Senate Bill S1315

2023-2024 Legislative Session

Requires mandatory health insurance coverage for prosthetic devices

download bill text pdf

Sponsored By

Current Bill Status - In Senate Committee Insurance 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

Do you support this bill?

Please enter your contact information

Home address is used to determine the senate district in which you reside. Your support or opposition to this bill is then shared immediately with the senator who represents you.

Optional services from the NY State Senate:

Create an account. An account allows you to officially support or oppose key legislation, sign petitions with a single click, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.

Include a custom message for your Senator? (Optional)

Enter a message to your senator. Many New Yorkers use this to share the reasoning behind their support or opposition to the bill. Others might share a personal anecdote about how the bill would affect them or people they care about.
Actions

co-Sponsors

2023-S1315 (ACTIVE) - Details

Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2015-2016: S5943
2017-2018: S704
2019-2020: S5174
2021-2022: S3649

2023-S1315 (ACTIVE) - Summary

Requires mandatory health insurance coverage for prosthetic devices; requires coverage where the model is determined to be medically necessary for rehabilitative and habilitative purposes.

2023-S1315 (ACTIVE) - Sponsor Memo

2023-S1315 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1315
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 11, 2023
                                ___________
 
 Introduced  by  Sen.  ORTT  --  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  mandatory  health
   insurance coverage for providing prosthetic 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  POLICY  WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
 COMPREHENSIVE TYPE COVERAGE TO A POLICYHOLDER SHALL PROVIDE COVERAGE FOR
 PROSTHETIC DEVICES THAT ARE INTENDED FOR MEDICALLY NECESSARY REHABILITA-
 TIVE AND HABILITATIVE PURPOSES AS REQUIRED BY 42 U.S.C. § 18022.  COVER-
 AGE  SHALL  INCLUDE  THE  COST  OF  REPAIR  OR REPLACEMENT OF PROSTHETIC
 DEVICES DUE TO NORMAL WEAR AND TEAR, IF A  PROSTHETIC  DEVICE  HAS  BEEN
 OUTGROWN  OR  NO  LONGER FITS PROPERLY, OR WHERE A CHANGE IN THE MEDICAL
 CONDITION MAKES REPLACEMENT NECESSARY. COVERAGE SHALL  NOT  INCLUDE  THE
 COSTS  OF  REPAIR  OR REPLACEMENT OF A PROSTHETIC DEVICE THAT IS COVERED
 UNDER THE WARRANTY OF THE MANUFACTURE OR WHEN THE REPAIR OR  REPLACEMENT
 IS  NECESSARY  DUE TO MISUSE OR NEGLIGENCE. THE TERM "PROSTHETIC DEVICE"
 AS USED IN THIS PARAGRAPH INCLUDES AN ARTIFICIAL  LIMB,  BUT  SHALL  NOT
 INCLUDE  SHOES  OR  ANY  OTHER  ARTICLE  CONSIDERED  AS ORDINARY WEARING
 APPAREL, WHETHER OR NOT SPECIFICALLY CONSTRUCTED. THE TERM  "POLICYHOLD-
 ER"  AS  USED IN THIS PARAGRAPH SHALL MEAN A VETERAN OF THE ARMED FORCES
 WHO RESIDES IN THE STATE OF NEW YORK AND WHOSE  MEDICAL  NEED  FOR  SUCH
 PROSTHETIC  DEVICE RESULTED FROM AN INJURY SUFFERED WHILE ON ACTIVE DUTY
 SERVING IN THE ARMED FORCES. SUCH COVERAGE SHALL BE  SUBJECT  TO  ANNUAL
 DEDUCTIBLES AND COINSURANCE AS DEEMED APPROPRIATE BY THE SUPERINTENDENT.
 THE COVERAGE REQUIRED BY THIS PARAGRAPH SHALL BE IDENTICAL TO, AND SHALL
 NOT  ENHANCE OR INCREASE THE ESSENTIAL HEALTH BENEFIT COVERAGE CHOSEN BY
 THE STATE PURSUANT TO 45 CFR 156.100. NOTHING IN THIS PARAGRAPH SHALL BE
 CONSTRUED TO PREVENT THE MEDICAL MANAGEMENT  OR  UTILIZATION  REVIEW  OF
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05098-01-3
              

Comments

Open Legislation is a forum for New York State legislation. All comments are subject to review and community moderation is encouraged.

Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity, hate or toxic speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Attempts to intimidate and silence contributors or deliberately deceive the public, including excessive or extraneous posting/posts, or coordinated activity, are prohibited and may result in the temporary or permanent banning of the user. Comment moderation is generally performed Monday through Friday. By contributing or voting you agree to the Terms of Participation and verify you are over 13.

Create an account. An account allows you to sign petitions with a single click, officially support or oppose key legislation, and follow issues, committees, and bills that matter to you. When you create an account, you agree to this platform's terms of participation.