Senate Bill S8969

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8969--A
 
                             I N  S E N A T E
 
                             January 21, 2026
                                ___________
 
 Introduced  by  Sen.  BAILEY -- read twice and ordered printed, and when
   printed to be committed to the Committee  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 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  (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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD07423-07-6
 S. 8969--A                          2

 EDUCATIONAL SETTING IF SUCH SERVICES ARE PROVIDED UPON THE REFERRAL OF A
 PHYSICIAN.
   §  2.  Section  4303  of  the insurance law is amended by adding a new
 subsection (yy) to read as follows:
   (YY) (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
 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. 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.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8969--B
 
                             I N  S E N A T E
 
                             January 21, 2026
                                ___________
 
 Introduced  by  Sen.  BAILEY -- read twice and ordered printed, and when
   printed to be committed to the Committee  on  Insurance  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to  said  committee  --  reported  favorably  from  said committee and
   committed to the Committee on Finance --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee
 
 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 (k) of section 3221 of  the  insurance  law  is
 amended by adding a new paragraph 24 to read as follows:
   (24)  (A) EVERY LARGE GROUP POLICY DELIVERED OR ISSUED FOR DELIVERY IN
 THIS STATE WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR  COMPREHEN-
 SIVE-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 THERA-
 PY 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  EDUCATION  LAW.  SUCH  COVERAGE
 SHALL NOT BE SUBJECT TO 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD07423-09-6
 S. 8969--B                          2

 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.  Section  4303  of  the insurance law is amended by adding a new
 subsection (yy) to read as follows:
   (YY) (A) EVERY LARGE GROUP CONTRACT ISSUED BY A MEDICAL EXPENSE INDEM-
 NITY CORPORATION, HOSPITAL SERVICE CORPORATION AND HEALTH SERVICE CORPO-
 RATION 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 STUTTERING. SUCH SPEECH  THERAPY  SHALL
 INCLUDE,  BUT  NOT  BE LIMITED TO, HABILITATIVE 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 EDUCATION LAW. SUCH COVERAGE SHALL NOT BE
 SUBJECT TO 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
 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. This act shall take effect January 1, 2028  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.