NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6913
SPONSOR: Kim TITLE OF BILL:
An act to amend the insurance law, in relation to mandatory health
insurance coverage for acupuncture services
PURPOSE OR GENERAL IDEA OF BILL:
An act to amend the insurance law, in relation to mandatory health
insurance coverage for acupuncture services
SUMMARY OF PROVISIONS:
Section 1 would amend subsection (i) of section 3216 of the insurance
law is amended by adding anew paragraph 34.
Section 2 would amend section 4303 of the insurance law is amended by
adding a new subsection (rr).
Section 3 provides that the effective date for this legislation shall be
90 days after it is signed into law.
DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE):
JUSTIFICATION:
The ACA ensured access of all New Yorkers to a basic level of health-
care, which included "essential health benefits" which are loosely
outlined by the Federal Government. States are permitted to expand these
"essential health benefits" in order to provide their citizens with
greater access to basic levels of care. Acupuncture is currently not
provided for as an essential health benefit in New York and is not
covered by New York's basic health plan. This leaves many New Yorker's
without the ability to afford this important treatment.
Acupuncture has been shown to be effective in treating a number of
conditions, including chronic pain, nausea, headaches, anxiety,
depression, insomnia and infertility. Acupuncture is also a cost effec-
tive alternative to some other forms of treatment, often resulting in
permanent improvement for patients with chronic conditions. Acupuncture
has been shown to be effective in treating chronic pain as an alterna-
tive to opioids. This makes adding acupuncture as an essential health
benefit even more important given the opioid epidemic facing the state.
Ensuring that citizens have access to quality acupuncture as part of
their basic health insurance offered on the health exchange should be a
key part of New York's public health plan.
PRIOR LEGISLATIVE HISTORY:
2021-2022: A3165 Referred to insurance
2019-2020: A2925 Referred to insurance
2017-2018: A6103 Referred to insurance
2015-2016: A.10322 (Kim)
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
The State may be liable for any difference in premiums paid in the event
that adding acupuncture as an essential health benefit creates an addi-
tional cost to plans. Given its relative cost effectiveness compared to
other means of treatment, it could result in no cost/premium increases,
or a reduction.
EFFECTIVE DATE: This act shall take effect 90 days after it becomes
law.
STATE OF NEW YORK
________________________________________________________________________
6913
2023-2024 Regular Sessions
IN ASSEMBLY
May 9, 2023
___________
Introduced by M. of A. KIM -- read once and referred to the Committee on
Insurance
AN ACT to amend the insurance law, in relation to mandatory health
insurance coverage for acupuncture services
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subsection (i) of section 3216 of the insurance law is
2 amended by adding a new paragraph 39 to read as follows:
3 (39) Every policy issued within the health benefit exchange estab-
4 lished pursuant to section 1311 of the affordable care act, 42 U.S.C. §
5 18031, shall provide coverage for acupuncture treatment as defined in
6 section eight thousand two hundred eleven of the education law provided
7 by an individual licensed, authorized, or certified pursuant to article
8 one hundred sixty of the education law. However, acupuncture treatment
9 and services may be subject to reasonable deductible, co-payment and
10 co-insurance amount, reasonable fee or benefit limits, and reasonable
11 utilization review, provided that any such amounts, limits or review
12 shall be no greater than other essential health benefits covered by the
13 policy and provided further that any such amounts, limits, or review
14 shall not function to direct treatment in a manner discriminative
15 against acupuncture treatment. Nothing herein shall be construed as
16 impending or preventing either the provision or coverage of acupuncture
17 treatment and services by duly licensed or certified acupuncturist,
18 within the lawful scope of the practice of acupuncture, in hospital
19 facilities on a staff or employee basis.
20 § 2. Section 4303 of the insurance law is amended by adding a new
21 subsection (vv) to read as follows:
22 (vv) Every policy issued within the health benefit exchange estab-
23 lished pursuant to section 1311 of the affordable care act, 42 U.S.C. §
24 18031, shall provide coverage for acupuncture treatment as defined in
25 section eight thousand two hundred eleven of the education law provided
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03036-02-3
A. 6913 2
1 by an individual licensed, authorized, or certified pursuant to article
2 one hundred sixty of the education law. However, acupuncture treatment
3 and services may be subject to reasonable deductible, co-payment and
4 co-insurance amount, reasonable fee or benefit limits, and reasonable
5 utilization review, provided that any such amounts, limits or review
6 shall be no greater than other essential health benefits covered by the
7 policy and provided further that any such amounts, limits, or review
8 shall not function to direct treatment in a manner discriminative
9 against acupuncture treatment. Nothing herein shall be construed as
10 impeding or preventing either the provision or coverage of acupuncture
11 treatment and services by duly licensed or certified acupuncturists,
12 within the lawful scope of the practice of acupuncture, in hospital
13 facilities on a staff or employees basis.
14 § 3. This act shall take effect on the ninetieth day after it shall
15 have become a law and shall apply to policies and contracts issued,
16 renewed, modified, altered or amended on or after such effective date.
