NY State Assembly Bill 2015-A7545C

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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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 01, 2016	reported referred to ways and means
May 27, 2016	print number 7545c
May 27, 2016	amend and recommit to insurance
Jan 20, 2016	committed to insurance
Jan 06, 2016	ordered to third reading cal.296 returned to assembly died in senate
Jun 16, 2015	referred to rules delivered to senate passed assembly
Jun 15, 2015	ordered to third reading rules cal.398 rules report cal.398 reported
Jun 12, 2015	amend and recommit to rules 7545b
Jun 10, 2015	reported referred to rules
Jun 03, 2015	reported referred to ways and means
May 27, 2015	print number 7545a
May 27, 2015	amend and recommit to insurance
May 18, 2015	referred to insurance

Bill Amendments

Original

C (Active)

co-Sponsors

multi-Sponsors

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2015-A7545 - Details

Current Committee:: Assembly Ways And Means
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2013-2014: A6820
2017-2018: A6304
2019-2020: A6286

2015-A7545 - Summary

Requires mandatory health insurance coverage for certain individuals with prosthetic limbs; requires coverage where the model is determined to adequately meet the medical needs of the policy holder.

2015-A7545 - Bill Text download pdf

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

                                  7545

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                              May 18, 2015
                               ___________

Introduced  by M. of A. CRESPO -- Multi-Sponsored by -- M. of A. ARROYO,
  DAVILA, JOYNER, LAVINE, LINARES, PICHARDO, RIVERA, RODRIGUEZ, SEPULVE-
  DA -- read once and referred to the Committee on Insurance

AN ACT to amend the insurance  law,  in  relation  to  mandatory  health
  insurance coverage for 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 AND PROVIDES COVERAGE  FOR  DURABLE  MEDICAL
EQUIPMENT  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 THAT IS EQUIVALENT TO THE
COVERAGE PROVIDED FOR DURABLE MEDICAL EQUIPMENT.  COVERAGE SHALL NOT  BE
DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC DEVICE
IS THE MOST APPROPRIATE MODEL THAT ADEQUATELY MEETS THE MEDICAL NEEDS OF
THE  POLICY  HOLDER.  THE TERM "PROSTHETIC DEVICE" AS USED IN THIS PARA-
GRAPH INCLUDES AN ARTIFICIAL LIMB BUT SHALL NOT  INCLUDE  SHOES  OR  ANY
OTHER  ARTICLE  CONSIDERED  AS  ORDINARY WEARING APPAREL, WHETHER OR NOT
SPECIALLY CONSTRUCTED.  THE TERM "POLICY HOLDER" AS USED IN  THIS  PARA-
GRAPH  SHALL MEAN A VETERAN OF THE ARMED FORCES WHO RESIDES IN THE STATE
OF NEW YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC  DEVICE  RESULTED
FROM  AN  INJURY SUFFERED IN THE LINE OF DUTY WHILE SERVING IN THE ARMED
FORCES.
  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  AND PROVIDES COVERAGE FOR DURABLE MEDICAL
EQUIPMENT  SHALL  PROVIDE  COVERAGE  FOR  PROSTHETIC  DEVICES  THAT  ARE
INTENDED   FOR   MEDICALLY  NECESSARY  REHABILITATIVE  AND  HABILITATIVE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06364-03-5

A. 7545                             2

PURPOSES AS REQUIRED BY 42 U.S.C. S 18022  THAT  IS  EQUIVALENT  TO  THE
COVERAGE  PROVIDED FOR DURABLE MEDICAL EQUIPMENT.  COVERAGE SHALL NOT BE
DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC DEVICE
IS THE MOST APPROPRIATE MODEL THAT ADEQUATELY MEETS THE MEDICAL NEEDS OF
THE  POLICY  HOLDER.  THE TERM "PROSTHETIC DEVICE" AS USED IN THIS PARA-
GRAPH INCLUDES AN ARTIFICIAL LIMB BUT SHALL NOT  INCLUDE  SHOES  OR  ANY
OTHER  ARTICLE  CONSIDERED  AS  ORDINARY WEARING APPAREL, WHETHER OR NOT
SPECIALLY CONSTRUCTED. THE TERM "POLICY HOLDER" AS USED  IN  THIS  PARA-
GRAPH  SHALL MEAN A VETERAN OF THE ARMED FORCES WHO RESIDES IN THE STATE
OF NEW YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC  DEVICE  RESULTED
FROM  AN  INJURY SUFFERED IN THE LINE OF DUTY WHILE SERVING IN THE ARMED
FORCES.
  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 AND PROVIDES COVERAGE  FOR  DURABLE  MEDICAL
EQUIPMENT  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 THAT IS EQUIVALENT TO THE
COVERAGE PROVIDED FOR DURABLE MEDICAL EQUIPMENT.  COVERAGE SHALL NOT  BE
DENIED IF THE POLICY HOLDER'S PHYSICIAN DETERMINES THE PROSTHETIC DEVICE
IS THE MOST APPROPRIATE MODEL THAT ADEQUATELY MEETS THE MEDICAL NEEDS OF
THE  POLICY  HOLDER.    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.    THE  TERM  "POLICY  HOLDER"  AS  USED IN THIS
SUBSECTION SHALL MEAN A VETERAN OF THE ARMED FORCES WHO RESIDES  IN  THE
STATE  OF  NEW  YORK  AND  WHOSE MEDICAL NEED FOR SUCH PROSTHETIC DEVICE
RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY  WHILE  SERVING  IN
THE ARMED FORCES.
  S  4.  This  act shall take effect May 25, 2016 and shall apply to all
policies and contracts issued, renewed, altered, or amended on or  after
such effective date.

co-Sponsors

multi-Sponsors

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2015-A7545A - Details

Current Committee:: Assembly Ways And Means
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2013-2014: A6820
2017-2018: A6304
2019-2020: A6286

2015-A7545A - Summary

Requires mandatory health insurance coverage for certain individuals with prosthetic limbs; requires coverage where the model is determined to adequately meet the medical needs of the policy holder.

2015-A7545A - Bill Text download pdf

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

                                 7545--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                              May 18, 2015
                               ___________

Introduced  by  M.  of A. CRESPO, RAIA -- Multi-Sponsored by -- M. of A.
  ARROYO, DAVILA, JOYNER, LAVINE, LINARES, PICHARDO, RIVERA,  RODRIGUEZ,
  SEPULVEDA  --  read once and referred 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 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  PARA-
GRAPH  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 DEDUCT-
IBLES 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. S 300 GG-6(A). THE TERM "POLICY HOLDER" AS USED
IN THIS PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES  WHO  RESIDES

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06364-04-5

A. 7545--A                          2

IN  THE  STATE  OF  NEW  YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC
DEVICE RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE  SERV-
ING IN THE ARMED FORCES.
  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  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 PARA-
GRAPH 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  DEDUCT-
IBLES  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. S 300 GG-6(A). THE TERM "POLICY HOLDER"  AS  USED
IN  THIS  PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES WHO RESIDES
IN THE STATE OF NEW YORK AND WHOSE  MEDICAL  NEED  FOR  SUCH  PROSTHETIC
DEVICE  RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE SERV-
ING IN THE ARMED FORCES.
  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  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  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. S 300 GG-6(A). THE TERM "POLICY HOLDER" AS  USED  IN  THIS
SUBSECTION  SHALL  MEAN A VETERAN OF THE ARMED FORCES WHO RESIDES IN THE
STATE OF NEW YORK AND WHOSE MEDICAL  NEED  FOR  SUCH  PROSTHETIC  DEVICE
RESULTED  FROM  AN  INJURY SUFFERED IN THE LINE OF DUTY WHILE SERVING IN
THE ARMED FORCES.
  S 4. This act shall take effect May 25, 2016 and shall  apply  to  all
policies  and contracts issued, renewed, altered, or amended on or after
such effective date.

co-Sponsors

multi-Sponsors

View additional multi-sponsors

2015-A7545B - Details

Current Committee:: Assembly Ways And Means
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2013-2014: A6820
2017-2018: A6304
2019-2020: A6286

2015-A7545B - Summary

Requires mandatory health insurance coverage for certain individuals with prosthetic limbs; requires coverage where the model is determined to adequately meet the medical needs of the policy holder.

2015-A7545B - Bill Text download pdf

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

                                 7545--B

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                              May 18, 2015
                               ___________

Introduced  by  M.  of  A.  CRESPO,  RAIA,  RIVERA, PALMESANO, DUPREY --
  Multi-Sponsored by -- M. of A. ARROYO, DAVILA, HOOPER, JOYNER, LAVINE,
  LINARES, PICHARDO, RODRIGUEZ, SEPULVEDA -- read once and  referred  to
  the  Committee  on  Insurance  --  committee discharged, bill amended,
  ordered reprinted as amended and  recommitted  to  said  committee  --
  reported  and  referred to the Committee on Ways and Means -- reported
  and referred to the Committee on Rules -- Rules Committee  discharged,
  bill  amended,  ordered  reprinted  as  amended and recommitted to the
  Committee on Rules

AN ACT to amend the insurance  law,  in  relation  to  mandatory  health
  insurance coverage for 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.   S 18022. 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  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.  THE TERM "POLICY HOLDER" AS USED
IN THIS PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES  WHO  RESIDES
IN  THE  STATE  OF  NEW  YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC
DEVICE RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE  SERV-
ING IN THE ARMED FORCES.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06364-06-5

A. 7545--B                          2

  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.   S 18022. 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  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.  THE TERM "POLICY HOLDER" AS USED
IN THIS PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES  WHO  RESIDES
IN  THE  STATE  OF  NEW  YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC
DEVICE RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE  SERV-
ING IN THE ARMED FORCES.
  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.  S  18022.  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.  THE TERM "POLICY HOLDER" AS USED
IN THIS SUBSECTION SHALL MEAN A VETERAN OF THE ARMED FORCES WHO  RESIDES
IN  THE  STATE  OF  NEW  YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC
DEVICE RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE  SERV-
ING IN THE ARMED FORCES.
  S  4.  This  act shall take effect May 25, 2016 and shall apply to all
policies and contracts issued, renewed, altered, or amended on or  after
such effective date.

co-Sponsors

multi-Sponsors

View additional multi-sponsors

2015-A7545C (ACTIVE) - Details

Current Committee:: Assembly Ways And Means
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2013-2014: A6820
2017-2018: A6304
2019-2020: A6286

2015-A7545C (ACTIVE) - Summary

Requires mandatory health insurance coverage for certain individuals with prosthetic limbs; requires coverage where the model is determined to adequately meet the medical needs of the policy holder.

2015-A7545C (ACTIVE) - Bill Text download pdf

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

                                 7545--C

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                              May 18, 2015
                               ___________

Introduced  by  M.  of  A.  CRESPO,  RAIA,  RIVERA, PALMESANO, DUPREY --
  Multi-Sponsored by -- M. of A. ARROYO, DAVILA, HOOPER, JOYNER, LAVINE,
  LINARES, PICHARDO, RODRIGUEZ, SEPULVEDA -- read once and  referred  to
  the  Committee  on  Insurance  --  committee discharged, bill amended,
  ordered reprinted as amended and  recommitted  to  said  committee  --
  reported  and  referred to the Committee on Ways and Means -- reported
  and referred to the Committee on Rules -- Rules Committee  discharged,
  bill  amended,  ordered  reprinted  as  amended and recommitted to the
  Committee on Rules -- ordered to a third reading -- committed  to  the
  Committee  on  Insurance 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 mandatory health
  insurance coverage for 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.    S  18022. 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 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.  THE TERM "POLICY HOLDER" AS  USED
IN  THIS  PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES WHO RESIDES

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06364-10-6

A. 7545--C                          2

IN THE STATE OF NEW YORK AND WHOSE  MEDICAL  NEED  FOR  SUCH  PROSTHETIC
DEVICE  RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE SERV-
ING IN THE ARMED FORCES.
  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.   S 18022. 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  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.  THE TERM "POLICY HOLDER" AS USED
IN THIS PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES  WHO  RESIDES
IN  THE  STATE  OF  NEW  YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC
DEVICE RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE  SERV-
ING IN THE ARMED FORCES.
  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.  S  18022.  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.  THE TERM "POLICY HOLDER" AS USED
IN THIS SUBSECTION SHALL MEAN A VETERAN OF THE ARMED FORCES WHO  RESIDES
IN  THE  STATE  OF  NEW  YORK AND WHOSE MEDICAL NEED FOR SUCH PROSTHETIC
DEVICE RESULTED FROM AN INJURY SUFFERED IN THE LINE OF DUTY WHILE  SERV-
ING IN THE ARMED FORCES.
  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, altered, or amended on or after such effective date.

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Maritza Davila

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Earlene Hooper

Latoya Joyner

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Jose Rivera

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Janet Duprey

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