NY State Senate Bill 2023-S3211

Senate Bill S3211

2023-2024 Legislative Session

Provides for universal newborn nurse home visiting services; requires health insurance coverage for universal newborn nurse home visiting services

download bill text pdf

Current Bill Status - In Senate Committee Health 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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to health
Jan 30, 2023	referred to health

co-Sponsors

2023-S3211 (ACTIVE) - Details

See Assembly Version of this Bill:: A6526
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add §2500-l, Pub Health L; amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2021-2022 Legislative Session:: S8348, A9140

2023-S3211 (ACTIVE) - Summary

Provides for universal newborn nurse home visiting services; requires health insurance coverage for universal newborn nurse home visiting services; authorizes the department of health to apply for certain waivers; directs the superintendent of financial services to require an insurer, health carrier or health benefit plan to notify enrollees annually of universal newborn nurse home visiting services.

2023-S3211 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S3211

SPONSOR: CLEARE
 
TITLE OF BILL:

An act to amend the public health law, in relation to universal newborn
nurse home visiting services; to amend the insurance law, in relation to
requiring health insurance coverage for universal newborn nurse home
visiting services; authorizing the department of health to apply for
certain waivers; and directing the superintendent of financial services
to require an insurer, health carrier or health benefit plan to notify
enrollees annually of universal newborn nurse home visiting services

 
PURPOSE OR GENERAL IDEA OF BILL:

This bill extends access to free newborn nurse home visiting services,
as well as maternal education, to every mother, regardless of socioeco-
nomic status, race, or ethnicity which will work to dismantle the gener-
ational damage done by an inequitable health care system.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 adds section S 2500-1 to public health law requiring the
commissioner to design, implement, and maintain a voluntary, evidence-
based, state-wide program to provide universal newborn nurse home visit-
ing services to all families within the state.

Section 2 amends subsection (1) of section 3216 of the insurance law
adding a new paragraph 36 requiring that every hospital, surgical or
medical coverage provide coverage for a voluntary, evidence-based
universal newborn nurse home visiting service at no cost and inform each
individual covered of this service when a newborn is added under the
plan.

Section 3 amends subsection (k) of section 3221 of the insurance law
adding a new paragraph 22 requiring that every group or blanket policy
delivered or issued for delivery providing hospital, surgical, or
medical coverage provide coverage for a voluntary, evidence-based
universal newborn nurse home visiting service at no cost and inform each
individual covered of this service when a newborn is added under the
plan.

Section 4 amends section 4303 of the insurance law adding a subsection
(ss)requiring that any medical expense indemnity corporation, hospital
service corporation or health service corporation providing hospital,
surgical, or medical coverage provide coverage for a voluntary,
evidence-based universal newborn nurse home visiting service at no cost
and inform each individual covered of this service when a newborn is
added under the plan.

Section 5 authorizes the department of health to request a waiver for
state innovation for costs accrued under sections two, three and four of
this act.

Section 6 requires an annual notification to insurance enrollees of the
plan's provision of the universal newborn nurse home visiting services
to be delivered by mail or other agreed upon method, giving authori-
zation of implementation of notifications to the superintendent of
financial services.
 
JUSTIFICATION:

This bill will positively affect families and communities historically
impacted by systemically inequitable medical practices and economic
conditions. Targeting New York's most marginalized, this bill will close
the racial and economic care-gap that has led to higher rates of mater-
nal and infant mortality. Poverty, poor mental and physical health, high
juvenile crime rates, adverse childhood experiences, and poor academic
performance are prevalent within disadvantaged communities due to
systemic inequities built into policy, such as unequal access to health-
care and education. This bill extends access to free newborn nurse home
visiting services, as well as maternal education, to every mother,
regardless of socioeconomic status, race, or ethnicity which will work
to dismantle the generational damage done by an inequitable health care
system.

Newborn nurse home visiting services are not readily available to all
enrolled persons covered by insurance. This service is aimed at improv-
ing outcomes in one or more of the following: child health and develop-
ment, school readiness, family financial self-sufficiency, maternal
health, positive parenting, reducing adverse childhood experiences,
reducing family violence, and reducing crime. This will be achieved
through education, promotion of positive interaction between mother and
newborn to influence growth and development, and offering other guidance
to mothers that otherwise would be difficult to afford.

 
PRIOR LEGISLATIVE HISTORY:

New Bill.

 
FISCAL IMPLICATIONS:

TBD.

 
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law and shall apply to any policy issued, delivered, renewed,
and/or modified on or after the effective date of this act.  Effective
immediately, the addition, amendment and/or repeal of any rule or regu-
lation necessary for the implementation of this act on its effective
date are authorized to be made and completed on or before such effective
date.

2023-S3211 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3211
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 30, 2023
                                ___________
 
 Introduced  by  Sen.  CLEARE -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, in relation to universal  newborn
   nurse  home visiting services; to amend the insurance law, in relation
   to requiring health insurance coverage  for  universal  newborn  nurse
   home  visiting services; authorizing the department of health to apply
   for certain waivers; and directing  the  superintendent  of  financial
   services  to require an insurer, health carrier or health benefit plan
   to notify enrollees annually of universal newborn nurse home  visiting
   services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. The public health law is amended by adding  a  new  section
 2500-l to read as follows:
   §  2500-L.  UNIVERSAL NEWBORN NURSE HOME VISITING SERVICES. 1. AS USED
 IN THIS SECTION, "COMMUNITY" MEANS A GEOGRAPHIC REGION, COUNTY, TRIBE OR
 OTHER GROUP OF INDIVIDUALS LIVING IN PROXIMITY AS DEFINED BY THE DEPART-
 MENT BY RULE.
   2. (A) THE COMMISSIONER SHALL DESIGN, IMPLEMENT AND MAINTAIN A  VOLUN-
 TARY  STATEWIDE PROGRAM TO PROVIDE UNIVERSAL NEWBORN NURSE HOME VISITING
 SERVICES TO ALL FAMILIES WITH NEWBORNS RESIDING IN THIS STATE TO SUPPORT
 HEALTHY CHILD DEVELOPMENT  AND  STRENGTHEN  FAMILIES.  THE  COMMISSIONER
 SHALL  DESIGN  THE  UNIVERSAL  NEWBORN NURSE HOME VISITING PROGRAM TO BE
 FLEXIBLE SO AS TO MEET THE NEEDS OF THE COMMUNITIES  WHERE  THE  PROGRAM
 OPERATES.
   (B) IN DESIGNING THE PROGRAM DESCRIBED IN PARAGRAPH (A) OF THIS SUBDI-
 VISION,  THE  COMMISSIONER SHALL CONSULT, COORDINATE AND COLLABORATE, AS
 NECESSARY, WITH INSURERS THAT OFFER HEALTH BENEFIT PLANS IN THIS  STATE,
 HOSPITALS,  LOCAL  PUBLIC  HEALTH  AUTHORITIES,  THE  EARLY INTERVENTION
 PROGRAM, EXISTING EARLY CHILDHOOD  HOME  VISITING  PROGRAMS,  COMMUNITY-
 BASED ORGANIZATIONS AND SOCIAL SERVICE PROVIDERS.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08155-01-3

 S. 3211                             2
 
   3. THE PROGRAM SHALL PROVIDE NURSE HOME VISITING SERVICES THAT ARE:
   (A)  BASED  ON CRITERIA ESTABLISHED BY THE UNITED STATES DEPARTMENT OF
 HEALTH AND HUMAN SERVICES FOR AN  EVIDENCE-BASED  EARLY  CHILDHOOD  HOME
 VISITING SERVICE DELIVERY MODEL;
   (B)  PROVIDED  BY REGISTERED NURSES LICENSED IN THIS STATE TO FAMILIES
 CARING FOR NEWBORNS UP TO THE AGE OF SIX MONTHS,  INCLUDING  FOSTER  AND
 ADOPTIVE NEWBORNS;
   (C) PROVIDED IN THE FAMILY'S HOME; AND
   (D)  AIMED  AT  IMPROVING  OUTCOMES  IN  ONE  OR MORE OF THE FOLLOWING
 DOMAINS:
   (I) CHILD HEALTH;
   (II) CHILD DEVELOPMENT AND SCHOOL READINESS;
   (III) FAMILY ECONOMIC SELF-SUFFICIENCY;
   (IV) MATERNAL HEALTH;
   (V) POSITIVE PARENTING;
   (VI) REDUCING CHILD MISTREATMENT;
   (VII) REDUCING JUVENILE DELINQUENCY;
   (VIII) REDUCING FAMILY VIOLENCE; OR
   (IX) REDUCING CRIME.
   4. THE SERVICES PROVIDED IN THE PROGRAM MUST:
   (A) BE VOLUNTARY AND CARRY NO NEGATIVE CONSEQUENCES FOR A FAMILY  THAT
 DECLINES TO PARTICIPATE;
   (B) BE OFFERED IN EVERY COMMUNITY IN THIS STATE;
   (C)  INCLUDE  AN EVIDENCE-BASED ASSESSMENT OF THE PHYSICAL, SOCIAL AND
 EMOTIONAL FACTORS AFFECTING THE FAMILY;
   (D) BE OFFERED TO ALL FAMILIES WITH NEWBORNS RESIDING IN THE COMMUNITY
 WHERE THE PROGRAM OPERATES;
   (E) INCLUDE AT LEAST ONE VISIT DURING A NEWBORN'S FIRST  THREE  MONTHS
 OF  LIFE WITH THE OPPORTUNITY FOR THE FAMILY TO CHOOSE UP TO THREE ADDI-
 TIONAL VISITS;
   (F) INCLUDE A FOLLOW-UP VISIT NO LATER THAN  THREE  MONTHS  AFTER  THE
 LAST VISIT; AND
   (G) PROVIDE INFORMATION AND REFERRALS TO ADDRESS EACH FAMILY'S IDENTI-
 FIED NEEDS.
   5.  THE  AUTHORITY  SHALL  COLLECT  AND  ANALYZE DATA GENERATED BY THE
 PROGRAM TO ASSESS THE EFFECTIVENESS OF THE PROGRAM IN MEETING  THE  AIMS
 DESCRIBED  IN  PARAGRAPH  (D)  OF  SUBDIVISION THREE OF THIS SECTION AND
 SHALL WORK WITH OTHER STATE AGENCIES TO DEVELOP  PROTOCOLS  FOR  SHARING
 DATA,  INCLUDING  THE TIMELY SHARING OF DATA WITH PRIMARY CARE PROVIDERS
 OF CARE TO THE FAMILIES WITH NEWBORNS RECEIVING THE SERVICES.
   6.   THE  COMMISSIONER  SHALL  ADOPT  BY  RULE,  CONSISTENT  WITH  THE
 PROVISIONS  OF  THIS  SECTION, CRITERIA FOR UNIVERSAL NEWBORN NURSE HOME
 VISITING SERVICES THAT MUST BE COVERED BY HEALTH BENEFIT PLANS.
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 39 to read as follows:
   (39)(A) EVERY POLICY WHICH  PROVIDES  HOSPITAL,  SURGICAL  OR  MEDICAL
 COVERAGE  SHALL PROVIDE COVERAGE FOR UNIVERSAL NEWBORN NURSE HOME VISIT-
 ING SERVICES AS PRESCRIBED BY THE DEPARTMENT OF  HEALTH  BY  RULE  UNDER
 SECTION  TWENTY-FIVE  HUNDRED-L  OF THE PUBLIC HEALTH LAW.  THE COVERAGE
 MUST BE PROVIDED WITHOUT ANY  COST-SHARING,  COINSURANCE  OR  DEDUCTIBLE
 APPLICABLE TO THE SERVICES.
   (B) INSURERS MUST OFFER UNIVERSAL NEWBORN NURSE HOME VISITING SERVICES
 IN  THEIR HEALTH BENEFIT PLANS BUT AN INDIVIDUAL ENROLLED IN THE PLAN IS
 NOT REQUIRED TO RECEIVE THE SERVICES AS A CONDITION OF COVERAGE AND  MAY
 NOT BE PENALIZED OR IN ANY WAY DISCOURAGED FROM DECLINING THE SERVICES.
 S. 3211                             3

   (C)  AN  INSURER  MUST NOTIFY AN INDIVIDUAL ENROLLED IN THE PLAN ABOUT
 THE UNIVERSAL NEWBORN NURSE HOME VISITING SERVICES WHENEVER  SUCH  INDI-
 VIDUAL ADDS A NEWBORN TO COVERAGE UNDER THE PLAN.
   (D) AN INSURER MAY USE IN-NETWORK PROVIDERS OR MAY CONTRACT WITH LOCAL
 PUBLIC HEALTH AUTHORITIES TO PROVIDE THE SERVICES.
   (E)  THIS  PARAGRAPH DOES NOT REQUIRE AN INSURER TO REIMBURSE THE COST
 OF THE SERVICES IN ANY SPECIFIC MANNER. THE SERVICES MAY  BE  REIMBURSED
 USING:
   (I) A VALUE-BASED PAYMENT METHODOLOGY;
   (II) A CLAIM INVOICING PROCESS;
   (III) CAPITATED PAYMENTS;
   (IV)  A  PAYMENT  METHODOLOGY  THAT  TAKES INTO ACCOUNT THE NEED FOR A
 COMMUNITY-BASED ENTITY PROVIDING THE SERVICES TO EXPAND ITS CAPACITY  TO
 PROVIDE THE SERVICES AND ADDRESS HEALTH DISPARITIES; OR
   (V) ANY OTHER METHODOLOGY AGREED TO BY THE INSURER AND THE PROVIDER OF
 THE SERVICES.
   (F)  INSURERS  SHALL REPORT TO THE DEPARTMENT OF PUBLIC HEALTH, IN THE
 FORM AND MANNER PRESCRIBED BY THE  DEPARTMENT  OF  PUBLIC  HEALTH,  DATA
 REGARDING  CLAIMS SUBMITTED FOR SERVICES COVERED UNDER THIS PARAGRAPH TO
 MONITOR THE PROVISION OF  THE  UNIVERSAL  NEWBORN  NURSE  HOME  VISITING
 SERVICES.
   § 3. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23)(A)  EVERY GROUP  OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIV-
 ERY IN THIS STATE WHICH   PROVIDES   HOSPITAL,   SURGICAL   OR   MEDICAL
 COVERAGE  SHALL INCLUDE COVERAGE FOR UNIVERSAL NEWBORN NURSE HOME VISIT-
 ING SERVICES AS PRESCRIBED BY THE DEPARTMENT OF  HEALTH  BY  RULE  UNDER
 SECTION  TWENTY-FIVE  HUNDRED-L  OF THE PUBLIC HEALTH LAW.  THE COVERAGE
 MUST BE PROVIDED WITHOUT ANY  COST-SHARING,  COINSURANCE  OR  DEDUCTIBLE
 APPLICABLE TO THE SERVICES.
   (B) INSURERS MUST OFFER UNIVERSAL NEWBORN NURSE HOME VISITING SERVICES
 IN  THEIR HEALTH BENEFIT PLANS BUT AN INDIVIDUAL ENROLLED IN THE PLAN IS
 NOT REQUIRED TO RECEIVE THE SERVICES AS A CONDITION OF COVERAGE AND  MAY
 NOT BE PENALIZED OR IN ANY WAY DISCOURAGED FROM DECLINING THE SERVICES.
   (C)  AN  INSURER  MUST NOTIFY AN INDIVIDUAL ENROLLED IN THE PLAN ABOUT
 THE UNIVERSAL NEWBORN NURSE HOME VISITING SERVICES WHENEVER  SUCH  INDI-
 VIDUAL ADDS A NEWBORN TO COVERAGE UNDER THE PLAN.
   (D) AN INSURER MAY USE IN-NETWORK PROVIDERS OR MAY CONTRACT WITH LOCAL
 PUBLIC HEALTH AUTHORITIES TO PROVIDE THE SERVICES.
   (E)  THIS  PARAGRAPH DOES NOT REQUIRE AN INSURER TO REIMBURSE THE COST
 OF THE SERVICES IN ANY SPECIFIC MANNER. THE SERVICES MAY  BE  REIMBURSED
 USING:
   (I) A VALUE-BASED PAYMENT METHODOLOGY;
   (II) A CLAIM INVOICING PROCESS;
   (III) CAPITATED PAYMENTS;
   (IV)  A  PAYMENT  METHODOLOGY  THAT  TAKES INTO ACCOUNT THE NEED FOR A
 COMMUNITY-BASED ENTITY PROVIDING THE SERVICES TO EXPAND ITS CAPACITY  TO
 PROVIDE THE SERVICES AND ADDRESS HEALTH DISPARITIES; OR
   (V) ANY OTHER METHODOLOGY AGREED TO BY THE INSURER AND THE PROVIDER OF
 THE SERVICES.
   (F)  INSURERS  SHALL REPORT TO THE DEPARTMENT OF PUBLIC HEALTH, IN THE
 FORM AND MANNER PRESCRIBED BY THE  DEPARTMENT  OF  PUBLIC  HEALTH,  DATA
 REGARDING  CLAIMS SUBMITTED FOR SERVICES COVERED UNDER THIS PARAGRAPH TO
 MONITOR THE PROVISION OF  THE  UNIVERSAL  NEWBORN  NURSE  HOME  VISITING
 SERVICES.
 S. 3211                             4
 
   §  4.  Section  4303  of  the insurance law is amended by adding a new
 subsection (uu) to read as follows:
   (UU)(1) A MEDICAL  EXPENSE  INDEMNITY  CORPORATION, A HOSPITAL SERVICE
 CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES  COVERAGE  FOR
 HOSPITAL,  SURGICAL OR MEDICAL CARE SHALL INCLUDE COVERAGE FOR UNIVERSAL
 NEWBORN NURSE HOME VISITING SERVICES AS PRESCRIBED BY THE DEPARTMENT  OF
 HEALTH  BY RULE UNDER SECTION TWENTY-FIVE HUNDRED-L OF THE PUBLIC HEALTH
 LAW. THE COVERAGE MUST BE PROVIDED WITHOUT ANY COST-SHARING, COINSURANCE
 OR DEDUCTIBLE APPLICABLE TO THE SERVICES.
   (2) INSURERS MUST OFFER UNIVERSAL NEWBORN NURSE HOME VISITING SERVICES
 IN THEIR HEALTH BENEFIT PLANS BUT AN INDIVIDUAL ENROLLED IN THE PLAN  IS
 NOT  REQUIRED TO RECEIVE THE SERVICES AS A CONDITION OF COVERAGE AND MAY
 NOT BE PENALIZED OR IN ANY WAY DISCOURAGED FROM DECLINING THE SERVICES.
   (3) AN INSURER MUST NOTIFY AN INDIVIDUAL ENROLLED IN  THE  PLAN  ABOUT
 THE  UNIVERSAL  NEWBORN NURSE HOME VISITING SERVICES WHENEVER SUCH INDI-
 VIDUAL ADDS A NEWBORN TO COVERAGE UNDER THE PLAN.
   (4) AN INSURER MAY USE IN-NETWORK PROVIDERS OR MAY CONTRACT WITH LOCAL
 PUBLIC HEALTH AUTHORITIES TO PROVIDE THE SERVICES.
   (5) THIS PARAGRAPH DOES NOT REQUIRE AN INSURER TO REIMBURSE  THE  COST
 OF  THE  SERVICES IN ANY SPECIFIC MANNER. THE SERVICES MAY BE REIMBURSED
 USING:
   (A) A VALUE-BASED PAYMENT METHODOLOGY;
   (B) A CLAIM INVOICING PROCESS;
   (C) CAPITATED PAYMENTS;
   (D) A PAYMENT METHODOLOGY THAT TAKES  INTO  ACCOUNT  THE  NEED  FOR  A
 COMMUNITY-BASED  ENTITY PROVIDING THE SERVICES TO EXPAND ITS CAPACITY TO
 PROVIDE THE SERVICES AND ADDRESS HEALTH DISPARITIES; OR
   (E) ANY OTHER METHODOLOGY AGREED TO BY THE INSURER AND THE PROVIDER OF
 THE SERVICES.
   (6) INSURERS SHALL REPORT TO THE DEPARTMENT OF PUBLIC HEALTH,  IN  THE
 FORM  AND  MANNER  PRESCRIBED  BY  THE DEPARTMENT OF PUBLIC HEALTH, DATA
 REGARDING CLAIMS SUBMITTED FOR SERVICES COVERED UNDER THIS PARAGRAPH  TO
 MONITOR  THE  PROVISION  OF  THE  UNIVERSAL  NEWBORN NURSE HOME VISITING
 SERVICES.
   § 5. The department of health may request a  waiver  for  state  inno-
 vation  under  42 U.S.C. 18052 to obtain federal financial participation
 in the cost of services provided under sections two, three and  four  of
 this act.
   §  6. The superintendent of financial services shall require an insur-
 er, health carrier or health benefit plan to notify  enrollees  annually
 of universal newborn nurse home visiting services covered by such enrol-
 lees'  health benefit plan. The notice shall be delivered by mail unless
 the enrollee and health carrier have agreed on another method of notifi-
 cation. The  superintendent  of  financial  services  is  authorized  to
 promulgate necessary rules and regulations for the purposes of providing
 such notification.
   §  7.  This  act shall take effect on the ninetieth day after it shall
 have become a law and shall  apply  to  any  policy  issued,  delivered,
 renewed,  and/or  modified  on  or after the effective date of this act.
 Effective immediately, the addition, amendment and/or repeal of any rule
 or regulation necessary for the implementation of this act on its effec-
 tive date are authorized to be made and  completed  on  or  before  such
 effective date.

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Senate Bill S3211

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Sponsored By

Cordell Cleare