S T A T E O F N E W Y O R K
________________________________________________________________________
6923--A
2025-2026 Regular Sessions
I N A S S E M B L Y
March 18, 2025
___________
Introduced by M. of A. WEPRIN, PHEFFER AMATO -- read once and referred
to the Committee on Insurance -- recommitted to the Committee on
Insurance in accordance with Assembly Rule 3, sec. 2 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the insurance law, in relation to requiring health
insurance plans to provide coverage for continuous blood glucose moni-
tors for all children
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subparagraph (A) of paragraph 15-a of subsection (i) of
section 3216 of the insurance law, as amended by chapter 338 of the laws
of 2003, is amended to read as follows:
(A) Every policy which provides medical coverage that includes cover-
age for physician services in a physician's office and every policy
which provides major medical or similar comprehensive-type coverage
shall include coverage for the following equipment and supplies for the
treatment of diabetes AND OTHER SUGAR DISORDERS, if recommended or
prescribed by a physician or other licensed health care provider legally
authorized to prescribe under title eight of the education law, REGARD-
LESS OF THE PATIENT'S AGE: blood glucose monitors and blood glucose
monitors for the visually impaired, CONTINUOUS BLOOD GLUCOSE MONITORS,
INCLUDING BUT NOT LIMITED TO THOSE COVERED BY THE STATE'S PREFERRED
DIABETIC SUPPLY PROGRAM, data management systems, test strips for
glucose monitors and visual reading and urine testing strips, insulin,
injection aids, cartridges for the visually impaired, syringes, insulin
pumps and appurtenances thereto, insulin infusion devices, and oral
agents for controlling blood sugar. In addition, the commissioner of the
department of health shall provide and periodically update by rule or
regulation a list of additional diabetes equipment and related supplies
such as are medically necessary for the treatment of diabetes, for which
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10846-02-6
A. 6923--A 2
there shall also be coverage. Such policies shall also include coverage
for diabetes self-management education to ensure that persons with
diabetes are educated as to the proper self-management and treatment of
their diabetic condition, including information on proper diets. Such
coverage for self-management education and education relating to diet
shall be limited to visits medically necessary upon the diagnosis of
diabetes, where a physician diagnoses a significant change in the
patient's symptoms or conditions which necessitate changes in a
patient's self-management, or where reeducation or refresher education
is necessary. Such education may be provided by the physician or other
licensed health care provider legally authorized to prescribe under
title eight of the education law, or their staff, as part of an office
visit for diabetes diagnosis or treatment, or by a certified diabetes
nurse educator, certified nutritionist, certified dietitian or regis-
tered dietitian upon the referral of a physician or other licensed
health care provider legally authorized to prescribe under title eight
of the education law. Education provided by the certified diabetes nurse
educator, certified nutritionist, certified dietitian or registered
dietitian may be limited to group settings wherever practicable. Cover-
age for self-management education and education relating to diet shall
also include home visits when medically necessary.
§ 2. Subparagraph (A) of paragraph 7 of subsection (k) of section 3221
of the insurance law, as amended by chapter 338 of the laws of 2003, is
amended to read as follows:
(A) Every group or blanket accident and health insurance policy issued
or issued for delivery in this state which provides medical coverage
that includes coverage for physician services in a physician's office
and every policy which provides major medical or similar comprehensive-
type coverage shall include coverage for the following equipment and
supplies for the treatment of diabetes AND OTHER SUGAR DISORDERS, if
recommended or prescribed by a physician or other licensed health care
provider legally authorized to prescribe under title eight of the educa-
tion law, REGARDLESS OF THE PATIENT'S AGE: blood glucose monitors and
blood glucose monitors for the visually impaired, CONTINUOUS BLOOD
GLUCOSE MONITORS, INCLUDING BUT NOT LIMITED TO THOSE COVERED BY THE
STATE'S PREFERRED DIABETIC SUPPLY PROGRAM, data management systems, test
strips for glucose monitors and visual reading and urine testing strips,
insulin, injection aids, cartridges for the visually impaired, syringes,
insulin pumps and appurtenances thereto, insulin infusion devices, and
oral agents for controlling blood sugar. In addition, the commissioner
of the department of health shall provide and periodically update by
rule or regulation a list of additional diabetes equipment and related
supplies such as are medically necessary for the treatment of diabetes,
for which there shall also be coverage. Such policies shall also include
coverage for diabetes self-management education to ensure that persons
with diabetes are educated as to the proper self-management and treat-
ment of their diabetic condition, including information on proper diets.
Such coverage for self-management education and education relating to
diet shall be limited to visits medically necessary upon the diagnosis
of diabetes, where a physician diagnoses a significant change in the
patient's symptoms or conditions which necessitate changes in a
patient's self-management, or where reeducation or refresher education
is necessary. Such education may be provided by the physician or other
licensed health care provider legally authorized to prescribe under
title eight of the education law, or their staff, as part of an office
visit for diabetes diagnosis or treatment, or by a certified diabetes
A. 6923--A 3
nurse educator, certified nutritionist, certified dietitian or regis-
tered dietitian upon the referral of a physician or other licensed
health care provider legally authorized to prescribe under title eight
of the education law. Education provided by the certified diabetes nurse
educator, certified nutritionist, certified dietitian or registered
dietitian may be limited to group settings wherever practicable. Cover-
age for self-management education and education relating to diet shall
also include home visits when medically necessary.
§ 3. Paragraph 1 of subsection (u) of section 4303 of the insurance
law, as amended by chapter 338 of the laws of 2003, is amended to read
as follows:
(1) A medical expense indemnity corporation or a health service corpo-
ration which provides medical coverage that includes coverage for physi-
cian services in a physician's office and every policy which provides
major medical or similar comprehensive-type coverage shall include
coverage for the following equipment and supplies for the treatment of
diabetes AND OTHER SUGAR DISORDERS, if recommended or prescribed by a
physician or other licensed health care provider legally authorized to
prescribe under title eight of the education law, REGARDLESS OF THE
PATIENT'S AGE: blood glucose monitors and blood glucose monitors for
the visually impaired, CONTINUOUS BLOOD GLUCOSE MONITORS, INCLUDING BUT
NOT LIMITED TO THOSE COVERED BY THE STATE'S PREFERRED DIABETIC SUPPLY
PROGRAM, data management systems, test strips for glucose monitors and
visual reading and urine testing strips, insulin, injection aids,
cartridges for the visually impaired, syringes, insulin pumps and
appurtenances thereto, insulin infusion devices, and oral agents for
controlling blood sugar. In addition, the commissioner of the department
of health shall provide and periodically update by rule or regulation a
list of additional diabetes equipment and related supplies such as are
medically necessary for the treatment of diabetes, for which there shall
also be coverage. Such policies shall also include coverage for diabetes
self-management education to ensure that persons with diabetes are
educated as to the proper self-management and treatment of their diabet-
ic condition, including information on proper diets. Such coverage for
self-management education and education relating to diet shall be limit-
ed to visits medically necessary upon the diagnosis of diabetes, where a
physician diagnoses a significant change in the patient's symptoms or
conditions which necessitate changes in a patient's self-management, or
where reeducation or refresher education is necessary. Such education
may be provided by the physician or other licensed health care provider
legally authorized to prescribe under title eight of the education law,
or their staff, as part of an office visit for diabetes diagnosis or
treatment, or by a certified diabetes nurse educator, certified nutri-
tionist, certified dietitian or registered dietitian upon the referral
of a physician or other licensed health care provider legally authorized
to prescribe under title eight of the education law. Education provided
by the certified diabetes nurse educator, certified nutritionist, certi-
fied dietitian or registered dietitian may be limited to group settings
wherever practicable. Coverage for self-management education and educa-
tion relating to diet shall also include home visits when medically
necessary.
§ 4. This act shall take effect on the ninetieth day after it shall
have become a law, and shall apply to policies and contracts issued,
renewed, amended, modified or altered on or after such date.