Assembly Bill A2816

2019-2020 Legislative Session

Requires health insurance coverage for lymphedema

download bill text pdf

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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2019-A2816 (ACTIVE) - Details

See Senate Version of this Bill:
S3321
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
2015-2016: A436, S252
2017-2018: A2271, S4292
2021-2022: A491, S4867
2023-2024: A1876

2019-A2816 (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.

2019-A2816 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2816
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 25, 2019
                                ___________
 
 Introduced  by  M.  of  A. L. ROSENTHAL, LAVINE, PERRY, THIELE -- Multi-
   Sponsored by -- M.  of A. BARRON, COOK,  CRESPO,  CYMBROWITZ  --  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;
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding two new paragraphs 35 and 36 to read as follows:
   (35) 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
 LYMPHEDEMA TREATMENT BY THE  LYMPHOLOGY  ASSOCIATION  OF  NORTH  AMERICA
 (LANA)  OR  CERTIFIED  IN  ACCORDANCE  WITH  STANDARDS EQUIVALENT TO THE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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