NY State Senate Bill S3038

Current Bill Status - In Senate Committee Insurance Committee

Introduced
In Committee
On Floor Calendar
- Passed Senate
- Passed Assembly
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Actions

view actions (1)

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 27, 2023	referred to insurance

Co-Sponsors

S3038 (ACTIVE) - Details

See Assembly Version of this Bill:: A2823
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
2019-2020: S1994, A2897
2021-2022: S5332, A877

S3038 (ACTIVE) - Summary

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

S3038 (ACTIVE) - Sponsor Memo

 
BILL NUMBER: S3038

SPONSOR: STEC
 
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 I : 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 posi-
tive 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. One of the most
expensive treatments is an Intravenous Immunoglobulin or IVIG, which is
widely accepted as a treatment for PANS, along with long term antibiotic
regiments that families currently have to pay for out of pocket. This
bill would help to relieve this burden and give these families a
resource to treat the syndrome.

 
LEGISLATIVE HISTORY:

2022/2021: S5332 referred to Insurance; A877 referred to Insurance

2020/2019: S1994 referred to Insurance; A2897 referred to Insurance

2018/2017: S7256 referred to Insurance; A8839 referred to 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.

S3038 (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3038
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 27, 2023
                                ___________
 
 Introduced  by  Sens.  STEC, GALLIVAN -- 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 39 to read as follows:
   (39)(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 23 to read as follows:
   (23) (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.
                                                            LBD07308-01-3

 S. 3038                             2
 
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (uu) to read as follows:
   (UU)(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  SUBSECTION,  THE  TERM  "PEDIATRIC  ACUTE-ONSET
 NEUROPSYCHIATRIC  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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The New York State Senate

senate Bill S3038

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

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Co-Sponsors

S3038 (ACTIVE) - Details

S3038 (ACTIVE) - Summary

S3038 (ACTIVE) - Sponsor Memo

S3038 (ACTIVE) - Bill Text download pdf

Comments

senate Bill S3038

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Sponsored By

Daniel G. Stec

Current Bill Status - In Senate Committee Insurance Committee

Your Voice

Actions

Co-Sponsors

Patrick M. Gallivan

S3038 (ACTIVE) - Details

S3038 (ACTIVE) - Summary

S3038 (ACTIVE) - Sponsor Memo

S3038 (ACTIVE) - Bill Text download pdf

Comments