The New York State Senate

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3165
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 22, 2021
                                ___________
 
 Introduced  by  M. of A. KIM, BRONSON, LUPARDO -- 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 36 to read as follows:
   (36)  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.

                                                            LBD06044-01-1

 A. 3165                             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.