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
                                ___________
 
 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.