NY State Senate Bill S1994

Archive: Last Bill Status - In Senate Committee Insurance Committee

Introduced
In Committee
On Floor Calendar
- Passed Senate
- Passed Assembly
Delivered to Governor
Signed/Vetoed by Governor

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Actions

view actions (2)

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2020	referred to insurance
Jan 18, 2019	referred to insurance

Co-Sponsors

S1994 (ACTIVE) - Details

See Assembly Version of this Bill:: A2897
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2017-2018: S7256, A8839
2021-2022: S5332, A877
2023-2024: S3038, A2823

S1994 (ACTIVE) - Summary

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

S1994 (ACTIVE) - Sponsor Memo

 
BILL NUMBER: S1994

SPONSOR: LITTLE
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring certain
health insurance policies to cover costs for pediatric acute-onset
neuropsychiatric syndrome

 
PURPOSE:

This bill will require certain health insurance policies to cover costs
associated with pediatric acute-onset neuropsychiatric syndrome.

 
SUMMARY OF PROVISIONS:

Section 1: Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 34

Section 2: Subsection (k) of section 3221 of the insurance law is
amended by adding a new paragraph 22

Section 3: Section 4303 of the insurance law is amended by adding a new
subsection (oo)

 
JUSTIFICATION:

Pediatric acute-onset neuropsychiatric syndrome (PANS) is a misdirected
immune response, often with an encephalitic onset, which negatively
affects neurologic functioning, resulting in a rapid, acute onset of
OCD, restricted food intake or tics along with other neuropsychiatric
conditions.

Treating PANS must be carried out thoroughly to yield positive results.
Symptoms often begin to improve within one week of antibiotic treatment.
However, further interventions are often required to fully heal the
underlying causes and alleviate all the symptoms. If treated promptly
and thoroughly, symptoms can remit completely. If left untreated and
symptoms persist, permanent neurological injury can occur.

Currently insurance providers do not cover costs associated with pedia-
tric acute-onset neuropsychiatric syndrome which can cause a huge finan-
cial burden for families living with this diagnosis. This bill would
help to relieve this burden and give these families a resource to treat
the syndrome.

 
LEGISLATIVE HISTORY:

2017-18: S.7256/A.8839: Referred Insurance; Referred Insurance

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law and shall apply according to
its terms to all policies, contracts and certificates issued, renewed,
modified, altered or amended on or after such effective date.

S1994 (ACTIVE) - Bill Text download pdf


                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1994

                       2019-2020 Regular Sessions

                            I N  S E N A T E

                            January 18, 2019
                               ___________

Introduced  by  Sen.  LITTLE -- read twice and ordered printed, and when
  printed to be committed to the Committee on Insurance

AN ACT to amend the insurance law,  in  relation  to  requiring  certain
  health  insurance  policies  to  cover costs for pediatric acute-onset
  neuropsychiatric syndrome

  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)(A) EVERY HEALTH PLAN, AND HEALTH INSURANCE ISSUER OFFERING HEALTH
INSURANCE COVERAGE IN CONNECTION WITH A GROUP HEALTH PLAN, SHALL PROVIDE
COVERAGE FOR A PARTICIPANT OR BENEFICIARY WHO HAS PEDIATRIC  ACUTE-ONSET
NEUROPSYCHIATRIC  SYNDROME IF THE ATTENDING PHYSICIAN OF THE PARTICIPANT
OR BENEFICIARY CERTIFIES  IN  WRITING  THE  MEDICAL  NECESSITY  OF  THAT
PROPOSED COURSE OF REHABILITATIVE TREATMENT.
  (B) AS USED IN THIS PARAGRAPH, THE TERM "PEDIATRIC ACUTE-ONSET NEUROP-
SYCHIATRIC SYNDROME" SHALL HAVE THE SAME MEANING AS SUCH TERM IS USED IN
PARAGRAPH  (N)  OF  SUBDIVISION  ONE OF SECTION TWO HUNDRED SEVEN OF THE
PUBLIC HEALTH LAW.
  § 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 22 to read as follows:
  (22) (A) EVERY HEALTH  PLAN,  AND  HEALTH  INSURANCE  ISSUER  OFFERING
HEALTH  INSURANCE COVERAGE IN CONNECTION WITH A GROUP HEALTH PLAN, SHALL
PROVIDE COVERAGE FOR A PARTICIPANT  OR  BENEFICIARY  WHO  HAS  PEDIATRIC
ACUTE-ONSET  NEUROPSYCHIATRIC SYNDROME IF THE ATTENDING PHYSICIAN OF THE
PARTICIPANT OR BENEFICIARY CERTIFIES IN WRITING THE MEDICAL NECESSITY OF
THAT PROPOSED COURSE OF REHABILITATIVE TREATMENT.
  (B) AS USED IN THIS PARAGRAPH, THE TERM "PEDIATRIC ACUTE-ONSET NEUROP-
SYCHIATRIC SYNDROME" SHALL HAVE THE SAME MEANING AS SUCH TERM IS USED IN
PARAGRAPH (N) OF SUBDIVISION ONE OF SECTION TWO  HUNDRED  SEVEN  OF  THE
PUBLIC HEALTH LAW.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.

                                                           LBD02904-01-9

S. 1994                             2

  §  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (ss) to read as follows:
  (SS)(1) EVERY HEALTH PLAN, AND HEALTH INSURANCE ISSUER OFFERING HEALTH
INSURANCE COVERAGE IN CONNECTION WITH A GROUP HEALTH PLAN, SHALL PROVIDE
COVERAGE  FOR A PARTICIPANT OR BENEFICIARY WHO HAS PEDIATRIC ACUTE-ONSET
NEUROPSYCHIATRIC SYNDROME IF THE ATTENDING PHYSICIAN OF THE  PARTICIPANT
OR  BENEFICIARY  CERTIFIES  IN  WRITING  THE  MEDICAL  NECESSITY OF THAT
PROPOSED COURSE OF REHABILITATIVE TREATMENT.
  (2) AS USED IN THIS PARAGRAPH, THE TERM "PEDIATRIC ACUTE-ONSET NEUROP-
SYCHIATRIC SYNDROME" SHALL HAVE THE SAME MEANING AS SUCH TERM IS USED IN
PARAGRAPH (N) OF SUBDIVISION ONE OF SECTION TWO  HUNDRED  SEVEN  OF  THE
PUBLIC HEALTH LAW.
  §  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 accord-
ing to its terms to all policies,  contracts  and  certificates  issued,
renewed, modified, altered or amended on or after such effective date.

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senate Bill S1994

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Archive: Last Bill Status - In Senate Committee Insurance Committee

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Co-Sponsors

S1994 (ACTIVE) - Details

S1994 (ACTIVE) - Summary

S1994 (ACTIVE) - Sponsor Memo

S1994 (ACTIVE) - Bill Text download pdf

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senate Bill S1994

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Sponsored By

Betty Little

Archive: Last Bill Status - In Senate Committee Insurance Committee

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Co-Sponsors

Fred Akshar

S1994 (ACTIVE) - Details

S1994 (ACTIVE) - Summary

S1994 (ACTIVE) - Sponsor Memo

S1994 (ACTIVE) - Bill Text download pdf

Comments