S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2877
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 28, 2019
                                ___________
 
 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.
   §  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.
                                                            LBD07080-01-9
              

 A. 2877                             2
 
   § 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.
   §  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.