Senate Bill S9957

                                 
BILL NUMBER: S9957

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring health
insurance policies include coverage for anesthesia for the duration of a
medical procedure

 
PURPOSE:

To ensure that those providing medical, hospital, or surgical coverage
fully cover the cost of anesthesia required during pr ocedures in order
to protect the health of patients undergoing these medical procedures.

 
SUMMARY OF PROVISIONS:

Section one amends subsection (i) of section 3216 of the Insurance Law
by adding a new paragraph to ensure that every policy providing coverage
for hospital, surgical, or medical care shall cover the anesthesia
required during the entire procedure for which it is ne eded.

              

Section two amends subsection (I) of section 3221 of the Insurance Law
by adding a new paragraph to require that every insurer delivering a
group or blanket policy or issuing a group or blanket policy for deliv-
ery, which provides coverage for hospital, surgical, or medical care,
shall cover the anesthesia required during the entire procedure for
which it is needed.

Section three amends section 4303 of the Insurance Law by adding a new
subsection (ww) to ensure that every medical expense indemnity corpo-
ration, hospital service corporation, or health service corporation
providing coverage for hospital, surgical, or medical care shall cover
the anesthesia required during the entire procedure for which it is
needed.

Section four provides an effective date.

 
JUSTIFICATION:

The medical and patient communities have been alarmed by recent
announcements from insurers regarding changes to the coverage of anes
thesia costs during surgical procedures. Although the insurers have
since decided to take back the policy announced to not cover anes thesia
care if the surgery or procedure goes beyond arbitrary time limits, the
policy may still be under consideration for future imp lementation. This
bill will take action to address this issue and ensure peace of mind for
individuals who need to undergo surgery.

Restrictive measures, such as the ones announced, shift the cost of care
from insurance plans to working families across our state.  It also puts
lives at risk by creating uncertainty for individuals that are consider-
ing necessary medical procedures. New Yorkers shouldn't have to fear
what bill might be waiting for them after they wake up from surgery. A
patient's focus should be on their recovery, not how much they owe.
Until we decide as a state that health outcomes and not profits should
be driving our healthcare system, we can expect to see more decisions
like this one.

This bill mandates that those providing medical, hospital, or surgical
coverage must fully cover the cost of anesthesia required duri ng such
procedures performed by physicians. This bill restores peace of mind to
patients, allowing them to prioritize their health and well-being.

 
LEGISLATIVE HISTORY:

New bill

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act would take effect immediately.