Assembly Bill A436

2015-2016 Legislative Session

Requires health insurance coverage for lymphedema

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Sponsored By

Archive: Last Bill Status - In Assembly 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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2015-A436 (ACTIVE) - Details

See Senate Version of this Bill:
S252
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2013-2014: A8363, S3474
2017-2018: A2271, S4292
2019-2020: A2816, S3321
2021-2022: A491, S4867
2023-2024: A1876

2015-A436 (ACTIVE) - Summary

Requires health insurance policies and contracts shall provide coverage for the diagnosis and treatment of lymphedema; and requires such coverage shall include benefits for equipment, supplies, devices, complex decongestive therapy and out-patient self management training and education for the treatment of lymphedema.

2015-A436 (ACTIVE) - Bill Text download pdf

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

                                   436

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 7, 2015
                               ___________

Introduced  by M. of A. ROSENTHAL, SCHIMEL, BROOK-KRASNY, LAVINE, PERRY,
  ROBINSON, THIELE -- Multi-Sponsored by  --  M.  of  A.  BARRON,  COOK,
  CYMBROWITZ, MARKEY, TITONE, WEINSTEIN -- read once and referred to the
  Committee on Insurance

AN  ACT  to  amend  the  insurance law, in relation to requiring certain
  health insurance coverage for lymphedema

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

  Section  1.  Clause  (ii)  of  subparagraph  (A)  of  paragraph  20 of
subsection (i) of section 3216 of the insurance law, as added by chapter
21 of the laws of 1997, is amended and a new clause (iii)  is  added  to
read as follows:
  (ii)  surgery  and  reconstruction  of  the  other breast to produce a
symmetrical appearance; AND
  (III) PROSTHESES AND PHYSICAL COMPLICATIONS OF ALL STAGES OF MASTECTO-
MY, INCLUDING LYMPHEDEMA;
  S 2. Subsection (i) of section 3216 of the insurance law is amended by
adding two new paragraphs 32 and 33 to read as follows:
  (32) EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL, MEDICAL OR  MAJOR
MEDICAL  COVERAGE  SHALL PROVIDE COVERAGE FOR THE DIFFERENTIAL DIAGNOSIS
AND TREATMENT OF LYMPHEDEMA. SUCH COVERAGE SHALL INCLUDE, IN ADDITION TO
BENEFITS FOR A COURSE OF MANUAL LYMPH DRAINAGE WHOSE FREQUENCY AND DURA-
TION IS DETERMINED BY THE  TREATING  PHYSICIAN  OR  THERAPIST  BASED  ON
MEDICAL  NECESSITY  AND NOT BASED ON PHYSICAL THERAPY AND REHABILITATION
STANDARDS, BENEFITS FOR EQUIPMENT, SUPPLIES, DEVICES, COMPLEX  DECONGES-
TIVE THERAPY, AND OUT-PATIENT SELF-MANAGEMENT TRAINING AND EDUCATION FOR
THE TREATMENT OF LYMPHEDEMA, IF PRESCRIBED BY A HEALTH CARE PROFESSIONAL
LEGALLY  AUTHORIZED TO PRESCRIBE OR PROVIDE SUCH ITEMS UNDER TITLE EIGHT
OF THE EDUCATION  LAW.    LYMPHEDEMA  THERAPY  ADMINISTERED  UNDER  THIS
SECTION  SHALL  BE ADMINISTERED ONLY BY A THERAPIST CERTIFIED TO PERFORM

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

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