Assembly Bill A491A

2021-2022 Legislative Session

Requires health insurance coverage for lymphedema

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Assembly Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Bill Amendments

co-Sponsors

multi-Sponsors

2021-A491 - Details

See Senate Version of this Bill:
S4867
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2013-2014: A8363, S3474
2015-2016: A436, S252
2017-2018: A2271, S4292
2019-2020: A2816, S3321
2023-2024: A1876

2021-A491 - Summary

Requires health insurance policies and contracts shall provide coverage for the diagnosis and treatment of lymphedema, both primary and secondary lymphedema; requires such coverage shall include benefits for equipment, supplies, devices, complex decongestive therapy and out-patient self-management training and education for the treatment of lymphedema, both primary and secondary lymphedema.

2021-A491 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    491
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  M.  of A. L. ROSENTHAL, LAVINE, PERRY, THIELE, SANTABAR-
   BARA, FRONTUS -- Multi-Sponsored by -- M. of A. BARRON, COOK, CYMBROW-
   ITZ -- read once and referred to the Committee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  requiring  certain
   health insurance coverage for lymphedema
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Clause  (ii)  of  subparagraph  (A)  of  paragraph  20  of
 subsection (i) of section 3216 of the insurance law, as added by chapter
 21  of  the  laws of 1997, is amended and a new clause (iii) is added to
 read as follows:
   (ii) surgery and reconstruction of  the  other  breast  to  produce  a
 symmetrical appearance; AND
   (III) PROSTHESES AND PHYSICAL COMPLICATIONS OF ALL STAGES OF MASTECTO-
 MY, INCLUDING LYMPHEDEMA;
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding two new paragraphs 36 and 37 to read as follows:
   (36)  EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL, MEDICAL OR MAJOR
 MEDICAL COVERAGE SHALL PROVIDE COVERAGE FOR THE  DIFFERENTIAL  DIAGNOSIS
 AND TREATMENT OF LYMPHEDEMA. SUCH COVERAGE SHALL INCLUDE, IN ADDITION TO
 BENEFITS FOR A COURSE OF MANUAL LYMPH DRAINAGE WHOSE FREQUENCY AND DURA-
 TION  IS  DETERMINED  BY  THE  TREATING  PHYSICIAN OR THERAPIST BASED ON
 MEDICAL NECESSITY AND NOT BASED ON PHYSICAL THERAPY  AND  REHABILITATION
 STANDARDS,  BENEFITS FOR EQUIPMENT, SUPPLIES, DEVICES, COMPLEX DECONGES-
 TIVE THERAPY, AND OUT-PATIENT SELF-MANAGEMENT TRAINING AND EDUCATION FOR
 THE TREATMENT OF LYMPHEDEMA, IF PRESCRIBED BY A HEALTH CARE PROFESSIONAL
 LEGALLY AUTHORIZED TO PRESCRIBE OR PROVIDE SUCH ITEMS UNDER TITLE  EIGHT
 OF  THE  EDUCATION  LAW.    LYMPHEDEMA  THERAPY  ADMINISTERED UNDER THIS
 SECTION SHALL BE ADMINISTERED ONLY BY A THERAPIST CERTIFIED  TO  PERFORM
 LYMPHEDEMA  TREATMENT  BY  THE  LYMPHOLOGY  ASSOCIATION OF NORTH AMERICA
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

co-Sponsors

multi-Sponsors

2021-A491A (ACTIVE) - Details

See Senate Version of this Bill:
S4867
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2013-2014: A8363, S3474
2015-2016: A436, S252
2017-2018: A2271, S4292
2019-2020: A2816, S3321
2023-2024: A1876

2021-A491A (ACTIVE) - Summary

Requires health insurance policies and contracts shall provide coverage for the diagnosis and treatment of lymphedema, both primary and secondary lymphedema; requires such coverage shall include benefits for equipment, supplies, devices, complex decongestive therapy and out-patient self-management training and education for the treatment of lymphedema, both primary and secondary lymphedema.

2021-A491A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  491--A
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  M.  of A. L. ROSENTHAL, LAVINE, PERRY, THIELE, SANTABAR-
   BARA, FRONTUS -- Multi-Sponsored by -- M. of A. BARRON, COOK, CYMBROW-
   ITZ -- read once and referred to the Committee on Insurance -- commit-
   tee  discharged,  bill  amended,  ordered  reprinted  as  amended  and
   recommitted to said committee
 
 AN  ACT  to  amend  the  insurance law, in relation to requiring certain
   health insurance coverage for lymphedema
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Clause  (ii)  of  subparagraph  (A)  of  paragraph  20 of
 subsection (i) of section 3216 of the insurance law, as added by chapter
 21 of the laws of 1997, is amended and a new clause (iii)  is  added  to
 read as follows:
   (ii)  surgery  and  reconstruction  of  the  other breast to produce a
 symmetrical appearance; AND
   (III) PROSTHESES AND PHYSICAL COMPLICATIONS OF ALL STAGES OF MASTECTO-
 MY, INCLUDING LYMPHEDEMA;
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding two new paragraphs 36 and 37 to read as follows:
   (36) EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL, MEDICAL OR  MAJOR
 MEDICAL  COVERAGE  SHALL PROVIDE COVERAGE FOR THE DIFFERENTIAL DIAGNOSIS
 AND TREATMENT OF LYMPHEDEMA,  BOTH  PRIMARY  AND  SECONDARY  LYMPHEDEMA.
 SUCH  COVERAGE  SHALL  INCLUDE,  IN ADDITION TO BENEFITS FOR A COURSE OF
 MANUAL LYMPH DRAINAGE WHOSE FREQUENCY AND DURATION IS DETERMINED BY  THE
 TREATING PHYSICIAN OR THERAPIST BASED ON MEDICAL NECESSITY AND NOT BASED
 ON  PHYSICAL  THERAPY  AND REHABILITATION STANDARDS, BENEFITS FOR EQUIP-
 MENT, SUPPLIES, DEVICES, COMPLEX DECONGESTIVE THERAPY,  AND  OUT-PATIENT
 SELF-MANAGEMENT  TRAINING AND EDUCATION FOR THE TREATMENT OF LYMPHEDEMA,
 IF PRESCRIBED BY  A  HEALTH  CARE  PROFESSIONAL  LEGALLY  AUTHORIZED  TO
 PRESCRIBE  OR PROVIDE SUCH ITEMS UNDER TITLE EIGHT OF THE EDUCATION LAW.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

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