NY State Senate Bill 2015-S1708C

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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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 13, 2016	print number 1708c
Jan 13, 2016	amend and recommit to insurance
Jan 06, 2016	referred to insurance
Jun 15, 2015	print number 1708b
Jun 15, 2015	amend and recommit to insurance
May 18, 2015	print number 1708a
May 18, 2015	amend and recommit to insurance
Jan 14, 2015	referred to insurance

Bill Amendments

Original

C (Active)

co-Sponsors

View additional co-sponsors

2015-S1708 - Details

See Assembly Version of this Bill:: A1178
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: A770
2011-2012: A497
2013-2014: S3951, A1103
2017-2018: S2080, A2212
2019-2020: A3086
2021-2022: A4120
2023-2024: A4395

2015-S1708 - Summary

Relates to mandatory health insurance coverage for providing prosthetic devices.

2015-S1708 - Sponsor Memo

                                BILL NUMBER:S1708

TITLE OF BILL:

An act to amend the insurance law, in relation to mandatory health
insurance coverage for providing prosthetic devices

PURPOSE OR GENERAL IDEA OF BILL:

To provide mandatory coverage for prosthetic devices for children who
periodically need to have these devices altered or replaced due to
normal physical growth, for adults whose conditions change and to
account for updated technology, repair and replacement.

SUMMARY OF SPECIFIC PROVISIONS:

Sections 1, 2 & 3: Amends subsection (i) of section 3216, subsection

(1) of section 3221, and section 4303 of the Insurance Law to require
that 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.

Section 4: Effective date.

JUSTIFICATION:

Though not as common as in adults, children, even infants may need a
prosthetic device due to the loss of a limb. The overwhelming
experience for a child of losing a limb does not need to be compounded
by a long battle to pay for treatment. This legislation will provide
coverage to children and adults for prosthetic devices and to replace
or change these devices as needed to account for natural growth and
repairs of such devices.

LEGISLATIVE HISTORY:

S.3951-A of 2014: Died in Senate Insurance Committee, Died in Assembly
Insurance Committee
S.3951 of 2013:  Died in Senate Insurance Committee, Died in Assembly
Insurance Committee
S.2893 of 2010:  Died in Senate Insurance Committee, Died in Assembly
Insurance Committee
S.2893 of 2009:  Died in Senate Insurance Committee, Died in Assembly
Insurance Committee
S.1672 of 2008:  Died in Senate Insurance Committee, Died in Assembly
Insurance Committee
S.1672 of 2007:  Died in Senate Insurance Committee, Died in Assembly
Insurance Committee
S.599 of 2006:  Died in Senate Insurance Committee, Died in Assembly
Insurance Committee
S.599 of 2005:  Died in Senate Insurance Committee, Died in Assembly
Insurance Committee

FISCAL IMPLICATIONS:

None to the state.


EFFECTIVE DATE:

This act shall take effect on the ninetieth day after 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.

2015-S1708 - Bill Text download pdf

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

                                  1708

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 14, 2015
                               ___________

Introduced  by  Sens. BONACIC, ROBACH -- 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  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 32 to read as follows:
  (32)  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 19 to read as follows:
  (19)  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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00990-02-5

S. 1708                             2

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 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (pp) to read as follows:
  (PP)  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  4.  This  act shall take effect on the ninetieth day after 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.

co-Sponsors

View additional co-sponsors

2015-S1708A - Details

See Assembly Version of this Bill:: A1178
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: A770
2011-2012: A497
2013-2014: S3951, A1103
2017-2018: S2080, A2212
2019-2020: A3086
2021-2022: A4120
2023-2024: A4395

2015-S1708A - Summary

Relates to mandatory health insurance coverage for providing prosthetic devices.

2015-S1708A - Sponsor Memo

2015-S1708A - Bill Text download pdf

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

                                 1708--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 14, 2015
                               ___________

Introduced by Sens. BONACIC, HANNON, MARTINS, PANEPINTO, ROBACH, VENDIT-
  TO -- read twice and ordered printed, and when printed to be committed
  to  the  Committee on Insurance -- committee discharged, bill amended,
  ordered reprinted as amended and recommitted to said committee

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 32 to read as follows:
  (32)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES  THAT  ARE  INTENDED  FOR MEDICALLY NECESSARY REHABILITATIVE AND
HABILITATIVE PURPOSES AS REQUIRED BY 42 U.S.C. S 18022.  COVERAGE  SHALL
NOT BE DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC
DEVICE  ADEQUATELY  MEETS  THE  MEDICAL  NEEDS  OF  THE POLICY HOLDER IN
COMPLIANCE  WITH  THE  AGE,  DISABILITY  AND  EXPECTED  LENGTH  OF  LIFE
ANTI-DISCRIMINATION  REQUIREMENTS  OF 42 U.S.C. S 18022(B)(4)(B) AND THE
REQUIREMENT TO CONSIDER THE HEALTH CARE NEEDS OF DIVERSE SEGMENTS OF THE
POPULATION, INCLUDING PERSONS WITH DISABILITIES, PURSUANT TO 42 U.S.C. S
18022(B)(4)(C). THE TERM "PROSTHETIC DEVICE" AS USED IN  THIS  PARAGRAPH
INCLUDES  AN  ARTIFICIAL  LIMB  BUT SHALL NOT INCLUDE SHOES OR ANY OTHER
ARTICLE CONSIDERED AS ORDINARY WEARING APPAREL, WHETHER OR NOT SPECIALLY
CONSTRUCTED. SUCH COVERAGE SHALL BE SUBJECT TO  ANNUAL  DEDUCTIBLES  AND
COINSURANCE  AS  DEEMED APPROPRIATE BY THE SUPERINTENDENT.  THE COVERAGE
REQUIRED BY THIS PARAGRAPH SHALL BE IDENTICAL TO, AND SHALL NOT  ENHANCE
OR  INCREASE  THE COVERAGE REQUIRED AS PART OF ESSENTIAL HEALTH BENEFITS
AS REQUIRED PURSUANT TO SECTION 2707 (A) OF THE PUBLIC  HEALTH  SERVICES
ACT 42 U.S.C. 300 GG-6(A).
  S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00990-04-5

S. 1708--A                          2

  (19)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES  THAT  ARE  INTENDED  FOR MEDICALLY NECESSARY REHABILITATIVE AND
HABILITATIVE PURPOSES AS REQUIRED BY 42 U.S.C. S 18022.  COVERAGE  SHALL
NOT BE DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC
DEVICE  ADEQUATELY  MEETS  THE  MEDICAL  NEEDS  OF  THE POLICY HOLDER IN
COMPLIANCE  WITH  THE  AGE,  DISABILITY  AND  EXPECTED  LENGTH  OF  LIFE
ANTI-DISCRIMINATION  REQUIREMENTS  OF 42 U.S.C. S 18022(B)(4)(B) AND THE
REQUIREMENT TO CONSIDER THE HEALTH CARE NEEDS OF DIVERSE SEGMENTS OF THE
POPULATION, INCLUDING PERSONS WITH DISABILITIES, PURSUANT TO 42 U.S.C. S
18022(B)(4)(C). THE TERM "PROSTHETIC DEVICE" AS USED IN  THIS  PARAGRAPH
INCLUDES  AN  ARTIFICIAL  LIMB  BUT SHALL NOT INCLUDE SHOES OR ANY OTHER
ARTICLE CONSIDERED AS ORDINARY WEARING APPAREL, WHETHER OR NOT SPECIALLY
CONSTRUCTED. SUCH COVERAGE SHALL BE SUBJECT TO  ANNUAL  DEDUCTIBLES  AND
COINSURANCE  AS  DEEMED APPROPRIATE BY THE SUPERINTENDENT.  THE COVERAGE
REQUIRED BY THIS PARAGRAPH SHALL BE IDENTICAL TO, AND SHALL NOT  ENHANCE
OR  INCREASE  THE COVERAGE REQUIRED AS PART OF ESSENTIAL HEALTH BENEFITS
AS REQUIRED PURSUANT TO SECTION 2707 (A) OF THE PUBLIC  HEALTH  SERVICES
ACT 42 U.S.C. 300 GG-6(A).
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (pp) to read as follows:
  (PP) EVERY CONTRACT WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES THAT ARE INTENDED FOR  MEDICALLY  NECESSARY  REHABILITATIVE  AND
HABILITATIVE  PURPOSES  AS REQUIRED BY 42 U.S.C. S 18022. COVERAGE SHALL
NOT BE DENIED IF THE CONTRACT HOLDER'S PHYSICIAN  DETERMINES  THE  PROS-
THETIC  DEVICE ADEQUATELY MEETS THE MEDICAL NEEDS OF THE CONTRACT HOLDER
IN COMPLIANCE WITH THE AGE,  DISABILITY  AND  EXPECTED  LENGTH  OF  LIFE
ANTI-DISCRIMINATION  REQUIREMENTS  OF 42 U.S.C. S 18022(B)(4)(B) AND THE
REQUIREMENT TO CONSIDER THE HEALTH CARE NEEDS OF DIVERSE SEGMENTS OF THE
POPULATION, INCLUDING PERSONS WITH DISABILITIES, PURSUANT TO 42 U.S.C. S
18022(B)(4)(C). THE TERM "PROSTHETIC DEVICE" AS USED IN THIS  SUBSECTION
INCLUDES  AN  ARTIFICIAL  LIMB  BUT SHALL NOT INCLUDE SHOES OR ANY OTHER
ARTICLE CONSIDERED AS ORDINARY WEARING APPAREL, WHETHER OR NOT SPECIALLY
CONSTRUCTED. SUCH COVERAGE SHALL BE SUBJECT TO  ANNUAL  DEDUCTIBLES  AND
COINSURANCE  AS  DEEMED APPROPRIATE BY THE SUPERINTENDENT.  THE COVERAGE
REQUIRED BY THIS SUBSECTION SHALL BE IDENTICAL TO, AND SHALL NOT ENHANCE
OR INCREASE THE COVERAGE REQUIRED AS PART OF ESSENTIAL  HEALTH  BENEFITS
AS  REQUIRED  PURSUANT  TO SECTION 2707(A) OF THE PUBLIC HEALTH SERVICES
ACT 42 U.S.C. 300 GG-6(A).
  S 4. This act shall take effect on the ninetieth day  after  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.

co-Sponsors

View additional co-sponsors

2015-S1708B - Details

See Assembly Version of this Bill:: A1178
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: A770
2011-2012: A497
2013-2014: S3951, A1103
2017-2018: S2080, A2212
2019-2020: A3086
2021-2022: A4120
2023-2024: A4395

2015-S1708B - Summary

Relates to mandatory health insurance coverage for providing prosthetic devices.

2015-S1708B - Bill Text download pdf

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

                                 1708--B

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 14, 2015
                               ___________

Introduced  by Sens. BONACIC, AVELLA, BRESLIN, HANNON, LATIMER, MARTINS,
  PANEPINTO, ROBACH, VENDITTO -- read twice  and  ordered  printed,  and
  when  printed to be committed to the Committee on Insurance -- commit-
  tee discharged, bill amended, ordered reprinted as amended and  recom-
  mitted  to  said  committee  --  committee  discharged,  bill amended,
  ordered reprinted as amended and recommitted to said committee

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 32 to read as follows:
  (32)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES,  INCLUDING  REPAIRS  AND  REPLACEMENTS,  THAT  ARE INTENDED FOR
MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
BY 42 U.S.C. S18022.  AS  SUCH,  PROSTHETIC  DEVICE  COVERAGE  SHALL  BE
SUBJECT  TO  ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED APPROPRIATE BY
THE SUPERINTENDENT IN AMOUNTS NO GREATER  THAN  OTHER  ESSENTIAL  HEALTH
BENEFITS  COVERED BY THE POLICY. THE TERM "PROSTHETIC DEVICE" AS USED IN
THIS PARAGRAPH INCLUDES AN ARTIFICIAL LIMB AND ALL OF THE COMPONENTS AND
RELATED SERVICES THAT COMPRISE PROSTHETIC CARE  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 19 to read as follows:
  (19) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES, INCLUDING REPAIRS  AND  REPLACEMENTS,  THAT  ARE  INTENDED  FOR
MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
BY  42  U.S.C.  S18022.  AS  SUCH,  PROSTHETIC  DEVICE COVERAGE SHALL BE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00990-06-5

S. 1708--B                          2

SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED  APPROPRIATE  BY
THE  SUPERINTENDENT  IN  AMOUNTS  NO GREATER THAN OTHER ESSENTIAL HEALTH
BENEFITS COVERED BY THE POLICY. THE TERM "PROSTHETIC DEVICE" AS USED  IN
THIS PARAGRAPH INCLUDES AN ARTIFICIAL LIMB AND ALL OF THE COMPONENTS AND
RELATED  SERVICES  THAT  COMPRISE  PROSTHETIC CARE BUT SHALL NOT INCLUDE
SHOES OR ANY OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING  APPAREL,
WHETHER OR NOT SPECIALLY CONSTRUCTED.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (pp) to read as follows:
  (PP) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES, INCLUDING REPAIRS  AND  REPLACEMENTS,  THAT  ARE  INTENDED  FOR
MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
BY  42  U.S.C.  S18022.  AS  SUCH,  PROSTHETIC  DEVICE COVERAGE SHALL BE
SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED  APPROPRIATE  BY
THE  SUPERINTENDENT  IN  AMOUNTS  NO GREATER THAN OTHER ESSENTIAL HEALTH
BENEFITS COVERED BY THE POLICY. THE TERM "PROSTHETIC DEVICE" AS USED  IN
THIS  SUBSECTION  INCLUDES  AN ARTIFICIAL LIMB AND ALL OF THE COMPONENTS
AND RELATED SERVICES THAT COMPRISE PROSTHETIC CARE BUT SHALL NOT INCLUDE
SHOES OR ANY OTHER  ARTICLE  CONSIDERED  AS  ORDINARY  WEARING  APPAREL,
WHETHER OR NOT SPECIALLY CONSTRUCTED.
  S  4.  This  act shall take effect on the ninetieth day after 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.

co-Sponsors

View additional co-sponsors

2015-S1708C (ACTIVE) - Details

See Assembly Version of this Bill:: A1178
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: A770
2011-2012: A497
2013-2014: S3951, A1103
2017-2018: S2080, A2212
2019-2020: A3086
2021-2022: A4120
2023-2024: A4395

2015-S1708C (ACTIVE) - Summary

Relates to mandatory health insurance coverage for providing prosthetic devices.

2015-S1708C (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S1708C

 TITLE OF BILL :

An act to amend the insurance law, in relation to mandatory health
insurance coverage for providing prosthetic devices

 PURPOSE OR GENERAL IDEA OF BILL :

To provide mandatory coverage for prosthetic devices for children who
periodically need to have these devices altered or replaced due to
normal physical growth, for adults whose conditions change and to
account for updated technology, repair and replacement.

 SUMMARY OF SPECIFIC PROVISIONS :

In order to mandate coverage by health insurance providers for
prosthetic devices:

Section 1 of the bill amends Subsection (i) of Section 3216 of the
Insurance Law by adding a new paragraph 33

Section 2 of the bill amends Subsection (1) of Section 3221 of the
Insurance Law by adding a new paragraph 19

Section 3 of the bill amends Section 4303 of the Insurance Law by

adding a new subsection (qq)

 JUSTIFICATION :

Though not as common as in adults, children, even infants may need a
prosthetic device due to the loss of a limb. The overwhelming
experience for a child of losing a limb does not need to be compounded
by a long battle to pay for treatment. This legislation will provide
coverage to children and adults for prosthetic devices and to replace
or change these devices as needed to account for natural growth and
repairs of such devices.

 LEGISLATIVE HISTORY :

2014-15: A1178-B passed Assembly/S1708-B referred to Insurance
2013-14: A1103-A held in Insurance/S3951-A referred to Insurance
2011-12: A497 referred to Insurance
2009-10: A770 Held in Insurance / S2893 referred to Insurance
2007-08:  A1274 referred to / S1672 referred to Senate Insurance
2005-06: A450 referred to Insurance / S599 referred to Senate
Insurance 2003-04: A9459 referred to insurance
2001-02: A10033B referred to Insurance / S4533B referred to Insurance

 FISCAL IMPLICATIONS :

None to the state.

 EFFECTIVE DATE :
This act shall take effect on the ninetieth day after 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.

2015-S1708C (ACTIVE) - Bill Text download pdf

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

                                 1708--C

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 14, 2015
                               ___________

Introduced  by  Sens. BONACIC, AVELLA, BRESLIN, GOLDEN, HANNON, LATIMER,
  MARTINS, PANEPINTO,  RITCHIE,  ROBACH,  VENDITTO  --  read  twice  and
  ordered  printed, and when printed to be committed to the Committee on
  Insurance -- committee discharged, bill amended, ordered reprinted  as
  amended  and  recommitted  to  said committee -- committee discharged,
  bill amended, ordered reprinted as amended  and  recommitted  to  said
  committee  --  recommitted to the Committee on Insurance in accordance
  with Senate Rule 6, sec. 8  --  committee  discharged,  bill  amended,
  ordered reprinted as amended and recommitted to said committee

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 33 to read as follows:
  (33) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR  MEDICAL,  OR  SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES, INCLUDING REPAIRS  AND  REPLACEMENTS,  THAT  ARE  INTENDED  FOR
MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
BY  42  U.S.C.  S18022.  AS  SUCH,  PROSTHETIC  DEVICE COVERAGE SHALL BE
SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED  APPROPRIATE  BY
THE  SUPERINTENDENT  IN  AMOUNTS  NO GREATER THAN OTHER ESSENTIAL HEALTH
BENEFITS COVERED BY THE POLICY. THE TERM "PROSTHETIC DEVICE" AS USED  IN
THIS PARAGRAPH INCLUDES AN ARTIFICIAL LIMB AND ALL OF THE COMPONENTS AND
RELATED  SERVICES  THAT  COMPRISE  PROSTHETIC CARE 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 19 to read as follows:
  (19)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00990-08-6

S. 1708--C                          2

DEVICES,  INCLUDING  REPAIRS  AND  REPLACEMENTS,  THAT  ARE INTENDED FOR
MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
BY 42 U.S.C. S18022.  AS  SUCH,  PROSTHETIC  DEVICE  COVERAGE  SHALL  BE
SUBJECT  TO  ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED APPROPRIATE BY
THE SUPERINTENDENT IN AMOUNTS NO GREATER  THAN  OTHER  ESSENTIAL  HEALTH
BENEFITS  COVERED BY THE POLICY. THE TERM "PROSTHETIC DEVICE" AS USED IN
THIS PARAGRAPH INCLUDES AN ARTIFICIAL LIMB AND ALL OF THE COMPONENTS AND
RELATED SERVICES THAT COMPRISE PROSTHETIC CARE  BUT  SHALL  NOT  INCLUDE
SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING APPAREL,
WHETHER OR NOT SPECIALLY CONSTRUCTED.
  S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (qq) to read as follows:
  (QQ)  EVERY  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE  TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC
DEVICES,  INCLUDING  REPAIRS  AND  REPLACEMENTS,  THAT  ARE INTENDED FOR
MEDICALLY NECESSARY REHABILITATIVE AND HABILITATIVE PURPOSES AS REQUIRED
BY 42 U.S.C. S18022.  AS  SUCH,  PROSTHETIC  DEVICE  COVERAGE  SHALL  BE
SUBJECT  TO  ANNUAL DEDUCTIBLES AND COINSURANCE AS DEEMED APPROPRIATE BY
THE SUPERINTENDENT IN AMOUNTS NO GREATER  THAN  OTHER  ESSENTIAL  HEALTH
BENEFITS  COVERED BY THE POLICY. THE TERM "PROSTHETIC DEVICE" AS USED IN
THIS SUBSECTION INCLUDES AN ARTIFICIAL LIMB AND ALL  OF  THE  COMPONENTS
AND RELATED SERVICES THAT COMPRISE PROSTHETIC CARE BUT SHALL NOT INCLUDE
SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING APPAREL,
WHETHER OR NOT SPECIALLY CONSTRUCTED.
  S 4. This act shall take effect on the ninetieth day  after  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.

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