S T A T E O F N E W Y O R K
________________________________________________________________________
4677--A
2025-2026 Regular Sessions
I N A S S E M B L Y
February 4, 2025
___________
Introduced by M. of A. JACKSON -- read once and referred to the Commit-
tee on Insurance -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to requiring insurance
coverage for lactation support services
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph 10 of subsection (i) of section 3216 of the
insurance law is amended by adding a new subparagraph (C) to read as
follows:
(C) (I) COVERAGE PROVIDED UNDER THIS SUBPARAGRAPH SHALL INCLUDE OUTPA-
TIENT COVERAGE FOR COMPREHENSIVE LACTATION SUPPORT SERVICES, INCLUDING
SERVICES PROVIDED BY A LACTATION CONSULTANT. SUCH COVERAGE MAY BE
SUBJECT TO ANNUAL DEDUCTIBLES, COINSURANCE, AND COPAYMENTS AS MAY BE
DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT WITH
THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY, UNLESS
COMPREHENSIVE LACTATION SUPPORT SERVICES HAS IN EFFECT A RATING OF 'A'
OR 'B' IN THE CURRENT RECOMMENDATIONS OF THE UNITED STATES PREVENTIVE
SERVICES TASK FORCE OR AS PROVIDED FOR IN COMPREHENSIVE GUIDELINES
SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION.
(II) NOTHING IN THIS SUBPARAGRAPH SHALL BE CONSTRUED TO PREVENT THE
MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES OR PREVENT A
POLICY FROM REQUIRING THAT SERVICES BE PROVIDED THROUGH A NETWORK OF
PARTICIPATING PROVIDERS.
(III) FOR PURPOSES OF THIS SUBPARAGRAPH, "LACTATION CONSULTANT" MEANS
A HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE EIGHT OF THE EDUCATION
LAW WHO HOLDS THE INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT
(IBCLC) CREDENTIAL AND IS IN GOOD STANDING WITH THE INTERNATIONAL BOARD
OF LACTATION CONSULTANT EXAMINERS, WHO EVALUATES AND MANAGES LACTATION
AND INFANT FEEDING PROBLEMS AND PROVIDES PREVENTIVE CLINICAL CONSULTING
TO PREVENT OR MINIMIZE THE OCCURRENCE OF POTENTIAL PROBLEMS.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03999-03-5
A. 4677--A 2
§ 2. Paragraph 5 of subsection (k) of section 3221 of the insurance
law is amended by adding a new subparagraph (C) to read as follows:
(C) (I) COVERAGE PROVIDED UNDER THIS SUBPARAGRAPH SHALL INCLUDE OUTPA-
TIENT COVERAGE FOR COMPREHENSIVE LACTATION SUPPORT SERVICES, INCLUDING
SERVICES PROVIDED BY A LACTATION CONSULTANT. SUCH COVERAGE MAY BE
SUBJECT TO ANNUAL DEDUCTIBLES, COINSURANCE, AND COPAYMENTS AS MAY BE
DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT WITH
THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY, UNLESS
COMPREHENSIVE LACTATION SUPPORT SERVICES HAS IN EFFECT A RATING OF 'A'
OR 'B' IN THE CURRENT RECOMMENDATIONS OF THE UNITED STATES PREVENTIVE
SERVICES TASK FORCE OR AS PROVIDED FOR IN COMPREHENSIVE GUIDELINES
SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION.
(II) NOTHING IN THIS SUBPARAGRAPH SHALL BE CONSTRUED TO PREVENT THE
MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES OR PREVENT A
POLICY FROM REQUIRING THAT SERVICES BE PROVIDED THROUGH A NETWORK OF
PARTICIPATING PROVIDERS.
(III) FOR PURPOSES OF THIS SUBPARAGRAPH, "LACTATION CONSULTANT" MEANS
A HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE EIGHT OF THE EDUCATION
LAW WHO HOLDS THE INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT
(IBCLC) CREDENTIAL AND IS IN GOOD STANDING WITH THE INTERNATIONAL BOARD
OF LACTATION CONSULTANT EXAMINERS, WHO EVALUATES AND MANAGES LACTATION
AND INFANT FEEDING PROBLEMS AND PROVIDES PREVENTIVE CLINICAL CONSULTING
TO PREVENT OR MINIMIZE THE OCCURRENCE OF POTENTIAL PROBLEMS.
§ 3. Subsection (c) of section 4303 of the insurance law is amended by
adding a new paragraph 3 to read as follows:
(3) (A) COVERAGE PROVIDED UNDER THIS PARAGRAPH SHALL INCLUDE OUTPA-
TIENT COVERAGE FOR COMPREHENSIVE LACTATION SUPPORT SERVICES, INCLUDING
SERVICES PROVIDED BY A LACTATION CONSULTANT. SUCH COVERAGE MAY BE
SUBJECT TO ANNUAL DEDUCTIBLES, COINSURANCE, AND COPAYMENTS AS MAY BE
DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT WITH
THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY, UNLESS
COMPREHENSIVE LACTATION SUPPORT SERVICES HAS IN EFFECT A RATING OF 'A'
OR 'B' IN THE CURRENT RECOMMENDATIONS OF THE UNITED STATES PREVENTIVE
SERVICES TASK FORCE OR AS PROVIDED FOR IN COMPREHENSIVE GUIDELINES
SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION.
(B) NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO PREVENT THE
MEDICAL MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES OR PREVENT A
CONTRACT FROM REQUIRING THAT SERVICES BE PROVIDED THROUGH A NETWORK OF
PARTICIPATING PROVIDERS.
(C) FOR PURPOSES OF THIS PARAGRAPH, "LACTATION CONSULTANT" MEANS A
HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE EIGHT OF THE EDUCATION LAW
WHO HOLDS THE INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT (IBCLC)
CREDENTIAL AND IS IN GOOD STANDING WITH THE INTERNATIONAL BOARD OF
LACTATION CONSULTANT EXAMINERS, WHO EVALUATES AND MANAGES LACTATION AND
INFANT FEEDING PROBLEMS AND PROVIDES PREVENTIVE CLINICAL CONSULTING TO
PREVENT OR MINIMIZE THE OCCURRENCE OF POTENTIAL PROBLEMS.
§ 4. This act shall take effect on January 1, 2027 and shall apply to
any policy or contract issued, renewed, modified, altered or amended on
or after such effective date.