S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1442
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 12, 2017
                                ___________
 
 Introduced  by  M. of A. CAHILL -- Multi-Sponsored by -- M. of A. ENGLE-
   BRIGHT, GALEF, PERRY -- read once and referred  to  the  Committee  on
   Insurance
 
 AN  ACT  to  amend  the  insurance law, in relation to requiring certain
   health insurance policies to cover costs  for  scalp  hair  prosthesis
   worn  for  hair loss suffered as a result of alopecia areata, alopecia
   totalis or alopecia universalis
 
   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 34 to read as follows:
   (34) (A) A GROUP HEALTH PLAN, AND A HEALTH INSURANCE  ISSUER  OFFERING
 HEALTH  INSURANCE COVERAGE IN CONNECTION WITH A GROUP HEALTH PLAN, SHALL
 PROVIDE COVERAGE FOR SCALP HAIR PROSTHESIS FOR A PARTICIPANT OR  BENEFI-
 CIARY  WHO  HAS SCALP HAIR LOSS AS A RESULT OF ALOPECIA AREATA, ALOPECIA
 TOTALIS OR ALOPECIA  UNIVERSALIS  IF  THE  ATTENDING  PHYSICIAN  OF  THE
 PARTICIPANT OR BENEFICIARY CERTIFIES IN WRITING THE MEDICAL NECESSITY OF
 THAT PROPOSED COURSE OF REHABILITATIVE TREATMENT.
   (B)  AS  USED  IN  THIS  PARAGRAPH,  THE  TERM "SCALP HAIR PROSTHESIS"
 INCLUDES ANY ARTIFICIAL SUBSTITUTES FOR SCALP HAIR.
   (C) THE COVERAGE REQUIRED UNDER  THIS  PARAGRAPH  IS  NOT  SUBJECT  TO
 DOLLAR  LIMITS,  DEDUCTIBLES,  AND  COINSURANCE PROVISIONS THAT ARE LESS
 FAVORABLE THAN THOSE FOR OTHER PROSTHESIS COVERAGE  UNDER  THE  PLAN  OR
 COVERAGE, EXCEPT THAT A GROUP HEALTH PLAN OR HEALTH INSURANCE ISSUER MAY
 PROVIDE  THAT THE PLAN OR ISSUER WILL ONLY PAY FOR EIGHTY PERCENT OF THE
 CUSTOMARY AND USUAL COSTS OF THE SCALP HAIR PROSTHESIS EXCLUSIVE OF  ANY
 DEDUCTIBLE.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22)  (A)  A GROUP HEALTH PLAN, AND A HEALTH INSURANCE ISSUER OFFERING
 HEALTH INSURANCE COVERAGE IN CONNECTION WITH A GROUP HEALTH PLAN,  SHALL
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD01394-01-7

 A. 1442                             2
 
 PROVIDE  COVERAGE FOR SCALP HAIR PROSTHESIS FOR A PARTICIPANT OR BENEFI-
 CIARY WHO HAS SCALP HAIR LOSS AS A RESULT OF ALOPECIA  AREATA,  ALOPECIA
 TOTALIS  OR  ALOPECIA  UNIVERSALIS  IF  THE  ATTENDING  PHYSICIAN OF THE
 PARTICIPANT OR BENEFICIARY CERTIFIES IN WRITING THE MEDICAL NECESSITY OF
 THAT PROPOSED COURSE OF REHABILITATIVE TREATMENT.
   (B)  AS  USED  IN  THIS  PARAGRAPH,  THE  TERM "SCALP HAIR PROSTHESIS"
 INCLUDES ANY ARTIFICIAL SUBSTITUTES FOR SCALP HAIR.
   (C) THE COVERAGE REQUIRED UNDER  THIS  PARAGRAPH  IS  NOT  SUBJECT  TO
 DOLLAR  LIMITS,  DEDUCTIBLES,  AND  COINSURANCE PROVISIONS THAT ARE LESS
 FAVORABLE THAN THOSE FOR OTHER PROSTHESIS COVERAGE  UNDER  THE  PLAN  OR
 COVERAGE, EXCEPT THAT A GROUP HEALTH PLAN OR HEALTH INSURANCE ISSUER MAY
 PROVIDE  THAT THE PLAN OR ISSUER WILL ONLY PAY FOR EIGHTY PERCENT OF THE
 CUSTOMARY AND USUAL COSTS OF THE SCALP HAIR PROSTHESIS EXCLUSIVE OF  ANY
 DEDUCTIBLE.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (oo) to read as follows:
   (OO) (1) A GROUP HEALTH PLAN, AND A HEALTH INSURANCE  ISSUER  OFFERING
 HEALTH  INSURANCE COVERAGE IN CONNECTION WITH A GROUP HEALTH PLAN, SHALL
 PROVIDE COVERAGE FOR SCALP HAIR PROSTHESIS FOR A PARTICIPANT OR  BENEFI-
 CIARY  WHO  HAS SCALP HAIR LOSS AS A RESULT OF ALOPECIA AREATA, ALOPECIA
 TOTALIS OR ALOPECIA  UNIVERSALIS  IF  THE  ATTENDING  PHYSICIAN  OF  THE
 PARTICIPANT OR BENEFICIARY CERTIFIES IN WRITING THE MEDICAL NECESSITY OF
 THAT PROPOSED COURSE OF REHABILITATIVE TREATMENT.
   (2)  AS  USED  IN  THIS  SUBSECTION,  THE TERM "SCALP HAIR PROSTHESIS"
 INCLUDES ANY ARTIFICIAL SUBSTITUTES FOR SCALP HAIR.
   (3) THE COVERAGE REQUIRED UNDER THIS  SUBSECTION  IS  NOT  SUBJECT  TO
 DOLLAR  LIMITS,  DEDUCTIBLES,  AND  COINSURANCE PROVISIONS THAT ARE LESS
 FAVORABLE THAN THOSE FOR OTHER PROSTHESIS COVERAGE  UNDER  THE  PLAN  OR
 COVERAGE, EXCEPT THAT A GROUP HEALTH PLAN OR HEALTH INSURANCE ISSUER MAY
 PROVIDE  THAT THE PLAN OR ISSUER WILL ONLY PAY FOR EIGHTY PERCENT OF THE
 CUSTOMARY AND USUAL COSTS OF THE SCALP HAIR PROSTHESIS EXCLUSIVE OF  ANY
 DEDUCTIBLE.
   §  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 accord-
 ing to its terms to all policies,  contracts  and  certificates  issued,
 renewed, modified, altered or amended on or after such effective date.