Senate Bill S1295

                                
 
BILL NUMBER: S1295

SPONSOR: SERINO
 
TITLE OF BILL:

An act directing the superintendent of financial services to study the
relationship between patient access to care and treatment of Lyme
disease and health insurance coverage

 
PURPOSE:

To review the status of health insurance coverage for the treatment of
Lyme and other tick-borne related diseases.

 
SUMMARY OF PROVISIONS:

Section 1: Provides legislative findings.

Section 2: Directs the superintendent of the Department of Financial
Services, in consultation with the commissioner of the Department of
Health, to review various provisions related to the costs and range of
              

insurance coverage of Lyme and other tick-borne related diseases.

Section 3: Requires the superintendent to submit a report of the depart-
ment's findings, conclusions, and recommendations within 180 days of the
effective date of this act.

Section 4: Provides the effective date.

 
JUSTIFICATION:

Over 20,000 cases of Lyme disease were diagnosed in New York State
between the years 2012 and 2014, and the epidemic is rapidly spreading
across New York-beyond the Hudson Valley and Long Island where the
disease was primarily concentrated within the state. While New York has
taken action to combat in the spread of Lyme and other tick-borne
related diseases, it is important that we consider the toll such
diseases have taken on those who are unfortunate enough to contract
them, as well as ways to improve their health care outcomes. The New
York State Health Care Quality and Cost Containment Commission was
established by Chapter 57 of the laws of 2007 to study proposed changes
to individual and group health insurance policies, contracts and plans
and the potential impacts they may have. While the Cost Containment
Commission would be well suited to comprehensively investigate changes
to health insurance coverage - particularly Lyme and other tick-borne
diseases - the commission has never convened and its funding has been
dissolved through the budget process.

Unfortunately, the need for comprehensive examinations of how new cover-
age will impact consumer insurance costs and patient access are still
present. We have seen this need with respect to in vitro fertilization
and fertility treatments. In March of 2018, it was announced that the
Department of Financial Services would examine approaches to incorporat-
ing in vitro fertilization into health plans.  As part of the study, the
Department of Financial Services will examine, among other things, the
insurance premium consequences of in vitro fertilization coverage,
recommendations for appropriate coverage limitations to treatment
requirements, comparative state experiences in expanding coverage, and
recommendations for improved access for patients. While the commission
would have been an entity charged with considering these questions
across medical conditions, it is important that we work to ensure that
patient access to care is responsibly considered. As such, the unique
geographical spread of Lyme and tick-borne diseases, as well as the
disproportionate patient impacts in New York, make these diseases ripe
for consideration.

This bill would require that the Department of Financial Services
conduct a similar study considering the current scope of health insur-
ance coverage for Lyme and tick-borne diseases, as well as initiatives
in other states and the fiscal implications of various proposals. This
is a major step in establishing a conversation on what can be done to
address this prevalent issue in New York, and what appropriate responses
and coverage may look like.

 
LEGISLATIVE HISTORY:

2018: S.8539 Passed Senate

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.