|Assembly Actions - Lowercase
Senate Actions - UPPERCASE
|Jan 08, 2014||referred to insurance|
|Jan 09, 2013||referred to insurance|
senate Bill S1049
Archive: Last Bill Status - In Committee
- In Committee
- On Floor Calendar
- Passed Senate
- Passed Assembly
- Delivered to Governor
- Signed/Vetoed by Governor
S1049 - Details
S1049 - Summary
Requires insurance coverage under health insurance plans for diagnosis and treatment of craniofacial disorder; provides a referral from a health care provider under contract with the policy may be required.
S1049 - Sponsor Memo
BILL NUMBER:S1049 TITLE OF BILL: An act to amend the insurance law, in relation to health insurance coverage for craniofacial disorders PURPOSE: To require health insurance policies providing coverage for physician services, major medical or similar comprehensive-type coverage to cover the diagnosis and treatment of temporomandibular joint disorder. SUMMARY OF PROVISIONS: Amends the insurance law by adding a new paragraph 30 to section 3216(i), a new paragraph 19 to section 3221(k) and a new subsection (jj) to section 4303 to require every individual, group and managed care health policy and plan which provides medical coverage that includes physician services in a physician's office, or major medical, or similar comprehensive-type coverage to provide coverage for the diagnosis and treatment of temporomandibular joint disorder. Such coverage shall include orthodontic and dental treatment necessary to treat and repair all damage traceable to such temporomandibular joint disorder. The coverage may be subject to annual deductibles and coinsurance as deemed appropriate. JUSTIFICATION:
S1049 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 1049 2013-2014 Regular Sessions I N S E N A T E (PREFILED) January 9, 2013 ___________ Introduced by Sen. MAZIARZ -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to health insurance coverage for craniofacial disorders 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 30 to read as follows: (30)(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 DIAGNOSIS AND MEDICALLY NECESSARY TREATMENT, INCLUDING SURGICAL AND NONSURGICAL PROCEDURES, FOR A MUSCULOSKELETAL DISORDER THAT AFFECTS ANY BONE OR JOINT IN THE FACE, NECK OR HEAD AND IS THE RESULT OF ACCIDENT, TRAUMA, CONGENITAL DEFECT, DEVELOPMENTAL DEFECT, OR PATHOLOGY. SUBJECT TO SUBPARAGRAPH (B) OF THIS PARAGRAPH, THIS COVERAGE SHALL BE THE SAME AS THAT PROVIDED UNDER THE HEALTH INSURANCE PLAN FOR ANY OTHER MUSCU- LOSKELETAL DISORDER IN THE BODY AND MAY BE PROVIDED WHEN PRESCRIBED OR ADMINISTERED BY A PHYSICIAN OR A DENTIST. THIS PARAGRAPH SHALL NOT BE CONSTRUED TO REQUIRE COVERAGE FOR DENTAL SERVICES FOR THE DIAGNOSIS OR TREATMENT OF DENTAL DISORDERS OR DENTAL PATHOLOGY PRIMARILY AFFECTING THE GUMS, TEETH, OR ALVEOLAR RIDGE. (B) A REFERRAL FROM A HEALTH CARE PROVIDER UNDER CONTRACT WITH THE POLICY MAY BE REQUIRED. S 2. Subsection (k) of section 3221 of the insurance law is amended by adding a new paragraph 19 to read as follows: (19)(A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH PROVIDES MEDICAL COVERAGE THAT INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A PHYSICIAN'S OFFICE OR MAJOR MEDICAL OR SIMILAR EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
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