on health insurance coverage for autism spectrum disorder
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The insurance law is amended by adding a new section 342
to read as follows:
S 342. COVERAGE FOR AUTISM SPECTRUM DISORDER. (A) (1) THERE IS HEREBY
ESTABLISHED WITHIN THE DEPARTMENT AN ADVISORY PANEL ON HEALTH INSURANCE
COVERAGE FOR AUTISM SPECTRUM DISORDER. SUCH PANEL SHALL BE COMPOSED OF
NINE MEMBERS WHO ARE EXPERTS IN HEALTH CARE AND APPOINTED AS FOLLOWS:
SEVEN MEMBERS WHO ARE OFFICERS OR EMPLOYEES OF THE DEPARTMENT OF HEALTH,
OFFICE OF MENTAL HEALTH OR THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL
DISABILITIES SHALL BE APPOINTED BY THE GOVERNOR; AND THE TEMPORARY PRES-
IDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY SHALL EACH APPOINT A
MEMBER WHO IS A REPRESENTATIVE OF AN AUTISM ADVOCACY GROUP. EACH MEMBER
SHALL SERVE A TERM OF TWO YEARS. THE GOVERNOR SHALL DESIGNATE THE CHAIR
OF THE PANEL FROM AMONG HIS OR HER APPOINTEES. VACANCIES IN THE MEMBER-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00127-05-2
A. 4206--A 2
SHIP OF THE PANEL SHALL BE FILLED IN THE MANNER PROVIDED FOR ORIGINAL
APPOINTMENTS.
(2) THE MEMBERS OF THE PANEL SHALL RECEIVE NO COMPENSATION FOR THEIR
SERVICES BUT SHALL BE ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES
INCURRED IN THE PERFORMANCE OF THEIR DUTIES PURSUANT TO THIS SUBSECTION.
(3) THE ADVISORY PANEL ON HEALTH INSURANCE COVERAGE FOR AUTISM SPEC-
TRUM DISORDER SHALL ANNUALLY, ON OR BEFORE SEPTEMBER FIRST, COMPILE AND
SUBMIT TO THE SUPERINTENDENT A LIST OF SUCCESSFUL TREATMENT AND THERAPY
OPTIONS FOR AUTISM SPECTRUM DISORDER THAT WILL BE REQUIRED TO BE COVERED
PURSUANT TO PARAGRAPH TWENTY-FIVE OF SUBSECTION (I) OF SECTION THREE
THOUSAND TWO HUNDRED SIXTEEN, PARAGRAPH SEVENTEEN OF SUBSECTION (1) OF
SECTION THREE THOUSAND TWO HUNDRED TWENTY-ONE AND SUBSECTION (EE) OF
SECTION FOUR THOUSAND THREE HUNDRED THREE OF THIS CHAPTER.
(4) WITHIN FORTY-FIVE DAYS OF RECEIPT OF EACH LIST SUBMITTED PURSUANT
TO PARAGRAPH THREE OF THIS SUBSECTION, THE SUPERINTENDENT SHALL, ON AN
EMERGENCY BASIS, PROMULGATE AND IMPLEMENT RULES AND REGULATIONS REQUIR-
ING COVERAGE FOR THE TREATMENT AND THERAPY OPTIONS INCLUDED IN EACH SUCH
LIST.
(B) (1) WITHIN ONE HUNDRED EIGHTY DAYS OF THE SUBMISSION OF THE
INITIAL LIST TO THE SUPERINTENDENT PURSUANT TO PARAGRAPH THREE OF
SUBSECTION (A) OF THIS SECTION, THE DEPARTMENT SHALL ESTABLISH AND OPER-
ATE AN AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE. THE HOTLINE SHALL
BE A TOLL-FREE, TWENTY-FOUR HOUR A DAY CONSUMER CALL CENTER FOR FAMILIES
WITH AUTISTIC CHILDREN WHO HAVE COMPLAINTS ABOUT OR QUESTIONS ON INSUR-
ERS AND COVERAGE FOR AUTISM SPECTRUM DISORDER. ALL COMPLAINTS RECEIVED
BY SUCH HOTLINE SHALL BE DOCUMENTED AND REFERRED TO THE APPROPRIATE
OFFICIAL IN THE DEPARTMENT FOR CORRECTIVE ACTION.
(2) THE DEPARTMENT MAY CONTRACT WITH A QUALIFIED NOT-FOR-PROFIT CORPO-
RATION FOR THE PROVISION AND OPERATION OF THE HOTLINE REQUIRED BY THIS
SUBSECTION. ANY SUCH CONTRACT SHALL ONLY BE AWARDED AFTER THE DEPARTMENT
HAS CONDUCTED A REQUEST FOR PROPOSALS PROCESS. THE DEPARTMENT SHALL
SELECT A NOT-FOR-PROFIT CORPORATION WHICH HAS THE RESOURCES AND ABILITY
TO OPERATE A STATEWIDE HOTLINE, AND IS STAFFED BY EMPLOYEES AND/OR
VOLUNTEERS WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISORDER.
(3) IF THE DEPARTMENT ELECTS TO ESTABLISH AND OPERATE THE HOTLINE
USING ITS OWN PERSONNEL AND RESOURCES, SUCH HOTLINE SHALL BE STAFFED BY
OFFICERS AND EMPLOYEES WITH STRONG EXPERIENCE IN AUTISM SPECTRUM DISOR-
DER. UNTIL THE STATE CIVIL SERVICE COMMISSION SHALL HAVE ESTABLISHED
CIVIL SERVICE TITLES AND COMPETITIVE EXAMINATIONS FOR POSITIONS AS
EMPLOYEES OF THE HOTLINE, THE SUPERINTENDENT IS AUTHORIZED AND DIRECTED
TO APPOINT AND EMPLOY SUCH QUALIFIED OFFICERS AND EMPLOYEES AS SHALL BE
NECESSARY TO OPERATE THE AUTISM AND HEALTH INSURANCE COVERAGE HOTLINE.
(4) THE SUPERINTENDENT IS AUTHORIZED TO PROMULGATE AND IMPLEMENT ANY
RULES AND REGULATIONS NECESSARY TO CARRY OUT THE PROVISIONS OF THIS
SUBSECTION.
S 2. 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] INCLUDE FULL coverage for THE
PREVENTION, EARLY DETECTION, diagnosis and treatment of [medical condi-
tions otherwise covered by the policy solely because the treatment is
provided to diagnose or treat] autism spectrum disorder. For purposes of
this section, "autism spectrum disorder" means a neurobiological condi-
tion that includes autism, Asperger syndrome, Rett's syndrome, or perva-
sive developmental disorder.
A. 4206--A 3
S 3. Subparagraph (A) of paragraph 25 of subsection (i) of section
3216 of the insurance law, as amended by chapter 595 of the laws of
2011, is amended to read as follows:
(A) Every policy which provides coverage for hospital or surgical
coverage shall [not exclude] INCLUDE FULL coverage for [screening,] THE
PREVENTION, EARLY DETECTION, diagnosis and treatment of [medical condi-
tions otherwise covered by the policy solely because the treatment is
provided to diagnose or treat] autism spectrum disorder.
S 4. Paragraph 17 of subsection (l) of section 3221 of the insurance
law, as added by chapter 557 of the laws of 2006, is amended to read as
follows:
(17) A group or blanket accident or health insurance policy or issuing
a group or blanket policy for delivery in this state which provides
coverage for hospital, surgical, or medical care coverage shall [not
exclude] INCLUDE FULL coverage for THE PREVENTION, EARLY DETECTION,
diagnosis and treatment of [medical conditions otherwise covered by the
policy because the treatment is provided to diagnose or treat] autism
spectrum disorder. For purposes of this section, "autism spectrum disor-
der" means a neurobiological condition that includes autism, Asperger
syndrome, Rett's syndrome, or pervasive developmental disorder.
S 5. Subparagraph (A) of paragraph 17 of subsection (1) of section
3221 of the insurance law, as amended by chapter 595 of the laws of
2011, is amended to read as follows:
(A) Every group or blanket accident and health insurance policy deliv-
ered or issued for delivery in this state which provides coverage for
hospital or surgical care coverage shall [not exclude] INCLUDE FULL
coverage for [screening,] THE PREVENTION, EARLY DETECTION, diagnosis and
treatment of [medical conditions otherwise covered by the policy because
the treatment is provided to diagnose or treat] autism spectrum disor-
der.
S 6. Subsection (ee) of section 4303 of the insurance law, as added by
chapter 557 of the laws of 2006, is amended to read as follows:
(ee) A medical expense indemnity corporation, a hospital service
corporation or a health service corporation which provides coverage for
hospital, surgical, or medical care coverage shall [not exclude] INCLUDE
FULL coverage for THE PREVENTION, EARLY DETECTION, diagnosis and treat-
ment of [medical conditions otherwise covered by the policy solely
because the treatment is provided to diagnose or treat] autism spectrum
disorder. For purposes of this section, "autism spectrum disorder" means
a neurobiological condition that includes autism, Asperger syndrome,
Rett's syndrome, or pervasive developmental disorder.
S 7. Paragraph 1 of subsection (ee) of section 4303 of the insurance
law, as amended by chapter 596 of the laws of 2011, is amended to read
as follows:
(1) A medical expense indemnity corporation, a hospital service corpo-
ration or a health service corporation which provides coverage for
hospital or surgical care coverage shall [not exclude] INCLUDE FULL
coverage for [screening,] THE PREVENTION, EARLY DETECTION, diagnosis and
treatment of medical conditions otherwise covered by the contract solely
because the treatment is provided to diagnose or treat autism spectrum
disorder.
S 8. This act shall take effect on the thirtieth day after it shall
have become a law; provided, however, that sections three, five and
seven of this act shall take effect on the same date and in the same
manner as chapter 595 of the laws of 2011, as amended, takes effect.