S T A T E O F N E W Y O R K
________________________________________________________________________
6236
2015-2016 Regular Sessions
I N A S S E M B L Y
March 18, 2015
___________
Introduced by M. of A. ORTIZ -- read once and referred to the Committee
on Insurance
AN ACT to amend the insurance law, in relation to requiring health
insurance policies to provide coverage for medically necessary care
for the treatment of autism spectrum 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 is amended by adding a new subparagraph (H) to read as
follows:
(H) EVERY POLICY WHICH PROVIDES COVERAGE FOR HOSPITAL, SURGICAL, OR
MEDICAL CARE COVERAGE SHALL PROVIDE ANY AND ALL DIAGNOSTIC SCREENING,
TESTS, AND ASSESSMENTS AND TREATMENT INCLUDING MEDICAL CARE, CONSULTA-
TION, HABILITATION, REHABILITATION, SPEECH, BEHAVIORAL, OCCUPATIONAL AND
PHYSICAL THERAPIES, PEDIATRIC, NEUROLOGICAL, GASTRO-ENTEROLOGIC, AND ANY
OTHER MEDICALLY NECESSARY CARE THAT IS PROVIDED BY A LICENSED PROVIDER
REQUIRED FOR THE TREATMENT OF AUTISM SPECTRUM DISORDER, INCLUDING
ASPERGER'S DISORDER AND PERVASIVE DEVELOPMENTAL DISORDERS AS DETERMINED
BY THE TREATING PHYSICIAN.
S 2. Paragraph 17 of subsection (1) of section 3221 of the insurance
law is amended by adding a new subparagraph (H) to read as follows:
(H) EVERY POLICY WHICH PROVIDES COVERAGE FOR HOSPITAL, SURGICAL, OR
MEDICAL CARE COVERAGE SHALL PROVIDE ANY AND ALL DIAGNOSTIC SCREENING,
TESTS, AND ASSESSMENTS AND TREATMENT INCLUDING MEDICAL CARE, CONSULTA-
TION, HABILITATION, REHABILITATION, SPEECH, BEHAVIORAL, OCCUPATIONAL AND
PHYSICAL THERAPIES, PEDIATRIC, NEUROLOGICAL, GASTRO-ENTEROLOGIC, AND ANY
OTHER MEDICALLY NECESSARY CARE THAT IS PROVIDED BY A LICENSED PROVIDER
REQUIRED FOR THE TREATMENT OF AUTISM SPECTRUM DISORDER, INCLUDING
ASPERGER'S DISORDER AND PERVASIVE DEVELOPMENTAL DISORDERS AS DETERMINED
BY THE TREATING PHYSICIAN.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04388-01-5
A. 6236 2
S 3. Subsection (ee) of section 4303 of the insurance law is amended
by adding a new paragraph 8 to read as follows:
(8) EVERY POLICY WHICH PROVIDES COVERAGE FOR HOSPITAL, SURGICAL, OR
MEDICAL CARE COVERAGE SHALL PROVIDE ANY AND ALL DIAGNOSTIC SCREENING,
TESTS, AND ASSESSMENTS AND TREATMENT INCLUDING MEDICAL CARE, CONSULTA-
TION, HABILITATION, REHABILITATION, SPEECH, BEHAVIORAL, OCCUPATIONAL AND
PHYSICAL THERAPIES, PEDIATRIC, NEUROLOGICAL, GASTRO-ENTEROLOGIC, AND ANY
OTHER MEDICALLY NECESSARY CARE THAT IS PROVIDED BY A LICENSED PROVIDER
REQUIRED FOR THE TREATMENT OF AUTISM SPECTRUM DISORDER, INCLUDING
ASPERGER'S DISORDER AND PERVASIVE DEVELOPMENTAL DISORDERS AS DETERMINED
BY THE TREATING PHYSICIAN.
S 4. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law and shall apply to all
policies or contracts issued, renewed, modified, altered or amended on
and after such effective date.