Assembly Bill A2683

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2683
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 22, 2025
                                ___________
 
 Introduced  by M. of A. BORES -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the social  services  law  and  the  insurance  law,  in
   relation to coverage for a cranial prosthesis
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. This act shall be known and may be cited as the "wig insur-
 ance guarantee (W.I.G) act".
   § 2. Subdivision 2 of section 365-a of  the  social  services  law  is
 amended by adding a new paragraph (nn) to read as follows:
   (NN)  (I) CRANIAL PROSTHESIS FOR INDIVIDUALS EXPERIENCING PERMANENT OR
 TEMPORARY MEDICAL HAIR LOSS WHEN:
   (1) PRESCRIBED BY A LICENSED PROVIDER FOR THE COURSE OF TREATMENT  FOR
 A DIAGNOSED HEALTH CONDITION, CHRONIC ILLNESS, OR INJURY, INCLUDING, BUT
 NOT LIMITED TO, ALOPECIA AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPE-
 CIA, AND LUPUS;
   (2) THE POLICY PROVIDES COVERAGE FOR A CRANIAL PROSTHESIS TO A RECIPI-
 ENT NO MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS; AND
   (3)  THE  COVERAGE  IS LIMITED TO SEVEN HUNDRED FIFTY DOLLARS FOR EACH
 INSTANCE OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING  REQUIRE-
 MENTS THAT ARE OTHERWISE APPLICABLE.
   (II) FOR THE PURPOSES OF THIS PARAGRAPH, THE TERM "CRANIAL PROSTHESIS"
 MEANS A WIG OR HAIRPIECE.
   § 3. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 40 to read as follows:
   (40)  (A)  EVERY  POLICY  WHICH PROVIDES COVERAGE FOR PROSTHESES SHALL
 PROVIDE COVERAGE FOR CRANIAL  PROSTHESES  FOR  INDIVIDUALS  EXPERIENCING
 PERMANENT OR TEMPORARY MEDICAL HAIR LOSS PROVIDED:
   (I)  A  LICENSED  PROVIDER  PRESCRIBES  SUCH  CRANIAL PROSTHESIS FOR A
 COVERED PERSON'S COURSE OF TREATMENT FOR THE DIAGNOSED HEALTH CONDITION,

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04171-01-5
 A. 2683                             2
              

 
 CHRONIC ILLNESS, OR INJURY, INCLUDING,  BUT  NOT  LIMITED  TO,  ALOPECIA
 AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPECIA, AND LUPUS;
   (II)  THE  POLICY  PROVIDES  COVERAGE  FOR  A  CRANIAL PROSTHESIS TO A
 COVERED PERSON NO MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS; AND
   (III) THE COVERAGE IS LIMITED TO SEVEN HUNDRED FIFTY DOLLARS FOR  EACH
 INSTANCE  OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING REQUIRE-
 MENTS THAT ARE OTHERWISE APPLICABLE.
   (B) FOR PURPOSES OF THIS  PARAGRAPH,  THE  TERM  "CRANIAL  PROSTHESIS"
 MEANS A WIG OR HAIRPIECE.
   § 4. Subsection (l) 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 THAT PROVIDES COVERAGE  FOR  PROTHESES  SHALL  PROVIDE
 COVERAGE  FOR  CRANIAL PROSTHESES FOR INDIVIDUALS EXPERIENCING PERMANENT
 OR TEMPORARY MEDICAL HAIR LOSS PROVIDED:
   (I) A LICENSED PROVIDER  PRESCRIBES  THE  CRANIAL  PROSTHESIS  FOR  AN
 ENROLLEE'S    COURSE  OF  TREATMENT  FOR THE DIAGNOSED HEALTH CONDITION,
 CHRONIC ILLNESS, OR INJURY, INCLUDING,  BUT  NOT  LIMITED  TO,  ALOPECIA
 AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPECIA, AND LUPUS;
   (II) THE POLICY PROVIDES COVERAGE FOR A CRANIAL PROSTHESIS TO AN INDI-
 VIDUAL ENROLLEE NO MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS; AND
   (III)  THE COVERAGE IS LIMITED TO SEVEN HUNDRED FIFTY DOLLARS FOR EACH
 INSTANCE OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING  REQUIRE-
 MENTS THAT ARE OTHERWISE APPLICABLE.
   (B)  FOR  PURPOSES  OF  THIS  PARAGRAPH, THE TERM "CRANIAL PROSTHESIS"
 MEANS A WIG OR HAIRPIECE.
   § 5. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ww) to read as follows:
   (WW)(1)  A HOSPITAL SERVICE CORPORATION, HEALTH SERVICE CORPORATION OR
 MEDICAL EXPENSE INDEMNITY FUND WHICH PROVIDES  COVERAGE  FOR  PROSTHESES
 SHALL PROVIDE COVERAGE FOR CRANIAL PROSTHESES FOR INDIVIDUALS EXPERIENC-
 ING PERMANENT OR TEMPORARY MEDICAL HAIR LOSS PROVIDED:
   (A)  A  LICENSED  PROVIDER  PRESCRIBES  THE  CRANIAL PROSTHESIS FOR AN
 ENROLLEE'S OR SUBSCRIBER'S COURSE OF TREATMENT FOR THE DIAGNOSED  HEALTH
 CONDITION,  CHRONIC  ILLNESS,  OR INJURY, INCLUDING, BUT NOT LIMITED TO,
 ALOPECIA AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPECIA, AND LUPUS;
   (B) THE CONTRACT PROVIDES COVERAGE FOR  A  CRANIAL  PROSTHESIS  TO  AN
 INDIVIDUAL  ENROLLEE  OR  SUBSCRIBER  NO MORE FREQUENTLY THAN ONCE EVERY
 TWELVE MONTHS; AND
   (C) THE COVERAGE IS LIMITED TO SEVEN HUNDRED FIFTY  DOLLARS  FOR  EACH
 INSTANCE  OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING REQUIRE-
 MENTS THAT ARE OTHERWISE APPLICABLE.
   (2) FOR THE PURPOSES OF THIS SUBSECTION, THE TERM "CRANIAL PROSTHESIS"
 MEANS A WIG OR HAIRPIECE.
   § 6. This act shall take effect immediately and  shall  apply  to  any
 policy  issued,  delivered,  renewed,  and/or  modified on or after such
 effective date.