Senate Bill S8550

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8550
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             October 24, 2025
                                ___________
 
 Introduced  by  Sen.  WEIK  --  read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the insurance  law  and  the  social  services  law,  in
   relation to requiring certain health insurance plans cover electrocar-
   diograms  for  adults  and  children  who  have received a coronavirus
   vaccine

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Items (iii), (iv) and (v) of subparagraph (E) of paragraph
 17 of subsection (i) of section 3216 of the insurance law,  items  (iii)
 and  (iv)  as amended by chapter 219 of the laws of 2011 and item (v) as
 amended by section 3 of part M of chapter 57 of the laws  of  2019,  are
 amended and a new item (vi) is added to read as follows:
   (iii)  with  respect  to  children, including infants and adolescents,
 evidence-informed preventive care and screenings provided for in compre-
 hensive guidelines supported by the health resources and services admin-
 istration; [and]
   (iv) with respect  to  women,  such  additional  preventive  care  and
 screenings  not  described  in  item  (i)  of  this  subparagraph and as
 provided  for  in  comprehensive  guidelines  supported  by  the  health
 resources and services administration[.];
   (v) all FDA-approved contraceptive drugs, devices, and other products,
 including   all   over-the-counter  contraceptive  drugs,  devices,  and
 products as prescribed or as otherwise authorized under state or federal
 law; voluntary sterilization procedures pursuant to 42 U.S.C. 18022  and
 identified  in  the  comprehensive  guidelines  supported  by the health
 resources and services administration and thereby  incorporated  in  the
 essential  health  benefits  benchmark plan; patient education and coun-
 seling on contraception; and follow-up services related  to  the  drugs,
 devices,  products,  and  procedures  covered  under this [clause] ITEM,
 including, but not limited to, management of  side  effects,  counseling

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13556-02-5
              

 S. 8550                             2
 
 for  continued  adherence,  and  device insertion and removal. Except as
 otherwise authorized under this [clause]  ITEM,  a  contract  shall  not
 impose  any  restrictions  or delays on the coverage required under this
 [clause] ITEM. However, where the FDA has approved one or more therapeu-
 tic  and pharmaceutical equivalent, as defined by the FDA, versions of a
 contraceptive drug, device, or product, a contract is  not  required  to
 include  all  such therapeutic and pharmaceutical equivalent versions in
 its formulary, so long as at least one is included and  covered  without
 cost-sharing  and in accordance with this [clause] ITEM.  If the covered
 therapeutic and pharmaceutical equivalent versions of a drug, device, or
 product are not available or are deemed medically inadvisable a contract
 shall provide coverage for an alternate therapeutic  and  pharmaceutical
 equivalent version of the contraceptive drug, device, or product without
 cost-sharing.  (a)  This  coverage shall include emergency contraception
 without cost sharing when provided pursuant to a prescription, or  order
 under  section  sixty-eight  hundred  thirty-one of the education law or
 when lawfully provided over-the-counter. (b)  If  the  attending  health
 care  provider,  in [his or her] SUCH PROVIDER'S reasonable professional
 judgment, determines that the use of a non-covered therapeutic or  phar-
 maceutical  equivalent  of  a drug, device, or product is warranted, the
 health care provider's determination shall be final. The  superintendent
 shall  promulgate  regulations  establishing  a process, including time-
 frames, for an insured, an insured's designee  or  an  insured's  health
 care  provider  to request coverage of a non-covered contraceptive drug,
 device, or product. Such regulations shall include  a  requirement  that
 insurers  use  an exception form that shall meet criteria established by
 the superintendent. (c) This coverage must allow for the  dispensing  of
 up  to  twelve  months worth of a contraceptive at one time. (d) For the
 purposes  of  this  [clause]   ITEM,   "over-the-counter   contraceptive
 products" shall mean those products provided for in comprehensive guide-
 lines  supported  by the health resources and services administration as
 of January twenty-first, two thousand nineteen[.]; AND
   (VI) WITH RESPECT TO ADULTS AND CHILDREN WHO HAVE RECEIVED A CORONAVI-
 RUS VACCINE, AN ELECTROCARDIOGRAM TEST  AND  AN  INTERPRETATION  OF  THE
 RESULTS  OF  SUCH  TEST,  REGARDLESS OF WHETHER SUCH ADULTS AND CHILDREN
 HAVE A FAMILY HISTORY OF HEART DISEASE OR CONDITIONS, 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 STANDARDS.
   §  2.  Items  (iii)  and  (iv)  of  subparagraph (E) 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 item (v) is added  to
 read as follows:
   (iii)  with  respect  to  children, including infants and adolescents,
 evidence-informed preventive care and screenings provided for in compre-
 hensive guidelines supported by the health resources and services admin-
 istration; [and]
   (iv) with respect  to  women,  such  additional  preventive  care  and
 screenings  not  described  in  item  (i)  of  this  subparagraph and as
 provided  for  in  comprehensive  guidelines  supported  by  the  health
 resources and services administration[.]; AND
   (V)  WITH RESPECT TO ADULTS AND CHILDREN WHO HAVE RECEIVED A CORONAVI-
 RUS VACCINE,  AN ELECTROCARDIOGRAM TEST AND  AN  INTERPRETATION  OF  THE
 RESULTS  OF  SUCH  TEST,  REGARDLESS OF WHETHER SUCH ADULTS AND CHILDREN
 HAVE A FAMILY HISTORY OF HEART DISEASE OR CONDITIONS, IF  ORDERED  BY  A
 PHYSICIAN  OR  OTHER LICENSED PROFESSIONAL WHOSE SCOPE OF PRACTICE UNDER
 S. 8550                             3
 
 TITLE EIGHT OF THE EDUCATION LAW PROVIDES THE  AUTHORITY  TO  ADMINISTER
 SUCH A TEST, IN ACCORDANCE WITH PREVAILING CLINICAL STANDARDS.
   §  3.  Subparagraphs  (C)  and (D) of paragraph 3 of subsection (j) of
 section 4303 of the insurance law, as added by chapter 219 of  the  laws
 of  2011,  are  amended  and  a new subparagraph (E) is added to read as
 follows:
   (C) with respect  to  children,  including  infants  and  adolescents,
 evidence-informed preventive care and screenings provided for in compre-
 hensive guidelines supported by the health resources and services admin-
 istration; [and]
   (D) with respect to women, such additional preventive care and screen-
 ings not described in subparagraph (A) of this paragraph and as provided
 for  in  comprehensive  guidelines supported by the health resources and
 services administration[.]; AND
   (E) WITH RESPECT TO ADULTS AND CHILDREN WHO HAVE RECEIVED A  CORONAVI-
 RUS  VACCINE,    AN  ELECTROCARDIOGRAM TEST AND AN INTERPRETATION OF THE
 RESULTS OF SUCH TEST, REGARDLESS OF WHETHER  SUCH  ADULTS  AND  CHILDREN
 HAVE  A  FAMILY  HISTORY OF HEART DISEASE OR CONDITIONS, 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 STANDARDS.
   § 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)  WITH RESPECT TO ADULTS AND CHILDREN WHO HAVE RECEIVED A CORONA-
 VIRUS VACCINE,  AN ELECTROCARDIOGRAM TEST AND AN INTERPRETATION  OF  THE
 RESULTS  OF  SUCH  TEST,  REGARDLESS OF WHETHER SUCH ADULTS AND CHILDREN
 HAVE A FAMILY HISTORY OF HEART DISEASE OR CONDITIONS, 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 STANDARDS; PROVIDED,
 HOWEVER, THAT THE PROVISIONS OF THIS PARAGRAPH RELATING TO ELECTROCARDI-
 OGRAM  TESTS  SHALL NOT TAKE EFFECT UNLESS ALL NECESSARY APPROVALS UNDER
 FEDERAL LAW AND REGULATION HAVE BEEN OBTAINED TO RECEIVE FEDERAL  FINAN-
 CIAL 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.