S T A T E O F N E W Y O R K
________________________________________________________________________
3997
2019-2020 Regular Sessions
I N A S S E M B L Y
January 31, 2019
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Introduced by M. of A. WEPRIN -- Multi-Sponsored by -- M. of A. COLTON,
GALEF, GUNTHER, PERRY -- read once and referred to the Committee on
Insurance
AN ACT to amend the insurance law, in relation to coverage and benefits
of accident and health insurance policies for podiatric care
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph 2 of subsection (i) of section 3216 of the insur-
ance law is amended to read as follows:
(2) If a policy provides for reimbursement for any podiatrical service
within the lawful scope of practice of a licensed podiatrist, the
insured shall be entitled to THE SAME reimbursement for such service
whether it is performed by a physician or licensed podiatrist.
§ 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 22 to read as follows:
(22) EVERY POLICY WHICH PROVIDES COVERAGE FOR PODIATRIC CARE, AS
DEFINED IN SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED BY
A DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE
OF THE EDUCATION LAW, MAY BE SUBJECT TO REASONABLE DEDUCTIBLE, CO-PAY-
MENT AND CO-INSURANCE AMOUNTS, REASONABLE FEE OR BENEFIT LIMITS AND
REASONABLE UTILIZATION REVIEW, PROVIDED THAT ANY SUCH AMOUNTS, LIMITS
AND REVIEW: (A) SHALL NOT FUNCTION TO DIRECT TREATMENT IN A MANNER
DISCRIMINATIVE AGAINST PODIATRIC CARE; AND (B) INDIVIDUALLY AND COLLEC-
TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THAT SAME POLI-
CY TO CARE OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS IN THE
DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR SIMILAR CONDITIONS,
DISORDERS OR INJURIES. NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED AS
IMPEDING OR PREVENTING EITHER THE PROVISION OR COVERAGE OF PODIATRIC
CARE AND SERVICES BY DULY LICENSED DOCTORS OF PODIATRY WITHIN THE
LAWFUL SCOPE OF PODIATRIC CARE IN HOSPITAL FACILITIES ON A STAFF OR
EMPLOYEE BASIS.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07388-01-9
A. 3997 2
§ 3. Section 4303 of the insurance law is amended by adding a new
subsection (ss) to read as follows:
(SS) EVERY CONTRACT ISSUED BY A HEALTH SERVICE CORPORATION OR A
MEDICAL EXPENSE INDEMNITY CORPORATION THAT INCLUDES COVERAGE FOR PHYSI-
CIAN SERVICES IN A PHYSICIAN'S OFFICE, THAT PROVIDES MAJOR MEDICAL OR
SIMILAR COMPREHENSIVE-TYPE COVERAGE, AND COVERAGE FOR PODIATRIC CARE AS
DEFINED IN SECTION SEVEN THOUSAND ONE OF THE EDUCATION LAW, PROVIDED BY
A DOCTOR OF PODIATRY LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE
OF THE EDUCATION LAW, MAY BE SUBJECT TO REASONABLE DEDUCTIBLE, CO-PAY-
MENT AND CO-INSURANCE AMOUNTS, REASONABLE FEE OR BENEFIT LIMITS AND
REASONABLE UTILIZATION REVIEW, PROVIDED THAT ANY SUCH AMOUNTS, LIMITS
AND REVIEW: (1) SHALL NOT FUNCTION TO DIRECT TREATMENT IN A MANNER
DISCRIMINATIVE AGAINST PODIATRIC CARE; AND (2) INDIVIDUALLY AND COLLEC-
TIVELY SHALL BE NO DIFFERENT THAN THOSE APPLICABLE UNDER THE SAME POLICY
TO CARE OR SERVICES PROVIDED BY OTHER HEALTH PROFESSIONALS IN THE DIAG-
NOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR SIMILAR CONDITIONS,
DISORDERS OR INJURIES. NOTHING IN THIS SUBSECTION SHALL BE CONSTRUED AS
IMPEDING OR PREVENTING EITHER THE PROVISIONS OR COVERAGE OF PODIATRIC
CARE AND SERVICES BY DULY LICENSED DOCTORS OF PODIATRY WITHIN THE LAWFUL
SCOPE OF PODIATRIC CARE IN HOSPITAL FACILITIES ON A STAFF OR EMPLOYEE
BASIS.
§ 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, renewed, modified, altered or amended on
or after such effective date.