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.