NY State Senate Bill 2017-S7826

Senate Bill S7826

2017-2018 Legislative Session

Relates to requiring prescription drug coverage to include such supplements and vitamins, medical foods, and other medications to mitigate and/or treat the symptoms of mitochondrial disease

download bill text pdf

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 01, 2018	referred to insurance

2017-S7826 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2019-2020 Legislative Session:: S3015

2017-S7826 (ACTIVE) - Summary

Relates to requiring prescription drug coverage to include such supplements and vitamins, medical foods, and other medications as shall be deemed necessary by a physician to mitigate and/or treat the symptoms of mitochondrial disease.

2017-S7826 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S7826

SPONSOR: KENNEDY
 
TITLE OF BILL:  An act to amend the insurance law, in relation to
requiring prescription drug coverage to include such supplements and
vitamins, medical foods, and other medications as shall be deemed neces-
sary to mitigate and/or treat the symptoms of mitochondrial disease

 
PURPOSE:

To require insurance policies providing prescription drug coverage to
cover vitamins and supplements to mitigate the symptoms of mitochondrial
disease.

 
SUMMARY OF PROVISIONS:

Section 1 amends section 3216 of the insurance law by adding a new para-
graph that requires policies that cover prescription drugs to cover the
cost of vitamins, supplements, and other medications used to treat symp-
toms associated with mitochondrial disease.

Section 2 amends section 3221 of the insurance law by adding a new para-
graph that requires policies that cover prescription drugs to cover the
cost of vitamins, supplements, and other medications used to treat symp-
toms associated with mitochondrial disease.

Section 3 amends section 4303 of the insurance law by requiring all
contracts issued by corporations that cover prescription drugs to cover
the cost of vitamins, supplements, and other medications used to treat
symptoms associated with mitochondrial disease.

Section 4 is the effective date.

 
JUSTIFICATION:

Mitochondria are the powerhouse of the cell, and can be found in almost
every cell in the human body. These organelles perform essential func-
tions such as energy generation and breaking down waste products that
could harm the cell. Patients with mitochondrial disease have mitochond-
ria that cannot efficiently turn sugar and oxygen into energy. The
United Mitochondrial Disease Foundation estimates that 1,000 to 4,000
children are born with mitochondrial disease every year.

Some patients have had success in mitigating symptoms with tailored
prescriptions of vitamins and supplements known as 'mito-cocktails.'
However, these 'mito-cocktails' are not currently covered by insurance
companies and can cost over $300 per month per patient.  This legis-
lation would provide insurance coverage for vitamins and supplements
used to mitigate the symptoms of mitochondrial disease in suffering
patients.

 
LEGISLATIVE HISTORY:

New legislation.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law and shall apply to policies and
contracts issued, reissued, renewed, modified or amended on or after
such date.

2017-S7826 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7826
 
                             I N  S E N A T E
 
                               March 1, 2018
                                ___________
 
 Introduced  by  Sen. KENNEDY -- 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 requiring prescription
   drug coverage to include such supplements and vitamins, medical foods,
   and other medications as shall be deemed necessary to mitigate  and/or
   treat the symptoms of mitochondrial disease

   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)  EVERY POLICY WHICH PROVIDES COVERAGE FOR PRESCRIPTION DRUGS
 SHALL INCLUDE COVERAGE FOR THE COST OF SUCH  SUPPLEMENTS  AND  VITAMINS,
 MEDICAL  FOODS, AND OTHER MEDICATIONS USED TO TREAT THE SYMPTOMS ASSOCI-
 ATED WITH MITOCHONDRIAL DISEASE AS A PHYSICIAN SHALL DEEM  NECESSARY  TO
 MITIGATE  AND/OR  TREAT THE SYMPTOMS OF SUCH MITOCHONDRIAL DISEASE DIAG-
 NOSED THROUGH CLINICAL ASSESSMENT, MUSCLE BIOPSY, BIOCHEMICAL TESTING OR
 GENETIC TESTING IN A COVERED PERSON.
   (B) SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND  COIN-
 SURANCE  AS  MAY  BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE
 CONSISTENT WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN THE POLICY.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22) (A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR  DELIV-
 ERY  IN  THIS  STATE THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
 INCLUDE COVERAGE FOR THE COST OF SUCH SUPPLEMENTS AND VITAMINS,  MEDICAL
 FOODS,  AND OTHER MEDICATIONS USED TO TREAT THE SYMPTOMS ASSOCIATED WITH
 MITOCHONDRIAL DISEASE AS A PHYSICIAN SHALL DEEM  NECESSARY  TO  MITIGATE
 AND/OR  TREAT  THE  SYMPTOMS  OF  SUCH  MITOCHONDRIAL  DISEASE DIAGNOSED
 THROUGH CLINICAL  ASSESSMENT,  MUSCLE  BIOPSY,  BIOCHEMICAL  TESTING  OR
 GENETIC TESTING IN A COVERED PERSON.
   (B)  SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND COIN-
 SURANCE AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT  AND  AS  ARE
 CONSISTENT WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN THE POLICY.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD14787-01-8

 S. 7826                             2
 
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (oo) to read as follows:
   (OO)  (1)  EVERY  CONTRACT  ISSUED  BY  A  CORPORATION  SUBJECT TO THE
 PROVISIONS OF THIS ARTICLE  WHICH  PROVIDES  COVERAGE  FOR  PRESCRIPTION
 DRUGS  SHALL INCLUDE COVERAGE FOR THE COST OF SUCH SUPPLEMENTS AND VITA-
 MINS, MEDICAL FOODS, AND OTHER MEDICATIONS USED TO  TREAT  THE  SYMPTOMS
 ASSOCIATED  WITH  MITOCHONDRIAL DISEASE AS A PHYSICIAN SHALL DEEM NECES-
 SARY TO MITIGATE AND/OR TREAT THE SYMPTOMS OF SUCH MITOCHONDRIAL DISEASE
 DIAGNOSED THROUGH CLINICAL ASSESSMENT, MUSCLE BIOPSY, BIOCHEMICAL  TEST-
 ING OR GENETIC TESTING IN A COVERED PERSON.
   (2)  SUCH COVERAGE MAY BE SUBJECT TO SUCH ANNUAL DEDUCTIBLES AND COIN-
 SURANCE AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT  AND  AS  ARE
 CONSISTENT   WITH  THOSE  ESTABLISHED  FOR  OTHER  BENEFITS  WITHIN  THE
 CONTRACT.
   § 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
 policies and contracts issued, reissued, renewed, modified or amended on
 or after such date.

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