S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6425
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               April 6, 2023
                                ___________
 
 Introduced  by  M.  of  A.  O'DONNELL  --  read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance  law,  in  relation  to  requiring  health
   insurance  plans  to  provide  coverage  for epinephrine auto-injector
   devices
 
   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 39 to read as follows:
   (39) EVERY INSURER ISSUING A POLICY OF ACCIDENT AND  HEALTH  INSURANCE
 DELIVERED  OR  ISSUED  FOR  DELIVERY  IN THIS STATE WHICH PROVIDES MAJOR
 MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE  SHALL  INCLUDE  COVERAGE
 FOR  TWO  MEDICALLY  NECESSARY EPINEPHRINE AUTO-INJECTOR DEVICES FOR THE
 EMERGENCY TREATMENT OF LIFE-THREATENING ALLERGIC REACTIONS.  SUCH COVER-
 AGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND  COINSURANCE    AS  MAY  BE
 DEEMED  APPROPRIATE  BY  THE  SUPERINTENDENT  AND AS ARE CONSISTENT WITH
 THOSE  ESTABLISHED FOR OTHER BENEFITS WITHIN A  GIVEN  POLICY;  PROVIDED
 HOWEVER,  THE TOTAL AMOUNT THAT A COVERED PERSON IS REQUIRED TO PAY OUT-
 OF-POCKET FOR SUCH DEVICES SHALL BE CAPPED AT AN AMOUNT  NOT  TO  EXCEED
 ONE  HUNDRED  DOLLARS ANNUALLY REGARDLESS   OF THE INSURED'S DEDUCTIBLE,
 COPAYMENT, COINSURANCE OR ANY OTHER COST-SHARING  REQUIREMENT.  FOR  THE
 PURPOSES  OF  THIS  PARAGRAPH,  "EPINEPHRINE AUTO-INJECTOR DEVICE" SHALL
 HAVE THE SAME MEANING AS PROVIDED IN PARAGRAPH (B) OF SUBDIVISION ONE OF
 SECTION THREE THOUSAND-C OF THE PUBLIC HEALTH LAW.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23) EVERY GROUP OR BLANKET POLICY OF ACCIDENT  AND  HEALTH  INSURANCE
 DELIVERED  OR  ISSUED  FOR DELIVERY IN THIS STATE WHICH PROVIDES MEDICAL
 COVERAGE THAT INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A  PHYSICIAN'S
 OFFICE  AND EVERY POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMILAR COMPRE-
 HENSIVE-TYPE  COVERAGE SHALL PROVIDE COVERAGE FOR TWO  MEDICALLY  NECES-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10597-01-3
              

 A. 6425                             2
 
 SARY  EPINEPHRINE  AUTO-INJECTOR  DEVICES FOR THE EMERGENCY TREATMENT OF
 LIFE-THREATENING ALLERGIC REACTIONS.  SUCH COVERAGE MAY  BE  SUBJECT  TO
 ANNUAL  DEDUCTIBLES  AND COINSURANCE AS MAY BE DEEMED APPROPRIATE BY THE
 SUPERINTENDENT  AND  AS ARE CONSISTENT WITH THOSE  ESTABLISHED FOR OTHER
 BENEFITS WITHIN A GIVEN POLICY; PROVIDED HOWEVER, THE TOTAL AMOUNT  THAT
 A COVERED PERSON IS REQUIRED TO PAY OUT-OF-POCKET FOR SUCH DEVICES SHALL
 BE  CAPPED  AT  AN  AMOUNT  NOT  TO  EXCEED ONE HUNDRED DOLLARS ANNUALLY
 REGARDLESS  OF THE INSURED'S DEDUCTIBLE, COPAYMENT, COINSURANCE  OR  ANY
 OTHER  COST-SHARING  REQUIREMENT.    FOR THE PURPOSES OF THIS PARAGRAPH,
 "EPINEPHRINE AUTO-INJECTOR  DEVICE"  SHALL  HAVE  THE  SAME  MEANING  AS
 PROVIDED IN PARAGRAPH (B) OF SUBDIVISION ONE OF SECTION THREE THOUSAND-C
 OF THE PUBLIC HEALTH LAW.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (vv) to read as follows:
   (VV) EVERY MEDICAL EXPENSE  INDEMNITY  CORPORATION,  HOSPITAL  SERVICE
 CORPORATION AND HEALTH SERVICE CORPORATION WHICH PROVIDES MEDICAL COVER-
 AGE  THAT  INCLUDES  COVERAGE  FOR  PHYSICIAN  SERVICES IN A PHYSICIAN'S
 OFFICE AND EVERY POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMILAR  COMPRE-
 HENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR TWO MEDICALLY NECESSARY
 EPINEPHRINE  AUTO-INJECTOR  DEVICES FOR THE EMERGENCY TREATMENT OF LIFE-
 THREATENING ALLERGIC REACTIONS.  SUCH COVERAGE MAY BE SUBJECT TO  ANNUAL
 DEDUCTIBLES  AND COINSURANCE  AS MAY BE DEEMED APPROPRIATE BY THE SUPER-
 INTENDENT AND AS ARE CONSISTENT WITH THOSE ESTABLISHED FOR  OTHER  BENE-
 FITS  WITHIN  A  GIVEN POLICY; PROVIDED HOWEVER, THE TOTAL AMOUNT THAT A
 COVERED PERSON IS REQUIRED TO PAY OUT-OF-POCKET FOR SUCH  DEVICES  SHALL
 BE  CAPPED  AT  AN  AMOUNT  NOT  TO  EXCEED ONE HUNDRED DOLLARS ANNUALLY
 REGARDLESS  OF THE INSURED'S DEDUCTIBLE, COPAYMENT, COINSURANCE  OR  ANY
 OTHER  COST-SHARING  REQUIREMENT.  FOR  THE PURPOSES OF THIS SUBSECTION,
 "EPINEPHRINE AUTO-INJECTOR  DEVICE"  SHALL  HAVE  THE  SAME  MEANING  AS
 PROVIDED IN PARAGRAPH (B) OF SUBDIVISION ONE OF SECTION THREE THOUSAND-C
 OF THE PUBLIC HEALTH LAW.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law, and shall apply to any contract or renewal or  exten-
 sion of contract dated after this act shall have become a law.