S T A T E O F N E W Y O R K
________________________________________________________________________
2925
2019-2020 Regular Sessions
I N A S S E M B L Y
January 28, 2019
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Introduced by M. of A. KIM, BRONSON, LUPARDO, D'URSO -- read once and
referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to mandatory health
insurance coverage for acupuncture services
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 35 to read as follows:
(35) EVERY POLICY ISSUED WITHIN THE HEALTH BENEFIT EXCHANGE ESTAB-
LISHED PURSUANT TO SECTION 1311 OF THE AFFORDABLE CARE ACT, 42 U.S.C. §
18031, SHALL PROVIDE COVERAGE FOR ACUPUNCTURE TREATMENT AS DEFINED IN
SECTION EIGHT THOUSAND TWO HUNDRED ELEVEN OF THE EDUCATION LAW PROVIDED
BY AN INDIVIDUAL LICENSED, AUTHORIZED, OR CERTIFIED PURSUANT TO ARTICLE
ONE HUNDRED SIXTY OF THE EDUCATION LAW. HOWEVER, ACUPUNCTURE TREATMENT
AND SERVICES MAY BE SUBJECT TO REASONABLE DEDUCTIBLE, CO-PAYMENT AND
CO-INSURANCE AMOUNT, REASONABLE FEE OR BENEFIT LIMITS, AND REASONABLE
UTILIZATION REVIEW, PROVIDED THAT ANY SUCH AMOUNTS, LIMITS OR REVIEW
SHALL BE NO GREATER THAN OTHER ESSENTIAL HEALTH BENEFITS COVERED BY THE
POLICY AND PROVIDED FURTHER THAT ANY SUCH AMOUNTS, LIMITS, OR REVIEW
SHALL NOT FUNCTION TO DIRECT TREATMENT IN A MANNER DISCRIMINATIVE
AGAINST ACUPUNCTURE TREATMENT. NOTHING HEREIN SHALL BE CONSTRUED AS
IMPENDING OR PREVENTING EITHER THE PROVISION OR COVERAGE OF ACUPUNCTURE
TREATMENT AND SERVICES BY DULY LICENSED OR CERTIFIED ACUPUNCTURIST,
WITHIN THE LAWFUL SCOPE OF THE PRACTICE OF ACUPUNCTURE, IN HOSPITAL
FACILITIES ON A STAFF OR EMPLOYEE BASIS.
§ 2. Section 4303 of the insurance law is amended by adding a new
subsection (ss) to read as follows:
(SS) EVERY POLICY ISSUED WITHIN THE HEALTH BENEFIT EXCHANGE ESTAB-
LISHED PURSUANT TO SECTION 1311 OF THE AFFORDABLE CARE ACT, 42 U.S.C. §
18031, SHALL PROVIDE COVERAGE FOR ACUPUNCTURE TREATMENT AS DEFINED IN
SECTION EIGHT THOUSAND TWO HUNDRED ELEVEN OF THE EDUCATION LAW PROVIDED
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03865-01-9
A. 2925 2
BY AN INDIVIDUAL LICENSED, AUTHORIZED, OR CERTIFIED PURSUANT TO ARTICLE
ONE HUNDRED SIXTY OF THE EDUCATION LAW. HOWEVER, ACUPUNCTURE TREATMENT
AND SERVICES MAY BE SUBJECT TO REASONABLE DEDUCTIBLE, CO-PAYMENT AND
CO-INSURANCE AMOUNT, REASONABLE FEE OR BENEFIT LIMITS, AND REASONABLE
UTILIZATION REVIEW, PROVIDED THAT ANY SUCH AMOUNTS, LIMITS OR REVIEW
SHALL BE NO GREATER THAN OTHER ESSENTIAL HEALTH BENEFITS COVERED BY THE
POLICY AND PROVIDED FURTHER THAT ANY SUCH AMOUNTS, LIMITS, OR REVIEW
SHALL NOT FUNCTION TO DIRECT TREATMENT IN A MANNER DISCRIMINATIVE
AGAINST ACUPUNCTURE TREATMENT. NOTHING HEREIN SHALL BE CONSTRUED AS
IMPEDING OR PREVENTING EITHER THE PROVISION OR COVERAGE OF ACUPUNCTURE
TREATMENT AND SERVICES BY DULY LICENSED OR CERTIFIED ACUPUNCTURISTS,
WITHIN THE LAWFUL SCOPE OF THE PRACTICE OF ACUPUNCTURE, IN HOSPITAL
FACILITIES ON A STAFF OR EMPLOYEES BASIS.
§ 3. 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, modified, altered or amended on or after such effective date.