S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  3654--A
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             January 29, 2025
                                ___________
 
 Introduced  by  Sen.  BAILEY -- read twice and ordered printed, and when
   printed to be committed to the  Committee  on  Insurance  --  reported
   favorably  from  said  committee  and  committed  to  the Committee on
   Finance -- 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
   insurers to provide coverage for speech therapy for stuttering
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 41 to read as follows:
   (41)(A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
 COMPREHENSIVE-TYPE COVERAGE SHALL, UPON THE  REFERRAL  OF  A  PHYSICIAN,
 PROVIDE  COVERAGE  FOR ALL COSTS FOR SPEECH THERAPY FOR STUTTERING. SUCH
 SPEECH THERAPY SHALL INCLUDE, BUT NOT BE LIMITED TO, HABILITATIVE SPEECH
 THERAPY TREATMENT AND REHABILITATIVE SPEECH THERAPY TREATMENT FOR  STUT-
 TERING,  PROVIDED  SUCH  TREATMENT IS PERFORMED BY A HEALTH CARE PROFES-
 SIONAL LICENSED PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW.  NO INSUR-
 ER SHALL IMPOSE UPON ANY PERSON  RECEIVING  BENEFITS  PURSUANT  TO  THIS
 PARAGRAPH  ANY  DURATIONAL  BENEFIT  LIMITATION OR MAXIMUM FOR BENEFITS,
 SERVICES, OR VISITS PROVIDED UNDER THIS PARAGRAPH.
   (B) NOTHING IN THIS  PARAGRAPH  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.
   (C)  COVERAGE  MAY BE DENIED ON THE BASIS THAT SUCH TREATMENT IS BEING
 PROVIDED TO THE INSURED PURSUANT TO  AN  INDIVIDUALIZED  FAMILY  SERVICE
 PLAN  UNDER  SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THE PUBLIC HEALTH
 LAW OR AN INDIVIDUALIZED EDUCATION PLAN UNDER ARTICLE EIGHTY-NINE OF THE
 EDUCATION LAW. THE PROVISION OF SERVICES PURSUANT TO  AN  INDIVIDUALIZED
 FAMILY  SERVICE PLAN UNDER SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07423-04-5
              

 S. 3654--A                          2
 
 PUBLIC HEALTH LAW OR AN  INDIVIDUALIZED  EDUCATION  PLAN  UNDER  ARTICLE
 EIGHTY-NINE  OF  THE  EDUCATION  LAW SHALL NOT AFFECT COVERAGE UNDER THE
 POLICY FOR SERVICES PROVIDED ON  A  SUPPLEMENTAL  BASIS  OUTSIDE  OF  AN
 EDUCATIONAL SETTING IF SUCH SERVICES ARE PROVIDED UPON THE REFERRAL OF A
 PHYSICIAN.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 24 to read as follows:
   (24)  (A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIV-
 ERY IN THIS STATE WHICH PROVIDES  MEDICAL,  MAJOR  MEDICAL,  OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE  SHALL,  UPON  THE REFERRAL OF A PHYSICIAN,
 PROVIDE COVERAGE FOR ALL COSTS FOR SPEECH THERAPY FOR  STUTTERING.  SUCH
 SPEECH THERAPY SHALL INCLUDE, BUT NOT BE LIMITED TO, HABILITATIVE SPEECH
 THERAPY  TREATMENT AND REHABILITATIVE SPEECH THERAPY TREATMENT FOR STUT-
 TERING, PROVIDED SUCH TREATMENT IS PERFORMED BY A  HEALTH  CARE  PROFES-
 SIONAL LICENSED PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW.  NO INSUR-
 ER  SHALL  IMPOSE  UPON  ANY  PERSON RECEIVING BENEFITS PURSUANT TO THIS
 PARAGRAPH ANY DURATIONAL BENEFIT LIMITATION  OR  MAXIMUM  FOR  BENEFITS,
 SERVICES, OR VISITS PROVIDED UNDER THIS PARAGRAPH.
   (B)  NOTHING  IN  THIS  PARAGRAPH  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.
   (C) COVERAGE MAY BE DENIED ON THE BASIS THAT SUCH TREATMENT  IS  BEING
 PROVIDED  TO  THE  INSURED  PURSUANT TO AN INDIVIDUALIZED FAMILY SERVICE
 PLAN UNDER SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THE  PUBLIC  HEALTH
 LAW OR AN INDIVIDUALIZED EDUCATION PLAN UNDER ARTICLE EIGHTY-NINE OF THE
 EDUCATION  LAW.  THE PROVISION OF SERVICES PURSUANT TO AN INDIVIDUALIZED
 FAMILY SERVICE PLAN UNDER SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF  THE
 PUBLIC  HEALTH  LAW  OR  AN  INDIVIDUALIZED EDUCATION PLAN UNDER ARTICLE
 EIGHTY-NINE OF THE EDUCATION LAW SHALL NOT  AFFECT  COVERAGE  UNDER  THE
 POLICY  FOR  SERVICES  PROVIDED  ON  A  SUPPLEMENTAL BASIS OUTSIDE OF AN
 EDUCATIONAL SETTING IF SUCH SERVICES ARE PROVIDED UPON THE REFERRAL OF A
 PHYSICIAN.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ww) to read as follows:
   (WW) (A) EVERY MEDICAL EXPENSE INDEMNITY CORPORATION, HOSPITAL SERVICE
 CORPORATION AND HEALTH SERVICE CORPORATION WHICH PROVIDES MEDICAL, MAJOR
 MEDICAL,  OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL, UPON REFERRAL OF
 A PHYSICIAN, PROVIDE COVERAGE FOR ALL COSTS FOR SPEECH THERAPY FOR STUT-
 TERING. SUCH SPEECH THERAPY SHALL INCLUDE, BUT NOT BE LIMITED TO,  HABI-
 LITATIVE  SPEECH  THERAPY  TREATMENT  AND  REHABILITATIVE SPEECH THERAPY
 TREATMENT FOR STUTTERING, PROVIDED SUCH  TREATMENT  IS  PERFORMED  BY  A
 HEALTH  CARE PROFESSIONAL LICENSED PURSUANT TO TITLE EIGHT OF THE EDUCA-
 TION LAW.  NO CORPORATION SHALL IMPOSE UPON ANY PERSON  RECEIVING  BENE-
 FITS  PURSUANT  TO  THIS SUBSECTION ANY DURATIONAL BENEFIT LIMITATION OR
 MAXIMUM  FOR  BENEFITS,  SERVICES,  OR  VISITS   PROVIDED   UNDER   THIS
 SUBSECTION.
   (B)  NOTHING  IN  THIS  SUBSECTION  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.
   (C) COVERAGE MAY BE DENIED ON THE BASIS THAT SUCH TREATMENT  IS  BEING
 PROVIDED  TO  THE  INSURED  PURSUANT TO AN INDIVIDUALIZED FAMILY SERVICE
 PLAN UNDER SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF THE  PUBLIC  HEALTH
 LAW OR AN INDIVIDUALIZED EDUCATION PLAN UNDER ARTICLE EIGHTY-NINE OF THE
 EDUCATION  LAW.  THE PROVISION OF SERVICES PURSUANT TO AN INDIVIDUALIZED
 S. 3654--A                          3
 
 FAMILY SERVICE PLAN UNDER SECTION TWENTY-FIVE HUNDRED FORTY-FIVE OF  THE
 PUBLIC  HEALTH  LAW  OR  AN  INDIVIDUALIZED EDUCATION PLAN UNDER ARTICLE
 EIGHTY-NINE OF THE EDUCATION LAW SHALL NOT  AFFECT  COVERAGE  UNDER  THE
 POLICY  FOR  SERVICES  PROVIDED  ON  A  SUPPLEMENTAL BASIS OUTSIDE OF AN
 EDUCATIONAL SETTING IF SUCH SERVICES ARE PROVIDED UPON THE REFERRAL OF A
 PHYSICIAN.
   § 4. This act shall take effect on the first of January next  succeed-
 ing  the  date  on  which  it shall have become a law and shall apply to
 policies and contracts issued, renewed, modified, altered or amended  on
 or  after  such  effective  date.  Effective  immediately, the addition,
 amendment and/or repeal of any rule  or  regulation  necessary  for  the
 implementation  of  this  act on its effective date are authorized to be
 made and completed on or before such effective date.