Assembly Bill A2695

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2695
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 22, 2025
                                ___________
 
 Introduced  by M. of A. DURSO -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the insurance  law  and  the  social  services  law,  in
   relation  to  requiring  certain  health  insurance plans cover annual
   electrocardiograms for covered children under the age of nineteen

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Clauses (ii) and (iii) of subparagraph (B) of paragraph 17
 of subsection (i) of section 3216 of the insurance law,  as  amended  by
 chapter  219  of  the laws of 2011, are amended and a new clause (iv) is
 added to read as follows:
   (ii) at each visit, services in accordance with the  prevailing  clin-
 ical  standards  of  such  designated  association,  including a medical
 history, a  complete  physical  examination,  developmental  assessment,
 anticipatory  guidance,  appropriate  immunizations and laboratory tests
 which tests are ordered at the time of the visit and  performed  in  the
 practitioner's  office, as authorized by law, or in a clinical laborato-
 ry; [and]
   (iii) necessary immunizations, as determined by the superintendent  in
 consultation  with  the  commissioner  of health, consisting of at least
 adequate dosages of  vaccine  against  diphtheria,  pertussis,  tetanus,
 polio,  measles, rubella, mumps, haemophilus influenzae type b and hepa-
 titis b, which meet the standards approved by the United  States  public
 health service for such biological products[.]; AND
   (IV) AN ELECTROCARDIOGRAM TEST AND AN INTERPRETATION OF THE RESULTS OF
 SUCH  TEST  AT LEAST ONCE ANNUALLY AND WITH GREATER FREQUENCY IF ORDERED
 BY A PHYSICIAN OR OTHER LICENSED PROFESSIONAL WHOSE  SCOPE  OF  PRACTICE
 UNDER  TITLE EIGHT OF THE EDUCATION LAW PROVIDES THE AUTHORITY TO ADMIN-
 ISTER SUCH A TEST, IN ACCORDANCE WITH PREVAILING CLINICAL STANDARDS.
   § 2. Clauses (ii) and (iii) of subparagraph  (B)  of  paragraph  8  of
 subsection (l) of section 3221 of the insurance law, as amended by chap-
 ter  219 of the laws of 2011, are amended and a new clause (iv) is added
 to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD05728-01-5
 A. 2695                             2
 
   (ii) at each visit, services in accordance with the  prevailing  clin-
 ical  standards  of  such  designated  association,  including a medical
 history, a  complete  physical  examination,  developmental  assessment,
 anticipatory  guidance,  appropriate  immunizations and laboratory tests
 which  tests  are  ordered at the time of the visit and performed in the
 practitioner's office, as authorized by law, or in a clinical  laborato-
 ry; [and]
   (iii)  necessary immunizations, as determined by the superintendent in
 consultation with the commissioner of health,  consisting  of  at  least
 adequate  dosages  of  vaccine  against  diphtheria, pertussis, tetanus,
 polio, measles, rubella, mumps, haemophilus influenzae type b and  hepa-
 titis  b,  which meet the standards approved by the United States public
 health service for such biological products[.]; AND
   (IV) AN ELECTROCARDIOGRAM TEST AND AN INTERPRETATION OF THE RESULTS OF
 SUCH TEST AT LEAST ONCE ANNUALLY AND WITH GREATER FREQUENCY  IF  ORDERED
 BY  A  PHYSICIAN  OR OTHER LICENSED PROFESSIONAL WHOSE SCOPE OF PRACTICE
 UNDER TITLE EIGHT OF THE EDUCATION LAW PROVIDES THE AUTHORITY TO  ADMIN-
 ISTER SUCH A TEST, IN ACCORDANCE WITH PREVAILING CLINICAL STANDARDS.
   §  3.  Subparagraphs  (B)  and (C) of paragraph 2 of subsection (j) of
 section 4303 of the insurance law, as amended by chapter 219 of the laws
 of 2011, are amended and a new subparagraph (C-1) is added  to  read  as
 follows:
   (B) at each visit, services in accordance with the prevailing clinical
 standards of such designated association, including a medical history, a
 complete  physical  examination,  developmental assessment, anticipatory
 guidance, appropriate immunizations and laboratory tests which tests are
 ordered at the time of the visit and  performed  in  the  practitioner's
 office, as authorized by law, or in a clinical laboratory, [and]
   (C)  necessary  immunizations,  as determined by the superintendent in
 consultation with the commissioner of health,  consisting  of  at  least
 adequate  dosages  of  vaccine  against  diphtheria, pertussis, tetanus,
 polio, measles, rubella, mumps, haemophilus influenzae type b and  hepa-
 titis  b,  which meet the standards approved by the United States public
 health service for such biological products[.], AND
   (C-1) AN ELECTROCARDIOGRAM TEST AND AN INTERPRETATION OF  THE  RESULTS
 OF  SUCH  TEST  AT  LEAST  ONCE  ANNUALLY  AND WITH GREATER FREQUENCY IF
 ORDERED BY A PHYSICIAN OR OTHER LICENSED  PROFESSIONAL  WHOSE  SCOPE  OF
 PRACTICE  UNDER  TITLE EIGHT OF THE EDUCATION LAW PROVIDES THE AUTHORITY
 TO ADMINISTER SUCH A TEST, IN ACCORDANCE WITH PREVAILING CLINICAL STAND-
 ARDS.
   § 4. Subdivision 2 of section 365-a of  the  social  services  law  is
 amended by adding a new paragraph (t-1) to read as follows:
   (T-1)  SCREENING,  INCLUDING AN ELECTROCARDIOGRAM TEST AND INTERPRETA-
 TION OF THE RESULTS OF SUCH TEST IN CHILDREN EIGHTEEN YEARS  OF  AGE  OR
 UNDER, AT LEAST ONCE ANNUALLY AND WITH GREATER FREQUENCY IF ORDERED BY A
 PHYSICIAN  OR  OTHER LICENSED PROFESSIONAL WHOSE SCOPE OF PRACTICE UNDER
 TITLE EIGHT OF THE EDUCATION LAW PROVIDES THE  AUTHORITY  TO  ADMINISTER
 SUCH  A  TEST  AND IF DONE IN ACCORDANCE WITH PREVAILING CLINICAL STAND-
 ARDS; PROVIDED, HOWEVER, THAT THE PROVISIONS OF THIS PARAGRAPH  RELATING
 TO  ELECTROCARDIOGRAM  TESTS  SHALL NOT TAKE EFFECT UNLESS ALL NECESSARY
 APPROVALS UNDER FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE
 FEDERAL FINANCIAL PARTICIPATION IN THE COSTS OF SUCH SERVICES.
   § 5. This act shall take effect immediately and  shall  apply  to  any
 policy  issued,  delivered,  renewed,  and/or  modified  on or after the
 effective date of this act.